Effects of a Brain-Computer Interface With Virtual Reality (VR) Neurofeedback: A Pilot Study in Chronic Stroke Patients
Rehabilitation for stroke patients with severe motor impairments (e.g., inability to perform wrist or finger extension on the affected side) is burdensome and difficult because most current rehabilitation options require some volitional movement to retrain the affected side. However, although these...
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doaj-686c591c84344841903f9644a13d03702020-11-25T03:12:38ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612019-06-011310.3389/fnhum.2019.00210460405Effects of a Brain-Computer Interface With Virtual Reality (VR) Neurofeedback: A Pilot Study in Chronic Stroke PatientsAthanasios Vourvopoulos0Octavio Marin Pardo1Stéphanie Lefebvre2Meghan Neureither3David Saldana4Esther Jahng5Sook-Lei Liew6Sook-Lei Liew7Neural Plasticity and Neurorehabilitation Laboratory, Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United StatesNeural Plasticity and Neurorehabilitation Laboratory, Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United StatesNeural Plasticity and Neurorehabilitation Laboratory, Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United StatesNeural Plasticity and Neurorehabilitation Laboratory, Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United StatesNeural Plasticity and Neurorehabilitation Laboratory, Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United StatesNeural Plasticity and Neurorehabilitation Laboratory, Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United StatesNeural Plasticity and Neurorehabilitation Laboratory, Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United StatesDepartment of Neurology, Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, United StatesRehabilitation for stroke patients with severe motor impairments (e.g., inability to perform wrist or finger extension on the affected side) is burdensome and difficult because most current rehabilitation options require some volitional movement to retrain the affected side. However, although these patients participate in therapy requiring volitional movement, previous research has shown that they may receive modest benefits from action observation, virtual reality (VR), and brain-computer interfaces (BCIs). These approaches have shown some success in strengthening key motor pathways thought to support motor recovery after stroke, in the absence of volitional movement. The purpose of this study was to combine the principles of VR and BCI in a platform called REINVENT and assess its effects on four chronic stroke patients across different levels of motor impairment. REINVENT acquires post-stroke EEG signals that indicate an attempt to move and drives the movement of a virtual avatar arm, allowing patient-driven action observation neurofeedback in VR. In addition, synchronous electromyography (EMG) data were also captured to monitor overt muscle activity. Here we tested four chronic stroke survivors and show that this EEG-based BCI can be safely used over repeated sessions by stroke survivors across a wide range of motor disabilities. Finally, individual results suggest that patients with more severe motor impairments may benefit the most from EEG-based neurofeedback, while patients with more mild impairments may benefit more from EMG-based feedback, harnessing existing sensorimotor pathways. We note that although this work is promising, due to the small sample size, these results are preliminary. Future research is needed to confirm these findings in a larger and more diverse population.https://www.frontiersin.org/article/10.3389/fnhum.2019.00210/fullbrain-computer interfacesvirtual realityaction observationstrokeneurorehabilitation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Athanasios Vourvopoulos Octavio Marin Pardo Stéphanie Lefebvre Meghan Neureither David Saldana Esther Jahng Sook-Lei Liew Sook-Lei Liew |
spellingShingle |
Athanasios Vourvopoulos Octavio Marin Pardo Stéphanie Lefebvre Meghan Neureither David Saldana Esther Jahng Sook-Lei Liew Sook-Lei Liew Effects of a Brain-Computer Interface With Virtual Reality (VR) Neurofeedback: A Pilot Study in Chronic Stroke Patients Frontiers in Human Neuroscience brain-computer interfaces virtual reality action observation stroke neurorehabilitation |
author_facet |
Athanasios Vourvopoulos Octavio Marin Pardo Stéphanie Lefebvre Meghan Neureither David Saldana Esther Jahng Sook-Lei Liew Sook-Lei Liew |
author_sort |
Athanasios Vourvopoulos |
title |
Effects of a Brain-Computer Interface With Virtual Reality (VR) Neurofeedback: A Pilot Study in Chronic Stroke Patients |
title_short |
Effects of a Brain-Computer Interface With Virtual Reality (VR) Neurofeedback: A Pilot Study in Chronic Stroke Patients |
title_full |
Effects of a Brain-Computer Interface With Virtual Reality (VR) Neurofeedback: A Pilot Study in Chronic Stroke Patients |
title_fullStr |
Effects of a Brain-Computer Interface With Virtual Reality (VR) Neurofeedback: A Pilot Study in Chronic Stroke Patients |
title_full_unstemmed |
Effects of a Brain-Computer Interface With Virtual Reality (VR) Neurofeedback: A Pilot Study in Chronic Stroke Patients |
title_sort |
effects of a brain-computer interface with virtual reality (vr) neurofeedback: a pilot study in chronic stroke patients |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Human Neuroscience |
issn |
1662-5161 |
publishDate |
2019-06-01 |
description |
Rehabilitation for stroke patients with severe motor impairments (e.g., inability to perform wrist or finger extension on the affected side) is burdensome and difficult because most current rehabilitation options require some volitional movement to retrain the affected side. However, although these patients participate in therapy requiring volitional movement, previous research has shown that they may receive modest benefits from action observation, virtual reality (VR), and brain-computer interfaces (BCIs). These approaches have shown some success in strengthening key motor pathways thought to support motor recovery after stroke, in the absence of volitional movement. The purpose of this study was to combine the principles of VR and BCI in a platform called REINVENT and assess its effects on four chronic stroke patients across different levels of motor impairment. REINVENT acquires post-stroke EEG signals that indicate an attempt to move and drives the movement of a virtual avatar arm, allowing patient-driven action observation neurofeedback in VR. In addition, synchronous electromyography (EMG) data were also captured to monitor overt muscle activity. Here we tested four chronic stroke survivors and show that this EEG-based BCI can be safely used over repeated sessions by stroke survivors across a wide range of motor disabilities. Finally, individual results suggest that patients with more severe motor impairments may benefit the most from EEG-based neurofeedback, while patients with more mild impairments may benefit more from EMG-based feedback, harnessing existing sensorimotor pathways. We note that although this work is promising, due to the small sample size, these results are preliminary. Future research is needed to confirm these findings in a larger and more diverse population. |
topic |
brain-computer interfaces virtual reality action observation stroke neurorehabilitation |
url |
https://www.frontiersin.org/article/10.3389/fnhum.2019.00210/full |
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