title: Effects of neurofeedback training with an electroencephalogram-based brain-computer interface for hand paralysis in patients with chronic stroke: a preliminary case series study.
abstract: OBJECTIVE
  To explore the effectiveness of neurorehabilitative training using an electroencephalogram-based brain- computer interface for hand paralysis following stroke.
  
  
  METHODS
  A case series study.
  
  
  METHODS
  Eight outpatients with chronic stroke demonstrating moderate to severe hemiparesis.
  
  
  METHODS
  Based on analysis of volitionally decreased amplitudes of sensory motor rhythm during motor imagery involving extending the affected fingers, real-time visual feedback was provided. After successful motor imagery, a mechanical orthosis partially extended the fingers. Brain-computer interface interventions were carried out once or twice a week for a period of 4-7 months, and clinical and neurophysiological examinations pre- and post-intervention were compared.
  
  
  RESULTS
  New voluntary electromyographic activity was measured in the affected finger extensors in 4 cases who had little or no muscle activity before the training, and the other participants exhibited improvement in finger function. Significantly greater suppression of the sensory motor rhythm over both hemispheres was observed during motor imagery. Transcranial magnetic stimulation showed increased cortical excitability in the damaged hemisphere. Success rates of brain-computer interface training tended to increase as the session progressed in 4 cases.
  
  
  CONCLUSIONS
  Brain-computer interface training appears to have yielded some improvement in motor function and brain plasticity. Further controlled research is needed to clarify the role of the brain-computer interface system.
authors.affiliation: Department of Rehabilitation Medicine, Keio University Tsukigase Rehabilitation Center, 380-2 Tsukigase. krugreims@yahoo.co.jp
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Shindo
authors.forename: Kimiko
authors.initials: K
authors.lastname: Kawashima
authors.forename: Junichi
authors.initials: J
authors.lastname: Ushiba
authors.forename: Naoki
authors.initials: N
authors.lastname: Ota
authors.forename: Mari
authors.initials: M
authors.lastname: Ito
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ota
authors.forename: Akio
authors.initials: A
authors.lastname: Kimura
authors.forename: Meigen
authors.initials: M
authors.lastname: Liu
mesh_terms: D000368:Aged; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D019018:Imagery, Psychotherapy; D008297:Male; D008875:Middle Aged; D058765:Neurofeedback / Q000379:methods*; D010243:Paralysis / Q000503:physiopathology / Q000534:rehabilitation*; D020127:Recovery of Function; D020521:Stroke / Q000503:physiopathology / Q000523:psychology; D000071939:Stroke Rehabilitation; D050781:Transcranial Magnetic Stimulation; D016896:Treatment Outcome; D014584:User-Computer Interface