title: Learned self-regulation of the lesioned brain with epidural electrocorticography.
abstract: BACKGROUND
  Different techniques for neurofeedback of voluntary brain activations are currently being explored for clinical application in brain disorders. One of the most frequently used approaches is the self-regulation of oscillatory signals recorded with electroencephalography (EEG). Many patients are, however, unable to achieve sufficient voluntary control of brain activity. This could be due to the specific anatomical and physiological changes of the patient's brain after the lesion, as well as to methodological issues related to the technique chosen for recording brain signals.
  
  
  METHODS
  A patient with an extended ischemic lesion of the cortex did not gain volitional control of sensorimotor oscillations when using a standard EEG-based approach. We provided him with neurofeedback of his brain activity from the epidural space by electrocorticography (ECoG).
  
  
  RESULTS
  Ipsilesional epidural recordings of field potentials facilitated self-regulation of brain oscillations in an online closed-loop paradigm and allowed reliable neurofeedback training for a period of 4 weeks.
  
  
  CONCLUSIONS
  Epidural implants may decode and train brain activity even when the cortical physiology is distorted following severe brain injury. Such practice would allow for reinforcement learning of preserved neural networks and may well provide restorative tools for those patients who are severely afflicted.
authors.affiliation: Division of Functional and Restorative Neurosurgery and Division of Translational Neurosurgery, Department of Neurosurgery, Eberhard Karls University Tuebingen Tuebingen, Germany ; Neuroprosthetics Research Group, Werner Reichardt Centre for Integrative Neuroscience, Eberhard Karls University Tuebingen Tuebingen, Germany.
authors.forename: Alireza
authors.initials: A
authors.lastname: Gharabaghi
authors.affiliation: Division of Functional and Restorative Neurosurgery and Division of Translational Neurosurgery, Department of Neurosurgery, Eberhard Karls University Tuebingen Tuebingen, Germany ; Neuroprosthetics Research Group, Werner Reichardt Centre for Integrative Neuroscience, Eberhard Karls University Tuebingen Tuebingen, Germany.
authors.forename: Georgios
authors.initials: G
authors.lastname: Naros
authors.affiliation: Division of Functional and Restorative Neurosurgery and Division of Translational Neurosurgery, Department of Neurosurgery, Eberhard Karls University Tuebingen Tuebingen, Germany ; Neuroprosthetics Research Group, Werner Reichardt Centre for Integrative Neuroscience, Eberhard Karls University Tuebingen Tuebingen, Germany.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Khademi
authors.affiliation: Division of Functional and Restorative Neurosurgery and Division of Translational Neurosurgery, Department of Neurosurgery, Eberhard Karls University Tuebingen Tuebingen, Germany ; Neuroprosthetics Research Group, Werner Reichardt Centre for Integrative Neuroscience, Eberhard Karls University Tuebingen Tuebingen, Germany.
authors.forename: Jessica
authors.initials: J
authors.lastname: Jesser
authors.affiliation: Department of Computer Engineering, Wilhelm-Schickard Institute for Computer Science, Eberhard Karls University Tuebingen Tuebingen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Spüler
authors.affiliation: Department of Computer Engineering, Wilhelm-Schickard Institute for Computer Science, Eberhard Karls University Tuebingen Tuebingen, Germany.
authors.forename: Armin
authors.initials: A
authors.lastname: Walter
authors.affiliation: Department of Computer Engineering, Wilhelm-Schickard Institute for Computer Science, Eberhard Karls University Tuebingen Tuebingen, Germany ; Department of Computer Engineering, University of Leipzig Leipzig, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Bogdan
authors.affiliation: Department of Computer Engineering, Wilhelm-Schickard Institute for Computer Science, Eberhard Karls University Tuebingen Tuebingen, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rosenstiel
authors.affiliation: Institute for Medical Psychology and Behavioural Neurobiology, Eberhard Karls University Tuebingen Tuebingen, Germany ; Ospedale San Camillo, IRCCS Venice, Italy ; DZD, Eberhard Karls University Tuebingen Tuebingen, Germany.
authors.forename: Niels
authors.initials: N
authors.lastname: Birbaumer
keywords: brain-machine interface; cortical lesion; electrocorticography; epidural implant; neurofeedback; neuroprosthetics; stroke