Near-infrared Spectroscopy-mediated Neurofeedback Enhances Efficacy of Motor Imagery-based Training in Poststroke Victims: A Pilot Study

Under what scenario do you think your hospital will buy near-infrared spectroscopy for stroke rehab? They can't even provide music to patients.

Near-infrared Spectroscopy-mediated Neurofeedback Enhances Efficacy of Motor Imagery-based Training in Poststroke Victims: A Pilot Study

Masahito Mihara

,

Noriaki Hattori

,

Megumi Hatakenaka

,

Hajime Yagura

,

Teiji Kawano

,

Taro Hino

, and

Ichiro Miyai

Originally published12 Feb 2013https://doi.org/10.1161/STROKEAHA.111.674507Stroke. 2013;44:1091–1098

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Abstract

Background and Purpose—

Despite the findings that motor imagery and execution are supposed to share common neural networks, previous studies using imagery-based rehabilitation have revealed inconsistent results. In the present study, we investigated whether feedback of cortical activities (neurofeedback) using near-infrared spectroscopy could enhance the efficacy of imagery-based rehabilitation in stroke patients.

Methods—

Twenty hemiplegic patients with subcortical stroke received 6 sessions of mental practice with motor imagery of the distal upper limb in addition to standard rehabilitation. Subjects were randomly allocated to REAL and SHAM groups. In the REAL group, cortical hemoglobin signals detected by near-infrared spectroscopy were fed back during imagery. In the SHAM group, irrelevant randomized signals were fed back. Upper limb function was assessed using the finger and arm subscales of the Fugl-Meyer assessment and the Action Research Arm Test.

Results—

The hand/finger subscale of the Fugl-Meyer assessment showed greater functional gain in the REAL group, with a significant interaction between time and group (F_2,36=15.5; P<0.001). A significant effect of neurofeedback was revealed even in severely impaired subjects. Imagery-related cortical activation in the premotor area was significantly greater in the REAL group than in the SHAM group (T₅₈=2.4; P<0.05).

Conclusions—

Our results suggest that near-infrared spectroscopy–mediated neurofeedback may enhance the efficacy of mental practice with motor imagery and augment motor recovery in poststroke patients with severe hemiparesis.

 

Effectiveness of neurofeedback using near-infrared spectroscopy to enhance the efficacy of motor imagery-based rehabilitation in stroke patients: A Randomized trial

Useless. NO PROTOCOL, requests further study.

Using Fugl-Meyer for anything in stroke is the height of stupidity, nothing objective in it, so nothing is repeatable.

Effectiveness of neurofeedback using near-infrared spectroscopy to enhance the efficacy of motor imagery-based rehabilitation in stroke patients: A Randomized trial 

K J S SHAKTHI, Kameshwar Prasad

First published April 14, 2020,

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Abstract

Objective:

1. To study if neurofeedback using Near-infrared spectroscopy can enhance cortical activation associated with motor imagery in post-stroke rehabilitation

Background: Several reported previously on motor imagery-based rehabilitation in stroke patients. However, these reports have been irreconcilable. We studied along with motor imagery, whether Neurofeedback using Near-Infrared spectroscopy(NIRS) can enhance the efficacy of rehabilitation in stroke patients.

Design/Methods: Sixty patients with hemiplegia due to ischemic and hemorrhagic strokes visiting the AIIMS Neurology department from May 2017 to January 2019 were included in the study. The patients were randomly allocated into two groups. The intervention group received mental practice with motor imagery along with Neurofeedback using near-infrared spectroscopy. Both groups received standard stroke management.

Results: The patients in the intervention group showed significant improvement in the cortical activation when compared to the control group as measured by the change in oxyhemoglobin. At the end of 3 months HbO decreased in the control group(−0.6 + 6.6) whereas it increased in the intervention group(4.7 + 8.8) with a difference of −5.4, 95% Confidence Interval (CI) −9.4 to −1.4, p=0.008]. However, it failed to show a statistically significant difference in the clinical outcomes measured using Fugl Meyer Assessment Scale (90.8 + 30.9 and 101.8 + 26.0 in intervention and control group respectively with a difference of 10.9, 95% CI −3.7 to 25.6, p=0.14 ) and modified Rankin Scale (2.8 + 0.5 and 2.8 + 0.6 in intervention and control group respectively with 95% CI −0.3 to 0.2, p=0.79 ) in both the groups at the end of 3 months.

Conclusions: The Neurofeedback using NIRS has the potential to enhance the outcome of motor imagery-based rehabilitation in stroke patients. Further studies with large sample size and long follow up periods are required to establish the role of Neurofeedback with motor imagery in improving the motor recovery.

Disclosure: Dr. KJS has nothing to disclose. Dr. Prasad has nothing to disclose.

Effects of the multisensory rehabilitation product for home-based hand training after stroke on cortical activation by using NIRS methods

But you didn't compare it to these: So you didn't do your research correctly.

Margaret Yekutiel wrote a whole book about this in 2001, 'Sensory Re-Education of the Hand After Stroke'.

Effects of the multisensory rehabilitation product for home-based hand training after stroke on cortical activation by using NIRS methods

 Author links open overlay panelQinbiaoLiaJianFengbJiaGuoaZilinWangaPuhongLicHeshanLiua
1ZhijunFana1
https://doi.org/10.1016/j.neulet.2019.134682
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Highlights

•

    NIRS was designed to detect effect of stimulation on cortical activation response.
•

    Multisensory environment can induce cortical activation in most brain regions.
•

    Multisensory stimuli are more beneficial to neural activities and cognitive control.
•

    Activation of the motor cortex is closely related to the cognitive performance.

Abstract

Objective

This study aimed to assess the effects of the multisensory rehabilitation product for stroke patients on cortical activation response through near-infrared spectroscopy (NIRS).
Methods

The music rehabilitation glove (MRG), multisensory rehabilitation product, was developed with a user-centered design concept. The 40-channel NIRS system monitored the cortical activation changes in the motor cortex (MC), prefrontal cortex (PFC), temporal lobe (TL) and occipital lobe (OL) of 22 young subjects during "sequential finger-to-thumb opposition movements (SFTOM)" phase of traditional training and "musical finger-to-thumb opposition movements (MFTOM)" phase of MRG training.
Results

The two phases of training showed significant activation (P < 0.05) in the cerebral cortex compared with baseline, with more activation during MFTOM in the MC, PFC and TL. Compared with SFTOM, there were 22 channels of cortical activation in MFTOM that had significant enhancements (P < 0.05). There was also a significant positive correlation between the prefrontal cortex and motor cortex in the cortical activation.
Conclusions

According to these results, MFTOM-induced cortical activation in the MC, PFC and TL with visual, auditory and tactile stimuli was stronger than SFTOM, providing evidence that the multisensory stimulation is more beneficial to cortical activation and cognitive control to promote neurological recovery.
Abbreviations
MRGmusic rehabilitation glove
PFCprefrontal cortex
MCmotor cortex
TLtemporal lobe
OLoccipital lobe
LPFCleft prefrontal cortex
RPFCright prefrontal cortex
LMCleft motor cortex
RMCright motor cortex
LTLleft temporal lobe
RTLright temporal lobe
LOLleft occipital lobe
ROLright occipital lobe
SFTOMsequential finger-to-thumb opposition movements
MFTOMmusical finger-to-thumb opposition movements
BMCbilateral motor cortex

Median Nerve Electrical Stimulation–Induced Changes in Effective Connectivity in Patients With Stroke as Assessed With Functional Near-Infrared Spectroscopy

You tell us NOTHING AT ALL if better recovery was achieved, so useless. 

Median Nerve Electrical Stimulation–Induced Changes in Effective Connectivity in Patients With Stroke as Assessed With Functional Near-Infrared Spectroscopy

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Congcong Huo, PhD, Xinglou Li, MA, Jing Jing, MA, ...

First Published September 24, 2019 Research Article Find in PubMed

https://doi.org/10.1177/1545968319875952

Article information

Abstract

Background. The cortical plastic changes in response to median nerve electrical stimulation (MNES) in stroke patients have not been entirely illustrated.  
Objective. This study aimed to investigate MNES-related changes in effective connectivity (EC) within a cortical network after stroke by using functional near-infrared spectroscopy (fNIRS). Methods. The cerebral oxygenation signals in the bilateral prefrontal cortex (LPFC/RPFC), motor cortex (LMC/RMC), and occipital lobe (LOL/ROL) of 20 stroke patients with right hemiplegia were measured by fNIRS in 2 conditions: (1) resting state and (2) MNES applied to the right wrist. Coupling function together with dynamical Bayesian inference was used to assess MNES-related changes in EC among the cerebral low-frequency fluctuations.  
Results. Compared with the resting state, EC from LPFC and RPFC to LOL was significantly increased during the MNES state in stroke patients. Additionally, MNES triggered significantly higher coupling strengths from LMC and LOL to RPFC. The interregional main coupling direction was observed from LPFC to bilateral motor and occipital areas in responding to MNES, suggesting that MNES could promote the regulation function of ipsilesional prefrontal areas in the functional network. MNES can induce muscle twitch of the stroke-affected hand involving a decreased neural coupling of the contralesional motor area on the ipsilesional MC.  
Conclusions. MNES can trigger sensorimotor stimulations of the affected hand that sequentially involved functional reorganization of distant cortical areas after stroke. Investigating MNES-related changes in EC after stroke may help further our understanding of the neural mechanisms underlying MNES.

Keywords median nerve electrical stimulation, functional near-infrared spectroscopy, effective connectivity, neural mechanisms, stroke

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A Systemic Review of Functional Near-Infrared Spectroscopy for Stroke: Current Application and Future Directions

I got nothing out of this, too many uses of the word 'could' means this is all speculation.

A Systemic Review of Functional Near-Infrared Spectroscopy for Stroke: Current Application and Future Directions

Muyue Yang^1,2, Zhen Yang³, Tifei Yuan⁴, Wuwei Feng⁵ and Pu Wang^1*

• ¹Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai, China
• ²School of Medicine, Shanghai Jiao Tong University, Shanghai, China
• ³Core Facility of West China Hospital, Sichuan University, Chengdu, China
• ⁴Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
• ⁵Department of Neurology, Medical University of South Carolina, Charleston, SC, United States

Background: Survivors of stroke often experience significant disability and impaired quality of life. The recovery of motor or cognitive function requires long periods. Neuroimaging could measure changes in the brain and monitor recovery process in order to offer timely treatment and assess the effects of therapy. A non-invasive neuroimaging technique near-infrared spectroscopy (NIRS) with its ambulatory, portable, low-cost nature without fixation of subjects has attracted extensive attention.

Methods: We conducted a comprehensive literature review in order to review the use of NIRS in stroke or post-stroke patients in July 2018. NCBI Pubmed database, EMBASE database, Cochrane Library and ScienceDirect database were searched.

Results: Overall, we reviewed 66 papers. NIRS has a wide range of application, including in monitoring upper limb, lower limb recovery, motor learning, cortical function recovery, cerebral hemodynamic changes, cerebral oxygenation, as well as in therapeutic method, clinical researches, and evaluation of the risk for stroke.

Conclusions: This study provides a preliminary evidence of the application of NIRS in stroke patients as a monitoring, therapeutic, and research tool. Further studies could give more emphasize on the combination of NIRS with other techniques and its utility in the prevention of stroke.

Introduction

Stroke, which refers to a medical condition in which insufficient brain blood supply results in cell death, is a major cause of death and disability worldwide (1, 2). Survivors are accompanied with the deterioration or loss of functions, for example, sensorimotor sequelae including motor weakness and impairment of voluntary motor control, spasticity, incoordination, apraxia, sensory loss/numbness, dysphagia, and dysarthria, and stroke could also lead to various cognitive and psychiatric deficits (3–5). These disfunctions are associated with cortical impairment due to insufficient blood supply and brain oxygenation. Therefore, monitoring the changes of brain circulation and oxygenation could timely reflect rehabilitation and recovery and the effect of therapy.

Neuroimaging has been shown to be an effective monitoring and therapeutic tool, evaluating the evolution of neural activity and stroke rehabilitation and recovery (6). Traditional methods such as functional magnetic resonance imaging (fMRI), positron emission tomography, electroencephalography (EEG) and magnetoencephalography (MEG)—have provided considerable initial insight into brain changes during recovery. However, several shortcomings including a confining monitoring environment, subject head fixation and high cost have limited applications in tasks which require constant movement or real-time monitor (7, 8).

Near-infrared spectroscopy (NIRS), introduced in 1977 by Jöbsis et al. as a monitoring tool of cerebral and myocardial oxygenation (9), has partially overcome these difficulties. NIRS is a non-invasive neuroimaging tool that has several potential advantages including real-time monitor, low price, simplicity, portability, relatively small equipment, and it's almost completely safe and non-invasive nature (8).

NIRS can be divided into continuous wave NIRS (CW NIRS), time domain NIRS (TD NIRS), and frequency domain NIRS (FD NIRS). CW NIRS emits continuous wave and measures the changes in the intensity of the light that passed through the tissue, whereas TD NIRS utilizes a short pulse of laser light and measures the arrival times of photons emerging from the tissue. FD NIRS records the intensity of the detected light as well as the phase shift. These signals can then be converted to the concentration of oxygenated (oxy-Hb) and deoxygenated hemoglobin (deoxy-Hb). One of the most common used algorithm is Modified Beer–Lambert Law (MBLL). CW NIRS could not measure absolute concentrations of oxy-Hb and deoxy-Hb, because this method assumes a homogenous tissue which is not true. This does not change the results of qualitative analysis, but may lead to error in quantitative outcome. TD NIRS recording the temporal broadening of the pulse as it penetrates the investigated area allows accurate quantification of the concentrations and has better spatial resolution (10). Neural activity increases oxygen demands, thus increasing cerebral blood flow due to neurovascular coupling. NIRS could capture the changes of oxy-Hb and deoxy-Hb to infer changes in brain activity (6, 11). Recent years have witnessed rapid development of the techniques of NIRS from the single-location measurements to two dimensions and then three dimensions. One of its most promising application is in brain-computer interface (BCI) which was firstly introduced by Coyle et al. (12). BCI use brain activity to control external devices bypassing the peripheral nervous system. NIRS presents as a valuable tool in its brain signal acquisition for its non-invasive nature and real-time monitoring. However, fNIRS-BCI system is still mainly used in researches due to slow information transfer rate and low accuracy (13).

Stroke includes two major types: ischemic, due to lack of cerebral blood flow, and hemorrhagic, due to bleeding. During ischemic stroke cerebral blood supply is disrupted by narrowing of vessels caused by atherosclerosis or embolism. In hemorrhagic stroke caused by hypertension or ruptured aneurysm blood flow is reduced due to direct blood loss or vessel compression. In either case, a significant decline in blood supply could be observed. The reduction in cerebral oxygenation results in injury of neurovascular unit, decreased neuronal activity and accumulation of anaerobic metabolites. NIRS could monitor oxygenation signal changes, thus reflecting this pathophysiological process (1).

NIRS is well-established as a safe and effective monitoring tool for stroke recovery, including upper limb, lower limb recovery, motor learning, cortical function recovery (8), cerebral hemodynamic changes, cerebral oxygenation (14), therapy (15, 16), clinical researches and evaluation of the risk for stroke (17). Brain-computer interfaces (BCIs), a newly emerging tool, use brain activity to control external devices, facilitating paralyzed patients to interact with the environment. NIRS combined with BCI offers great potential as a therapeutic tool (18, 19). In addition, NIRS has used in several clinical studies (20, 21), reflecting hemodynamic or oxygenation changes of brain, as well as in evaluation of the risks for postoperative stroke and muscle metabolism (22). NIRS has shown to be an effective and promising method, however, its clinical value still remains controversial (23). Therefore, to address these discrepancies, we conducted this systematic review to summarize the existing application of NIRS in stroke patients.

Biofeedback effect of hybrid assistive limb in stroke rehabilitation: A proof of concept study using functional near infrared spectroscopy

Not available, for your doctor to get.

 

Biofeedback effect of hybrid assistive limb in stroke rehabilitation: A proof of concept study using functional near infrared spectroscopy

Neurofeedback-induced facilitation of the supplementary motor area affects postural stability

Followup needed since this was tested in healthy controls.
https://www.spiedigitallibrary.org/journals/Neurophotonics/volume-4/issue-4/045003/Neurofeedback-induced-facilitation-of-the-supplementary-motor-area-affects-postural/10.1117/1.NPh.4.4.045003.full?SSO=1

Hiroaki Fujimoto; Masahito Mihara; Noriaki Hattori; Megumi Hatakenaka; Hajime Yagura; Teiji Kawano; Ichiro Miyai; Hideki Mochizuki;

Author Affiliations +

Neurophotonics, 4(4), 045003 (2017). doi:10.1117/1.NPh.4.4.045003

Abstract

Near-infrared spectroscopy-mediated neurofeedback (NIRS-NFB) is a promising therapeutic intervention for patients with neurological diseases. Studies have shown that NIRS-NFB can facilitate task-related cortical activation and induce task-specific behavioral changes. These findings indicate that the effect of neuromodulation depends on local cortical function. However, when the target cortical region has multiple functions, our understanding of the effects is less clear. This is true in the supplementary motor area (SMA), which is involved both in postural control and upper-limb movement. To address this issue, we investigated the facilitatory effect of NIRS SMA neurofeedback on cortical activity and behavior, without any specific task. Twenty healthy individuals participated in real and sham neurofeedback. Balance and hand dexterity were assessed before and after each NIRS-NFB session. We found a significant interaction between assessment periods (pre/post) and condition (real/sham) with respect to balance as assessed by the center of the pressure path length but not for hand dexterity as assessed by the 9-hole peg test. SMA activity only increased during real neurofeedback. Our findings indicate that NIRS-NFB itself has the potential to modulate focal cortical activation, and we suggest that it be considered a therapy to facilitate the SMA for patients with postural impairment.

© The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

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Hiroaki Fujimoto, Masahito Mihara, Noriaki Hattori, Megumi Hatakenaka, Hajime Yagura, Teiji Kawano, Ichiro Miyai, Hideki Mochizuki, "Neurofeedback-induced facilitation of the supplementary motor area affects postural stability," Neurophotonics 4(4), 045003 (10 November 2017). http://dx.doi.org/10.1117/1.NPh.4.4.045003 Submission: Received 22 May 2017; Accepted 16 October 2017

Submission: Received 22 May 2017; Accepted 16 October 2017

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Near-Infrared Spectroscopy in Gait Disorders: Is It Time to Begin?

It was time at least a decade ago. Without objective analysis of your stroke gait problems your therapist has no fucking clue how to address the problems or even tell if you are improving.
http://journals.sagepub.com/doi/abs/10.1177/1545968317693304

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Vera Gramigna, PhD*, Giovanni Pellegrino, PhD*, Antonio Cerasa, PhD, Simone Cutini, PhD, Roberta Vasta, PhD, Giuseppe Olivadese, PhD, Iolanda Martino, PhD, Aldo Quattrone, PhD, MD

First Published February 14, 2017

Abstract

Walking is a complex motor behavior with a special relevance in clinical neurology. Many neurological diseases, such as Parkinson’s disease and stroke, are characterized by gait disorders whose neurofunctional correlates are poorly investigated. Indeed, the analysis of real walking with the standard neuroimaging techniques poses strong challenges, and only a few studies on motor imagery or walking observation have been performed so far. Functional near-infrared spectroscopy (fNIRS) is becoming an important research tool to assess functional activity in neurological populations or for special tasks, such as walking, because it allows investigating brain hemodynamic activity in an ecological setting, without strong immobility constraints. A systematic review following PRISMA guidelines was conducted on the fNIRS-based examination of gait disorders. Twelve of the initial yield of 489 articles have been included in this review. The lesson learnt from these studies suggest that oxy-hemoglobin levels within the prefrontal and premotor cortices are more sensitive to compensation strategies reflecting postural control and restoration of gait disorders. Although this field of study is in its relative infancy, the evidence provided encourages the translation of fNIRS in clinical practice, as it offers a unique opportunity to explore in depth the activity of the cortical motor system during real walking in neurological patients. We also discuss to what extent fNIRS may be applied for assessing the effectiveness of rehabilitation programs.

Near-Infrared Spectroscopy in Gait Disorders

No clue if this is scanning the brain or directly looking at the gait. Obviously not meant for survivors to read. 
http://journals.sagepub.com/doi/abs/10.1177/1545968317693304

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Vera Gramigna, PhD†, Giovanni Pellegrino, PhD†, Antonio Cerasa, PhD, Simone Cutini, PhD, Roberta Vasta, PhD, Giuseppe Olivadese, PhD, Iolanda Martino, PhD, Aldo Quattrone, PhD, MD

First Published February 14, 2017 review-article

Abstract

Walking is a complex motor behavior with a special relevance in clinical neurology. Many neurological diseases, such as Parkinson’s disease and stroke, are characterized by gait disorders whose neurofunctional correlates are poorly investigated. Indeed, the analysis of real walking with the standard neuroimaging techniques poses strong challenges, and only a few studies on motor imagery or walking observation have been performed so far. Functional near-infrared spectroscopy (fNIRS) is becoming an important research tool to assess functional activity in neurological populations or for special tasks, such as walking, because it allows investigating brain hemodynamic activity in an ecological setting, without strong immobility constraints. A systematic review following PRISMA guidelines was conducted on the fNIRS-based examination of gait disorders. Twelve of the initial yield of 489 articles have been included in this review. The lesson learnt from these studies suggest that oxy-hemoglobin levels within the prefrontal and premotor cortices are more sensitive to compensation strategies reflecting postural control and restoration of gait disorders. Although this field of study is in its relative infancy, the evidence provided encourages the translation of fNIRS in clinical practice, as it offers a unique opportunity to explore in depth the activity of the cortical motor system during real walking in neurological patients. We also discuss to what extent fNIRS may be applied for assessing the effectiveness of rehabilitation programs.

New design of a system that " interrogates " and shows how the brain relearns post stroke

If this works we may finally understand where functionality of dead areas goes to as it recovers. And we might then make repeatable therapy protocols.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=142245&CultureCode=en
Monitoring the rehabilitation of patients with neurological damage caused by a stroke, has encouraged Mexican scientists to work in the design and manufacture of a functional infrared spectroscopy (fNIRS -FD ) instrument capable of identifying the affected areas of the brain and the sites that were activated while analyzing the oxygen content in blood flow during therapy.
"It's a device consisting of a headband or helmet equipped with emitters and light detectors, oximeter (to measures oxygen levels), a monitor and software. Its operation is based on infrared light, which passes through the scalp to the skull leather and displays and “interrogates” brain activity in order to obtain information on cell metabolism, alterations in blood flow and amount of oxygen," explains Carlos Gerardo Treviño Palacios, researcher at the National Institute of Astrophysics, Optics and Electronics (INAOE) in Mexico.
He highlights that so far they are ending the development of an oximeter and software to display images. Also, they analyze information that will be provided to the base hardware and detectors, and work in the construction helmet. This will not only help rehabilitate patients, but will create a map of the brain to detect which parts are replacing areas that died in the motor cortex after stroke and watch how the body relearns with the help of rehabilitation.
"The aim is to build a non-invasive imaging system to avoid secluding the patient into a box camera during the shooting of brain “photography” with the limitations of the procedure , as happens with an MRI," says Treviño Palacios.
He notes that although the latter method also measures the concentration of oxygen, infrared spectroscopy despite having a lower resolution does not require the patient to lie still and requires only the use of a helmet, allowing the physician to observe brain activity and progress while continuing the patient’s rehabilitation therapy. Additional advantages are system portability and low cost.
"In parallel, we are looking for a fast optical signal, ie, a series of changes that occur a few milliseconds before the neuron is active in the images, which shows the action potential of the nerve cell," says the researcher at INAOE.
This project is jointly implemented by INAOE and the National Institute of Neurology and Neurosurgery of the Mexican Ministry of Health, where collaboration comes naturally to raise an investigation into an imaging modality based on the interaction of light with matter, after a previous collaboration where a rehabilitation therapy system was developed.
"The particular characteristics of the optical imaging system make it a unique tool in certain problems where the in-vivo and in- situ neuroimaging is required noninvasively and continuously for long periods of time. This is the case of the study of brain plasticity in patients going through motor rehabilitation, which should be monitored while practicing neuro-rehabilitation exercises during therapy sessions that can last from 45 minutes to an hour ," says  Treviño Palacios. (Agencia ID)

Near-Infrared Spectroscopy based Neurofeedback Training increases Specific Motor Imagery Related Cortical Activation compared to Sham Feedback

No clue on this one, your doctor and therapists had better know what this means and use it to help you recover.
http://www.sciencedirect.com/science/article/pii/S0301051113001233

Abstract

In the present study we implemented a real-time feedback system based on multichannel near-infrared spectroscopy (NIRS). Prior studies indicated that NIRS-based neurofeedback can enhance motor imagery related cortical activation. To specify these prior results and to confirm the efficacy of NIRS based neurofeedback training, we examined changes in blood oxygenation level collected in eight NIRS neurofeedback training sessions. The study design differentiated between a feedback group (N = 9) that got real feedback about their own brain activity and a sham feedback group (N = 8) that saw a playback of another person's feedback recording. All participants were instructed to imagine a right hand movement to control the vertical position of a ball displayed on a computer screen. Real neurofeedback induced specific and focused brain activation over left motor areas. This focal brain activation became even more specific over the eight training sessions. In contrast, sham feedback led to diffuse brain activation patterns over the whole cortex. These findings indicate that NIRS-based real-time neurofeedback induces focused activation in specific brain areas which can be useful when training patients with focal brain lesions to increase activity of specific brain areas for rehabilitation purpose.