Article,
Associative cued asynchronous BCI induces cortical plasticity in stroke patients
Contributors
Niazi, Imran Khan
0000-0001-8752-7224
[1]
[2]
[3]
Navid, Muhammad Samran
0000-0002-2849-874X
[2]
Rashid, Usman
0000-0002-1109-5493
[3]
Amjad, Imran
0000-0002-2824-0079
[2]
[4]
Olsen, Sharon
0000-0002-7453-9127
[3]
Haavik, Heidi
0000-0001-7182-2085
[2]
Alder, Gemma
0000-0002-8833-0375
[3]
Kumari, Nitika
0000-0002-5135-1682
[2]
[3]
Signal, Nada Elizabeth June
0000-0001-9595-0532
[3]
Taylor, Denise M
0000-0002-0955-5702
[3]
Farina, Dario
0000-0002-7883-2697
(Corresponding author)
[5]
Jochumsen, Mads R
0000-0001-7729-4359
[1]
Affiliations
- [1] Aalborg University [NORA names: AAU Aalborg University; University; Denmark; Europe, EU; Nordic; OECD];
- [2] New Zealand College of Chiropractic [NORA names: New Zealand; Oceania; OECD];
- [3] Auckland University of Technology [NORA names: New Zealand; Oceania; OECD];
- [4] Riphah International University [NORA names: Pakistan; Asia, South];
- [5] Imperial College London [NORA names: United Kingdom; Europe, Non-EU; OECD]
Abstract
OBJECTIVE: We propose a novel cue-based asynchronous brain-computer interface(BCI) for neuromodulation via the pairing of endogenous motor cortical activity with the activation of somatosensory pathways. METHODS: The proposed BCI detects the intention to move from single-trial EEG signals in real time, but, contrary to classic asynchronous-BCI systems, the detection occurs only during time intervals when the patient is cued to move. This cue-based asynchronous-BCI was compared with two traditional BCI modes (asynchronous-BCI and offline synchronous-BCI) and a control intervention in chronic stroke patients. The patients performed ankle dorsiflexion movements of the paretic limb in each intervention while their brain signals were recorded. BCI interventions decoded the movement attempt and activated afferent pathways via electrical stimulation. Corticomotor excitability was assessed using motor-evoked potentials in the tibialis-anterior muscle induced by transcranial magnetic stimulation before, immediately after, and 30 min after the intervention. RESULTS: The proposed cue-based asynchronous-BCI had significantly fewer false positives/min and false positives/true positives (%) as compared to the previously developed asynchronous-BCI. Linear-mixed-models showed that motor-evoked potential amplitudes increased following all BCI modes immediately after the intervention compared to the control condition (p <0.05). The proposed cue-based asynchronous-BCI resulted in the largest relative increase in peak-to-peak motor-evoked potential amplitudes(141% ± 33%) among all interventions and sustained it for 30 min(111% ± 33%). INTERPRETATION: These findings prove the high performance of a newly proposed cue-based asynchronous-BCI intervention. In this paradigm, individuals receive precise instructions (cue) to promote engagement, while the timing of brain activity is accurately detected to establish a precise association with the delivery of sensory input for plasticity induction.
