title: Improving Motor Corticothalamic Communication After Stroke Using Real-Time fMRI Connectivity-Based Neurofeedback.
abstract: Two thirds of stroke survivors experience motor impairment resulting in long-term disability. The anatomical substrate is often the disruption of cortico-subcortical pathways. It has been proposed that reestablishment of cortico-subcortical communication relates to functional recovery.
  
  
  
  In this study, we applied a novel training protocol to augment ipsilesional cortico-subcortical connectivity after stroke. Chronic stroke patients with severe motor impairment were provided online feedback of blood-oxygenation level dependent signal connectivity between cortical and subcortical regions critical for motor function using real-time functional magnetic resonance imaging neurofeedback.
  
  
  
  In this proof of principle study, 3 out of 4 patients learned to voluntarily modulate cortico-subcortical connectivity as intended.
  
  
  
  Our results document for the first time the feasibility and safety for patients with chronic stroke and severe motor impairment to self-regulate and augment ipsilesional cortico-subcortical connectivity through neurofeedback using real-time functional magnetic resonance imaging.
authors.affiliation: Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA Chan Division of Occupational Science and Occupational Therapy, Division of Physical Therapy and Biokinesiology, Department of Neurology, University of Southern California, Los Angeles, CA, USA sliew@usc.edu.
authors.forename: Sook-Lei
authors.initials: SL
authors.lastname: Liew
authors.affiliation: Institute for Medical and Biological Engineering, and Department of Psychiatry and Section of Neuroscience, Schools of Engineering, Medicine and Biology, Pontificia Universidad Católica de Chile, Santiago, Chile Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA.
authors.forename: Mohit
authors.initials: M
authors.lastname: Rana
authors.affiliation: Center for Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, Eberhard Karls University, Tübingen, Germany.
authors.forename: Sonja
authors.initials: S
authors.lastname: Cornelsen
authors.affiliation: Applied Neurotechnology Lab, Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany.
authors.forename: Marcos
authors.initials: M
authors.lastname: Fortunato de Barros Filho
authors.affiliation: Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany IRCSS, Ospedale San Camillo, Venice, Italy.
authors.forename: Niels
authors.initials: N
authors.lastname: Birbaumer
authors.affiliation: Institute for Medical and Biological Engineering, and Department of Psychiatry and Section of Neuroscience, Schools of Engineering, Medicine and Biology, Pontificia Universidad Católica de Chile, Santiago, Chile Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA.
authors.forename: Ranganatha
authors.initials: R
authors.lastname: Sitaram
authors.affiliation: Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA.
authors.forename: Leonardo G
authors.initials: LG
authors.lastname: Cohen
authors.affiliation: Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany Applied Neurotechnology Lab, Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany.
authors.forename: Surjo R
authors.initials: SR
authors.lastname: Soekadar
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D062207:Brain-Computer Interfaces; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000000981:diagnostic imaging*; D058765:Neurofeedback / Q000379:methods*; D009862:Online Systems; D010100:Oxygen / Q000097:blood; D020521:Stroke / Q000000981:diagnostic imaging*; D000071939:Stroke Rehabilitation
chemical_list: D010100:Oxygen
keywords: brain-machine interface (BMI); connectivity; neurofeedback; real-time functional magnetic resonance imaging (rtfMRI); stroke