Relationship between motor imagery ability and motor function of hemiplegic upper limbs and their use in stroke patients

Aims. While studies on healthy subjects have shown a partial overlap between the motor execution and motor imagery neural circuits, few have investigated brain activity during motor imagery in stroke patients with hemiparesis. This work is aimed at examining similarities between motor imagery and execution in a group of stroke patients. Materials and Methods. Eleven patients were asked to perform a visuomotor tracking task by either physically or mentally tracking a sine wave force target using their thumb and index finger during fMRI scanning. MIQ-RS questionnaire has been administered. Results and Conclusion. Whole-brain analyses confirmed shared neural substrates between motor imagery and motor execution in bilateral premotor cortex, SMA, and in the contralesional inferior parietal lobule. Additional region of interest-based analyses revealed a negative correlation between kinaesthetic imagery ability and percentage BOLD change in areas 4p and 3a; higher imagery ability was associated with negative and lower percentage BOLD change in primary sensorimotor areas during motor imagery.

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Brain Functional Changes in Stroke Following Rehabilitation Using Brain-Computer Interface-Assisted Motor Imagery With and Without tDCS: A Pilot Study

Frontiers in Human Neuroscience ◽

10.3389/fnhum.2021.692304 ◽

2021 ◽

Vol 15 ◽

Author(s):

Mengjiao Hu ◽

Hsiao-Ju Cheng ◽

Fang Ji ◽

Joanna Su Xian Chong ◽

Zhongkang Lu ◽

...

Keyword(s):

Motor Function ◽

Motor Imagery ◽

Brain Computer Interface ◽

Low Frequency ◽

Computer Interface ◽

Stroke Patients ◽

Post Intervention ◽

Functional Changes ◽

Post Stroke ◽

Assessment Scores

Brain-computer interface-assisted motor imagery (MI-BCI) or transcranial direct current stimulation (tDCS) has been proven effective in post-stroke motor function enhancement, yet whether the combination of MI-BCI and tDCS may further benefit the rehabilitation of motor functions remains unknown. This study investigated brain functional activity and connectivity changes after a 2 week MI-BCI and tDCS combined intervention in 19 chronic subcortical stroke patients. Patients were randomized into MI-BCI with tDCS group and MI-BCI only group who underwent 10 sessions of 20 min real or sham tDCS followed by 1 h MI-BCI training with robotic feedback. We derived amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), and functional connectivity (FC) from resting-state functional magnetic resonance imaging (fMRI) data pre- and post-intervention. At baseline, stroke patients had lower ALFF in the ipsilesional somatomotor network (SMN), lower ReHo in the contralesional insula, and higher ALFF/Reho in the bilateral posterior default mode network (DMN) compared to age-matched healthy controls. After the intervention, the MI-BCI only group showed increased ALFF in contralesional SMN and decreased ALFF/Reho in the posterior DMN. In contrast, no post-intervention changes were detected in the MI-BCI + tDCS group. Furthermore, higher increases in ALFF/ReHo/FC measures were related to better motor function recovery (measured by the Fugl-Meyer Assessment scores) in the MI-BCI group while the opposite association was detected in the MI-BCI + tDCS group. Taken together, our findings suggest that brain functional re-normalization and network-specific compensation were found in the MI-BCI only group but not in the MI-BCI + tDCS group although both groups gained significant motor function improvement post-intervention with no group difference. MI-BCI and tDCS may exert differential or even opposing impact on brain functional reorganization during post-stroke motor rehabilitation; therefore, the integration of the two strategies requires further refinement to improve efficacy and effectiveness.

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Recovery of Motor Imagery Ability in Stroke Patients

Rehabilitation Research and Practice ◽

10.1155/2011/283840 ◽

2011 ◽

Vol 2011 ◽

pp. 1-9 ◽

Cited By ~ 17

Author(s):

Sjoerd de Vries ◽

Marga Tepper ◽

Bert Otten ◽

Theo Mulder

Keyword(s):

Motor Imagery ◽

Mental Imagery ◽

Hand Function ◽

Mental Practice ◽

Imagery Ability ◽

Stroke Patients ◽

Motor Functioning ◽

Rehabilitation Process ◽

Implicit Motor ◽

The Relationship

Objective. To investigate whether motor imagery ability recovers in stroke patients and to see what the relationship is between different types of imagery and motor functioning after stroke.Methods. 12 unilateral stroke patients were measured at 3 and 6 weeks poststroke on 3 mental imagery tasks. Arm-hand function was evaluated using the Utrecht Arm-Hand task and the Brunnström Fugl-Meyer Scale. Age-matched healthy individuals (N=10) were included as controls.Results. Implicit motor imagery ability and visual motor imagery ability improved significantly at 6 weeks compared to 3 weeks poststroke.Conclusion. Our study shows that motor imagery can recover in the first weeks after stroke. This indicates that a group of patients who might not be initially selected for mental practice can, still later in the rehabilitation process, participate in mental practice programs. Moreover, our study shows that mental imagery modalities can be differently affected in individual patients and over time.

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Motor imagery ability in stroke patients: the relationship between implicit and explicit motor imagery measures

Frontiers in Human Neuroscience ◽

10.3389/fnhum.2013.00790 ◽

2013 ◽

Vol 7 ◽

Cited By ~ 16

Author(s):

Sjoerd de Vries ◽

Marga Tepper ◽

Wya Feenstra ◽

Hanneke Oosterveld ◽

Anne M. Boonstra ◽

...

Keyword(s):

Motor Imagery ◽

Imagery Ability ◽

Stroke Patients ◽

Implicit And Explicit ◽

The Relationship

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Conditional Granger Causality Analysis of Effective Connectivity during Motor Imagery and Motor Execution in Stroke Patients

BioMed Research International ◽

10.1155/2016/3870863 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 12

Author(s):

Li Wang ◽

Jingna Zhang ◽

Ye Zhang ◽

Rubing Yan ◽

Hongliang Liu ◽

...

Keyword(s):

Granger Causality ◽

Motor Function ◽

Motor Imagery ◽

Effective Connectivity ◽

Causality Analysis ◽

Motor Execution ◽

Stroke Patients ◽

Granger Causality Analysis ◽

Cortical Motor ◽

Motor Network

Aims.Motor imagery has emerged as a promising technique for the improvement of motor function following stroke, but the mechanism of functional network reorganization in patients during this process remains unclear. The aim of this study is to evaluate the cortical motor network patterns of effective connectivity in stroke patients.Methods.Ten stroke patients with right hand hemiplegia and ten normal control subjects were recruited. We applied conditional Granger causality analysis (CGCA) to explore and compare the functional connectivity between motor execution and motor imagery.Results.Compared with the normal controls, the patient group showed lower effective connectivity to the primary motor cortex (M1), the premotor cortex (PMC), and the supplementary motor area (SMA) in the damaged hemisphere but stronger effective connectivity to the ipsilesional PMC and M1 in the intact hemisphere during motor execution. There were tighter connections in the cortical motor network in the patients than in the controls during motor imagery, and the patients showed more effective connectivity in the intact hemisphere.Conclusions.The increase in effective connectivity suggests that motor imagery enhances core corticocortical interactions, promotes internal interaction in damaged hemispheres in stroke patients, and may facilitate recovery of motor function.

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Motor Imagery-Based Brain-Computer Interface Combined with Multimodal Feedback to Promote Upper Limb Motor Function after Stroke: A Preliminary Study

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/1116126 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Yi-Qian Hu ◽

Tian-Hao Gao ◽

Jie Li ◽

Jia-Chao Tao ◽

Yu-Long Bai ◽

...

Keyword(s):

Motor Function ◽

Motor Imagery ◽

Upper Limb ◽

Brain Computer Interface ◽

Chronic Stroke ◽

Computer Interface ◽

Stroke Patients ◽

Multimodal Feedback ◽

Before And After ◽

Extensor Carpi Radialis

Background. Recently, the brain-computer interface (BCI) has seen rapid development, which may promote the recovery of motor function in chronic stroke patients. Methods. Twelve stroke patients with severe upper limb and hand motor impairment were enrolled and randomly assigned into two groups: motor imagery (MI)-based BCI training with multimodal feedback (BCI group, n = 7) and classical motor imagery training (control group, n = 5). Motor function and electrophysiology were evaluated before and after the intervention. The Fugl-Meyer assessment-upper extremity (FMA-UE) is the primary outcome measure. Secondary outcome measures include an increase in wrist active extension or surface electromyography (the amplitude and cocontraction of extensor carpi radialis during movement), the action research arm test (ARAT), the motor status scale (MSS), and Barthel index (BI). Time-frequency analysis and power spectral analysis were used to reflect the electroencephalogram (EEG) change before and after the intervention. Results. Compared with the baseline, the FMA-UE score increased significantly in the BCI group ( p = 0.006). MSS scores improved significantly in both groups, while ARAT did not improve significantly. In addition, before the intervention, all patients could not actively extend their wrists or just had muscle contractions. After the intervention, four patients regained the ability to extend their paretic wrists (two in each group). The amplitude and area under the curve of extensor carpi radialis improved to some extent, but there was no statistical significance between the groups. Conclusion. MI-based BCI combined with sensory and visual feedback might improve severe upper limb and hand impairment in chronic stroke patients, showing the potential for application in rehabilitation medicine.

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