Abstract
Stroke is a leading cause of motor disability worldwide, and robot-assisted therapies have been increasingly applied to facilitate the recovery process. However, the underlying mechanism and induced neuroplasticity change remain partially understood, and few studies have investigated this from a multimodality neuroimaging perspective. The current study adopted BCI-guided robot hand therapy as the training intervention and combined multiple neuroimaging modalities to comprehensively understand the potential association between motor function alteration and various neural correlates. We adopted EEG-informed fMRI technique to understand the functional regions sensitive to training intervention. Additionally, correlation analysis among training effects, nonlinear property change quantified by fractal dimension (FD), and integrity of M1-M1 (M1: primary motor cortex) anatomical connection were performed. EEG-informed fMRI analysis indicated that for iM1 (iM1: ipsilesional M1) regressors, regions with significantly increased partial correlation were mainly located in contralesional parietal, prefrontal, and sensorimotor areas and regions with significantly decreased partial correlation were mainly observed in the ipsilesional supramarginal gyrus and superior temporal gyrus. Pearson's correlations revealed that the interhemispheric asymmetry change significantly correlated with the training effect as well as the integrity of M1-M1 anatomical connection. In summary, our study suggested that multiple functional brain regions not limited to motor areas were involved during the recovery process from multimodality perspective. The correlation analyses suggested the essential role of interhemispheric interaction in motor rehabilitation. Besides, the underlying structural substrate of the bilateral M1-M1 connection might relate to the interhemispheric change. This study might give some insights in understanding the neuroplasticity induced by the integrated BCI-guided robot hand training intervention and further facilitate the design of therapies for chronic stroke patients.
Highlights
Stroke is the leading cause of death worldwide, and the survivors undergo various disabilities related to motor, sensory, and cognitive functions
Resting-state functional magnetic resonance imaging (fMRI) that measures the temporal correlation of the blood oxygen level-dependent (BOLD) signal between different regions at resting state has emerged as a powerful tool to map the functional organization of the brain [6]. fMRI measurements have
We further explored the association between corresponding asymmetry change and M1-M1 anatomical connection and found that the interhemispheric asymmetry change significantly correlated with the fractional anisotropy (FA) value of M1-M1 connection fibers, which indicated that more interhemispheric rebalance could be achieved for patients with lower M1-M1 anatomical connection
Summary
Stroke is the leading cause of death worldwide, and the survivors undergo various disabilities related to motor, sensory, and cognitive functions. Robot-assisted therapy is a kind of task-specific and high-intensity exercise in an active, functional, and highly repetitive manner [1]. A brain computer interface (BCI) can facilitate stroke rehabilitation by integrating the exoskeleton robots to develop the BCIguided robot-assisted therapy, which is believed to engage various brain functional regions [3] in the recovery process. Functional magnetic resonance imaging (fMRI) has become one of the most commonly used neuroimaging tools to assess the cortical alterations associated with learning, diseases, or rehabilitation [5]. Resting-state fMRI that measures the temporal correlation of the blood oxygen level-dependent (BOLD) signal between different regions at resting state has emerged as a powerful tool to map the functional organization of the brain [6]. Resting-state fMRI that measures the temporal correlation of the blood oxygen level-dependent (BOLD) signal between different regions at resting state has emerged as a powerful tool to map the functional organization of the brain [6]. fMRI measurements have
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