Brain plasticity following MI-BCI training combined with tDCS in a randomized trial in chronic subcortical stroke subjects: a preliminary study.

Xin Hong, Zhong Kang Lu, Irvin Teh, Fatima Ali Nasrallah, Wei Peng Teo, Kai Keng Ang, Kok Soon Phua, Cuntai Guan, Effie Chew, Kai-Hsiang Chuang

Journal: Scientific reports 2019;7(1):9222

PMID: 28835651

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Abstract

Brain-computer interface-assisted motor imagery (MI-BCI) or transcranial direct current stimulation (tDCS) has been used in stroke rehabilitation, though their combinatory effect is unknown. We investigated brain plasticity following a combined MI-BCI and tDCS intervention in chronic subcortical stroke patients with unilateral upper limb disability. Nineteen patients were randomized into tDCS and sham-tDCS groups. Diffusion and perfusion MRI, and transcranial magnetic stimulation were used to study structural connectivity, cerebral blood flow (CBF), and corticospinal excitability, respectively, before and 4 weeks after the 2-week intervention. After quality control, thirteen subjects were included in the CBF analysis. Eleven healthy controls underwent 2 sessions of MRI for reproducibility study. Whereas motor performance showed comparable improvement, long-lasting neuroplasticity can only be detected in the tDCS group, where white matter integrity in the ipsilesional corticospinal tract and bilateral corpus callosum was increased but sensorimotor CBF was decreased, particularly in the ipsilesional side. CBF change in the bilateral parietal cortices also correlated with motor function improvement, consistent with the increased white matter integrity in the corpus callosum connecting these regions, suggesting an involvement of interhemispheric interaction. The preliminary results indicate that tDCS may facilitate neuroplasticity and suggest the potential for refining rehabilitation strategies for stroke patients.

Address: Singapore Bioimaging Consortium, Agency for Science Technology and Research, 11 Biopolis Way, #02-02 Helios, Singapore, 138667, Singapore.; Institute for Infocomm Research, Agency for Science Technology and Research, 1 Fusionopolis Way, #21-01 Connexis (South Tower), Singapore, 138632, Singapore.; Clinical Imaging Research Center, Agency for Science Technology and Research, Centre for Translational Medicine (MD6), 14 Medical Drive, #B1-01, Singapore, 117599, Singapore.; Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford, OX3 7BN, UK.; Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, 4072, Australia.; Division of Neurology, National University Hospital System, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.; Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia.; School of Computer Science and Engineering, Nanynag Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore.; Division of Neurology, National University Hospital System, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore. [email protected].; Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, 1E Kent Ridge Road, Singapore, 119228, Singapore. [email protected].; Singapore Bioimaging Consortium, Agency for Science Technology and Research, 11 Biopolis Way, #02-02 Helios, Singapore, 138667, Singapore. [email protected].; Clinical Imaging Research Center, Agency for Science Technology and Research, Centre for Translational Medicine (MD6), 14 Medical Drive, #B1-01, Singapore, 117599, Singapore. [email protected].; Queensland Brain Institute and Centre for Advanced Imaging, The University of Queensland, Brisbane, Queensland, 4072, Australia. [email protected].

DOI: 10.1038/s41598-017-08928-5

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MeSH Terms: Adult, Aged, Brain-Computer Interfaces, Chronic Disease, Female, Humans, Imagery, Psychotherapy, Magnetic Resonance Imaging, Male, Middle Aged, Neuronal Plasticity, Stroke, Stroke Rehabilitation, Transcranial Direct Current Stimulation