Rapid functional reorganization of the targeted contralesional hemisphere induced by one week of noninvasive closed-loop neurofeedback guides motor recovery in post-stroke patients with chronic motor impairment: a phase I trial

the United States there is no chronic stroke rehab, you need to get recovered while still in the hospital, which means failure to recover since your incompetent? doctor and therapists KNOW NOTHING AND DO NOTHING ABOUT 100% RECOVERY!
Rapid functional reorganization of the targeted contralesional hemisphere induced by one week of noninvasive closed-loop neurofeedback guides motor recovery in post-stroke patients with chronic motor impairment: a phase I trial

• Kenichi Takasaki, 
• Seitaro Iwama, 
• Fumio Liu, 
• Miho Ogura-Hiramoto, 
• Kohei Okuyama, 
• Michiyuki Kawakami, 
• Katsuhiro Mizuno, 
• Shoko Kasuga, 
• Tomoyuki Noda, 
• Jun Morimoto, 
• Meigen Liu & 
• Junichi Ushiba 

Communications Medicine , Article number:  (2026) Cite this article

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Abstract

Background

Post-stroke hemiplegia of the upper extremities continues to pose a significant therapeutic hurdle. Contralesional uncrossed corticospinal pathways (CST) are involved in the recovery processes.

Methods

We test the safety, and preliminary efficacy of targeted upregulation of uncrossed CST excitability through self-modulation of cortical activities via noninvasive brain-machine interaction training (Registered with the University Hospital Medical Information Network: UMIN000017525). In this single-arm prospective trial, eight individuals with persistent severe post-stroke motor disability voluntarily actuated their affected shoulder using a brain-computer interface (BCI) bridging the contralesional motor cortex (M1) and an exoskeleton robot. While patients attempted to elevate the affected arm, scalp electroencephalogram (EEG) signals over the contralesional M1 were processed online to provide them with feedback on M1 excitability.

Results

Here we show that the BCI reconstructs neural pathways, allowing arm elevation without any adverse effects. As evidenced by an increase in primary outcome measure (Fugl- Meyer Assessment, p < 0.05, d = 1.24), seven days of consecutive system use results in rapid, sustained, and clinically significant improvement in motor function when removed from the system and promotes contralesional M1 functional remodeling.

Conclusions

This closed-loop system is safe, feasible, and a promising intervention that recruits intact neural resources to allow patients to recover upper-extremity motor abilities.

Wouldn't work for me, spasticity prevents movement and I have dead brain there, so no signals can be read!

Plain language summary

During a stroke, blood flow to the brain is blocked resulting in damage to parts of the brain. This study examines a method to support recovery of arm function in individuals with severe post-stroke paralysis. The approach aimed to enhance activity in intact brain pathways on the side opposite the side damaged by the stroke. Participants engaged in training with a brain-computer interface linked to a robotic exoskeleton. While attempting to lift their impaired arm, their brain activity was monitored and used to facilitate the movement. After seven consecutive days of training, participants demonstrated clear and sustained improvements in their ability to move the paralysed limb, without any adverse effects. These findings indicate that targeted modulation of preserved brain networks may represent a safe and promising strategy to improve upper-limb recovery in people living with long-term stroke-related disability.

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