Frontiers in Neuroscience (Nov 2018)
Behavioral Outcomes Following Brain–Computer Interface Intervention for Upper Extremity Rehabilitation in Stroke: A Randomized Controlled Trial
- Alexander B. Remsik,
- Alexander B. Remsik,
- Alexander B. Remsik,
- Keith Dodd,
- Keith Dodd,
- Leroy Williams,
- Leroy Williams,
- Leroy Williams,
- Jaclyn Thoma,
- Jaclyn Thoma,
- Tyler Jacobson,
- Tyler Jacobson,
- Janerra D. Allen,
- Janerra D. Allen,
- Hemali Advani,
- Rosaleena Mohanty,
- Rosaleena Mohanty,
- Matt McMillan,
- Matt McMillan,
- Shruti Rajan,
- Shruti Rajan,
- Matt Walczak,
- Brittany M. Young,
- Brittany M. Young,
- Brittany M. Young,
- Brittany M. Young,
- Brittany M. Young,
- Zack Nigogosyan,
- Cameron A. Rivera,
- Mohsen Mazrooyisebdani,
- Neelima Tellapragada,
- Leo M. Walton,
- Leo M. Walton,
- Klevest Gjini,
- Klevest Gjini,
- Peter L.E. van Kan,
- Theresa J. Kang,
- Theresa J. Kang,
- Justin A. Sattin,
- Veena A. Nair,
- Dorothy Farrar Edwards,
- Justin C. Williams,
- Justin C. Williams,
- Vivek Prabhakaran,
- Vivek Prabhakaran,
- Vivek Prabhakaran,
- Vivek Prabhakaran,
- Vivek Prabhakaran,
- Vivek Prabhakaran
Affiliations
- Alexander B. Remsik
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Alexander B. Remsik
- Department of Kinesiology, University of Wisconsin – Madison, Madison, WI, United States
- Alexander B. Remsik
- Institute for Clinical and Translational Research, University of Wisconsin – Madison, Madison, WI, United States
- Keith Dodd
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Keith Dodd
- Department of Biomedical Engineering, University of Wisconsin – Madison, Madison, WI, United States
- Leroy Williams
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Leroy Williams
- Department of Educational Psychology, University of Wisconsin – Madison, Madison, WI, United States
- Leroy Williams
- Center for Women’s Health Research, University of Wisconsin – Madison, Madison, WI, United States
- Jaclyn Thoma
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Jaclyn Thoma
- Neuroscience Training Program, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
- Tyler Jacobson
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Tyler Jacobson
- Neuroscience Training Program, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
- Janerra D. Allen
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Janerra D. Allen
- Department of Materials Science and Engineering, University of Wisconsin – Madison, Madison, WI, United States
- Hemali Advani
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Rosaleena Mohanty
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Rosaleena Mohanty
- Department of Electrical and Computer Engineering, University of Wisconsin – Madison, Madison, WI, United States
- Matt McMillan
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Matt McMillan
- Department of Biomedical Engineering, University of Wisconsin – Madison, Madison, WI, United States
- Shruti Rajan
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Shruti Rajan
- 0Department of Psychology, University of Wisconsin – Madison, Madison, WI, United States
- Matt Walczak
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Brittany M. Young
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Brittany M. Young
- Institute for Clinical and Translational Research, University of Wisconsin – Madison, Madison, WI, United States
- Brittany M. Young
- Neuroscience Training Program, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
- Brittany M. Young
- 1Clinical Neuroengineering Training Program, University of Wisconsin – Madison, Madison, WI, United States
- Brittany M. Young
- 2Medical Scientist Training Program, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
- Zack Nigogosyan
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Cameron A. Rivera
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Mohsen Mazrooyisebdani
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Neelima Tellapragada
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Leo M. Walton
- Department of Biomedical Engineering, University of Wisconsin – Madison, Madison, WI, United States
- Leo M. Walton
- Neuroscience Training Program, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
- Klevest Gjini
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Klevest Gjini
- 3Department of Neurology, University of Wisconsin – Madison, Madison, WI, United States
- Peter L.E. van Kan
- Department of Kinesiology, University of Wisconsin – Madison, Madison, WI, United States
- Theresa J. Kang
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Theresa J. Kang
- 3Department of Neurology, University of Wisconsin – Madison, Madison, WI, United States
- Justin A. Sattin
- Neuroscience Training Program, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
- Veena A. Nair
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Dorothy Farrar Edwards
- Department of Kinesiology, University of Wisconsin – Madison, Madison, WI, United States
- Justin C. Williams
- Department of Kinesiology, University of Wisconsin – Madison, Madison, WI, United States
- Justin C. Williams
- 4Department of Neurological Surgery, University of Wisconsin – Madison, Madison, WI, United States
- Vivek Prabhakaran
- Department of Radiology, University of Wisconsin – Madison, Madison, WI, United States
- Vivek Prabhakaran
- Neuroscience Training Program, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
- Vivek Prabhakaran
- 0Department of Psychology, University of Wisconsin – Madison, Madison, WI, United States
- Vivek Prabhakaran
- 2Medical Scientist Training Program, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
- Vivek Prabhakaran
- 3Department of Neurology, University of Wisconsin – Madison, Madison, WI, United States
- Vivek Prabhakaran
- 5Department of Psychiatry, University of Wisconsin – Madison, Madison, WI, United States
- DOI
- https://doi.org/10.3389/fnins.2018.00752
- Journal volume & issue
-
Vol. 12
Abstract
Stroke is a leading cause of persistent upper extremity (UE) motor disability in adults. Brain–computer interface (BCI) intervention has demonstrated potential as a motor rehabilitation strategy for stroke survivors. This sub-analysis of ongoing clinical trial (NCT02098265) examines rehabilitative efficacy of this BCI design and seeks to identify stroke participant characteristics associated with behavioral improvement. Stroke participants (n = 21) with UE impairment were assessed using Action Research Arm Test (ARAT) and measures of function. Nine participants completed three assessments during the experimental BCI intervention period and at 1-month follow-up. Twelve other participants first completed three assessments over a parallel time-matched control period and then crossed over into the BCI intervention condition 1-month later. Participants who realized positive change (≥1 point) in total ARAT performance of the stroke affected UE between the first and third assessments of the intervention period were dichotomized as “responders” (<1 = “non-responders”) and similarly analyzed. Of the 14 participants with room for ARAT improvement, 64% (9/14) showed some positive change at completion and approximately 43% (6/14) of the participants had changes of minimal detectable change (MDC = 3 pts) or minimally clinical important difference (MCID = 5.7 points). Participants with room for improvement in the primary outcome measure made significant mean gains in ARATtotal score at completion (ΔARATtotal = 2, p = 0.028) and 1-month follow-up (ΔARATtotal = 3.4, p = 0.0010), controlling for severity, gender, chronicity, and concordance. Secondary outcome measures, SISmobility, SISadl, SISstrength, and 9HPTaffected, also showed significant improvement over time during intervention. Participants in intervention through follow-up showed a significantly increased improvement rate in SISstrength compared to controls (p = 0.0117), controlling for severity, chronicity, gender, as well as the individual effects of time and intervention type. Participants who best responded to BCI intervention, as evaluated by ARAT score improvement, showed significantly increased outcome values through completion and follow-up for SISmobility (p = 0.0002, p = 0.002) and SISstrength (p = 0.04995, p = 0.0483). These findings may suggest possible secondary outcome measure patterns indicative of increased improvement resulting from this BCI intervention regimen as well as demonstrating primary efficacy of this BCI design for treatment of UE impairment in stroke survivors.Clinical Trial Registration:ClinicalTrials.gov, NCT02098265.
Keywords