{Reference Type}: Journal Article
{Title}: Hebbian plasticity induced by temporally coincident BCI enhances post-stroke motor recovery.
{Author}: Krueger J;Krauth R;Reichert C;Perdikis S;Vogt S;Huchtemann T;Dürschmid S;Sickert A;Lamprecht J;Huremovic A;Görtler M;Nasuto SJ;Tsai IC;Knight RT;Hinrichs H;Heinze HJ;Lindquist S;Sailer M;Millán JDR;Sweeney-Reed CM;
{Journal}: Sci Rep
{Volume}: 14
{Issue}: 1
{Year}: 2024 08 12
{Factor}: 4.996
{DOI}: 10.1038/s41598-024-69037-8
{Abstract}: Functional electrical stimulation (FES) can support functional restoration of a paretic limb post-stroke. Hebbian plasticity depends on temporally coinciding pre- and post-synaptic activity. A tight temporal relationship between motor cortical (MC) activity associated with attempted movement and FES-generated visuo-proprioceptive feedback is hypothesized to enhance motor recovery. Using a brain-computer interface (BCI) to classify MC spectral power in electroencephalographic (EEG) signals to trigger FES-delivery with detection of movement attempts improved motor outcomes in chronic stroke patients. We hypothesized that heightened neural plasticity earlier post-stroke would further enhance corticomuscular functional connectivity and motor recovery. We compared subcortical non-dominant hemisphere stroke patients in BCI-FES and Random-FES (FES temporally independent of MC movement attempt detection) groups. The primary outcome measure was the Fugl-Meyer Assessment, Upper Extremity (FMA-UE). We recorded high-density EEG and transcranial magnetic stimulation-induced motor evoked potentials before and after treatment. The BCI group showed greater: FMA-UE improvement; motor evoked potential amplitude; beta oscillatory power and long-range temporal correlation reduction over contralateral MC; and corticomuscular coherence with contralateral MC. These changes are consistent with enhanced post-stroke motor improvement when movement is synchronized with MC activity reflecting attempted movement.