http://nnr.sagepub.com/content/30/7/671?etoc
- Sook-Lei Liew, PhD, OTR/L1,2⇑
- Mohit Rana, PhD3,4,5
- Sonja Cornelsen, Dipl. Psych6
- Marcos Fortunato de Barros Filho, MD7
- Niels Birbaumer, PhD4,8
- Ranganatha Sitaram, PhD3,4,5
- Leonardo G. Cohen, MD1
- Surjo R. Soekadar, MD4,7
- 1Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA
- 2Chan Division of Occupational Science and Occupational Therapy, Division of Physical Therapy and Biokinesiology, Department of Neurology, University of Southern California, Los Angeles, CA, USA
- 3Institute for Medical and Biological Engineering, and Department of Psychiatry and Section of Neuroscience, Schools of Engineering, Medicine and Biology, Pontificia Universidad Católica de Chile, Santiago, Chile
- 4Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany
- 5Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
- 6Center for Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, Eberhard Karls University, Tübingen, Germany
- 7Applied Neurotechnology Lab, Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany
- 8IRCSS, Ospedale San Camillo, Venice, Italy
- Sook-Lei Liew, PhD, OTR/L, USC Neural Plasticity and Neurorehabilitation Laboratory, 1540 Alcazar St, CHP 133 MC 9003, Los Angeles, CA 90089-0080, USA. Email: sliew@usc.edu
- Surjo R. Soekadar, MD, Applied Neurotechnology Lab, University Hospital of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany. Email: surjo.soekadar@uni-tuebingen.de
Abstract
Background. Two thirds of stroke
survivors experience motor impairment resulting in long-term disability.
The anatomical substrate is
often the disruption of cortico-subcortical
pathways. It has been proposed that reestablishment of
cortico-subcortical communication
relates to functional recovery.
Objective.
In this study, we applied a novel training protocol to augment
ipsilesional cortico-subcortical connectivity after stroke.
Chronic stroke patients with severe motor
impairment were provided online feedback of blood-oxygenation level
dependent signal
connectivity between cortical and subcortical
regions critical for motor function using real-time functional magnetic
resonance
imaging neurofeedback.
Results. In this proof of principle study, 3 out of 4 patients learned to voluntarily modulate cortico-subcortical connectivity as
intended.
Conclusions. Our results
document for the first time the feasibility and safety for patients with
chronic stroke and severe motor impairment
to self-regulate and augment ipsilesional
cortico-subcortical connectivity through neurofeedback using real-time
functional
magnetic resonance imaging.
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