A dual-therapy approach to boost motor recovery after a stroke

June 20, 2018, Ecole Polytechnique Federale de Lausanne
Credit: Ecole Polytechnique Federale de Lausanne

Paralysis of an arm and/or leg is one of the most common effects of a stroke. But thanks to research carried out by scientists at the Defitech Foundation Chair in Brain-Machine Interface and collaborators, stroke victims may soon be able to recover greater use of their paralyzed limbs. The scientists' pioneering approach brings together two known types of therapies—a brain-computer interface (BCI) and functional electrical stimulation (FES) - and has been published in Nature Communications.

"The key is to stimulate the nerves of the paralyzed arm precisely when the stroke-affected part of the brain activates to move the limb, even if the patient can't actually carry out the movement. That helps reestablish the link between the two nerve pathways where the signal comes in and goes out," says José del R. Millán, who holds the Defitech Chair at EPFL.

Twenty-seven aged 36 to 76 took part in the clinical trial. All had a similar lesion that resulted in moderate to severe arm paralysis following a stroke occurring at least ten months earlier. Half of the patients were treated with the ' dual-therapy approach and reported clinically significant improvements. The other half were treated only with FES and served as a control group.

For the first group, the scientists used a BCI system to link the patients' brains to computers using electrodes. That let the scientists pinpoint exactly where the occurred in the brain tissue when the patients tried to reach out their hands. Every time that the electrical activity was identified, the system immediately stimulated the arm muscle controlling the corresponding wrist and finger movements. The patients in the second group also had their arm muscles stimulated, but at random times. This enabled the scientists to determine how much of the additional motor-function improvement could be attributed to the BCI system.

Reactivated tissue

The scientists noted a significant improvement in arm mobility among patients in the first group after just ten one-hour sessions. When the full round of treatment was completed, some of the first-group patients' scores on the Fugl-Meyer Assessment—a test used to evaluate motor recovery among patients with post-stroke hemiplegia—were over twice as high as those of the second group.

"Patients who received the BCI treatment showed more activity in the neural tissue surrounding the affected area. Due to their plasticity, they could help make up for the functioning of the damaged tissue," says Millán.

Electroencephalographies (EEGs) of the patients clearly showed an increase in the number of connections among the motor cortex regions of their damaged brain hemisphere, which corresponded with the increased ease in carrying out the associated movements. What's more, the enhanced motor function didn't seem to diminish with time. Evaluated again 6-12 months later, the patients hadn't lost any of their recovered mobility.

Explore further: Electrically stimulating the brain may restore movement after stroke

More information: A. Biasiucci et al, Brain-actuated functional electrical stimulation elicits lasting arm motor recovery after stroke, Nature Communications (2018). DOI: 10.1038/s41467-018-04673-z

Related Stories

Electrically stimulating the brain may restore movement after stroke

June 18, 2018
UC San Francisco scientists have improved mobility in rats that had experienced debilitating strokes by using electrical stimulation to restore a distinctive pattern of brain cell activity associated with efficient movement. ...

Electrical nerve stimulation could help patients regain motor functions sooner

May 2, 2018
Researchers at The Ohio State University Wexner Medical Center are among the first in the world studying how a specific type of neurostimulator can improve rehabilitation for stroke patients.

Physical therapy helps recover arm function in chronic CVA

May 4, 2018
(HealthDay)—Physical therapy promotes the recovery of arm function and neuroplasticity in all chronic stroke patients, according to a study published online April 25 in the Journal of Evaluation in Clinical Practice.

Potential brain-machine interface for hand paralysis

January 15, 2018
A brain-machine interface that combines brain stimulation with a robotic device controlling hand movement increases the output of pathways connecting the brain and spinal cord, according to a study of healthy adults published ...

Noninvasive brain stimulation leads to fine motor improvement after stroke

May 11, 2018
Stroke is common and accompanied by complex disabilities—such as lower and upper limb disability, speech impairment, and chronic post-stroke pain. An analysis of published studies found that non-invasive brain stimulation ...

Stroke patient improvement with a brain-computer interface

August 30, 2017
University of Adelaide researchers have shown that it is possible for stroke patients to improve motor function using special training involving connecting brain signals with a computer.

Recommended for you

Breast milk may be best for premature babies' brain development

September 21, 2018
Babies born before their due date show better brain development when fed breast milk rather than formula, a study has found.

Early warning sign of psychosis detected

September 21, 2018
Brains of people at risk of psychosis exhibit a pattern that can help predict whether they will go on to develop full-fledged schizophrenia, a new Yale-led study shows. The findings could help doctors begin early intervention ...

White matter repair and traumatic brain injury

September 20, 2018
Traumatic brain injury (TBI) is a leading cause of death and disability in the U.S., contributing to about 30 percent of all injury deaths, according to the CDC. TBI causes damage to both white and gray matter in the brain, ...

'Gut sense' is hardwired, not hormonal

September 20, 2018
If you've ever felt nauseous before an important presentation, or foggy after a big meal, then you know the power of the gut-brain connection.

Genomic dark matter activity connects Parkinson's and psychiatric diseases

September 20, 2018
Dopamine neurons are located in the midbrain, but their tendril-like axons can branch far into the higher cortical areas, influencing how we move and how we feel. New genetic evidence has revealed that these specialized cells ...

Gut branches of vagus nerve essential components of brain's reward and motivation system

September 20, 2018
A novel gut-to-brain neural circuit establishes the vagus nerve as an essential component of the brain system that regulates reward and motivation, according to research conducted at the Icahn School of Medicine at Mount ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.