Improving Motor Corticothalamic Communication After Stroke Using Real-Time fMRI Connectivity-Based Neurofeedback

Once again this needs to be written up as a publicly available stroke protocol. That way it can be improved upon and actually help survivors. This research publishing model is totally fucking useless for survivors.  This is a job for that great stroke association.
http://nnr.sagepub.com/content/30/7/671?etoc

1. Sook-Lei Liew, PhD, OTR/L1,2⇑
2. Mohit Rana, PhD3,4,5
3. Sonja Cornelsen, Dipl. Psych6
4. Marcos Fortunato de Barros Filho, MD7
5. Niels Birbaumer, PhD4,8
6. Ranganatha Sitaram, PhD3,4,5
7. Leonardo G. Cohen, MD1
8. Surjo R. Soekadar, MD4,7

1. ¹Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA
2. 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
3. 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
4. ⁴Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany
5. ⁵Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
6. ⁶Center for Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, Eberhard Karls University, Tübingen, Germany
7. ⁷Applied Neurotechnology Lab, Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany
8. ⁸IRCSS, Ospedale San Camillo, Venice, Italy

1. 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
2. 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.