Stroke survivors who had ceased to benefit from clinically important routine movement and arm control rehabilitation used an external robotic device powered by patients’ own brains. .
The results of the clinical trial were reported in the journal NeuroImage: Clinical.
Jose Luis Contreras-Vidal, director of the non-invasive brain machine interface systems lab at the University of Houston, said tests showed that most patients retained the benefits for at least two months out. after the treatment sessions have ended, suggesting the potential for long-term benefits. . He is also Hugh Roy and Lillie Cranz Cullen Distinguished Professor of Electrical and Computer Engineering.
The experiment involved training stroke survivors with restricted movement in one arm to use a brain-machine interface (BMI), a computer program that captures brain activity to determine the subject’s intentions. test and then stimulate an exoskeleton, or robotic device attached to the affected arm, to move in response to these intentions. The machine would not move unless a resolution was found, ensuring that subjects were still involved in the exercise.
The use of robots in retraining is not new, said Contreras-Vidal, co-lead researcher of the trial and a pioneer in noninvasive BMI systems. But robot-assisted exercise generally does not involve the user, which is essential to take advantage of the plasticity of the brain to allow patients to regain mobility.
This project ensures that the brain is engaged. We know if the arm is moving, this is because they are commanding it to move. That is a very powerful concept. “
Jose Luis Contreras-Vidal, Director, Noninvasive Brain Machine Interface Systems Laboratory, University of Houston
By testing the subjects over time before the trial began, researchers were able to confirm that any changes or improvements were the result of the intervention. In addition to improved arm movement, the researchers reported that the subjects also showed improvements in the use of their hands.
“This is a new way to measure what’s going on in the brain in response to a therapeutic intervention,” said Dr. Gerard Francisco, professor and chair of physical therapy and rehabilitation at the School McGovern Medicine at the University of Texas Health Science Center in Houston and co-principal investigator. “This study suggested that some interventions, in this case using the advanced robot, may stimulate specific parts of the brain to develop the intention to move. In the future, this means that we can augment existing treatment programs by raising awareness of the importance of engaging in specific parts of the brain that may increase the response to treatment. “
The lawsuit was filed at Hermann Memorial TIRR, where Francisco serves as chief medical officer and director of the NeuroRecovery Research Center. The project was a collaboration between UH, UTHealth, TIRR Memorial Hermann, Houston Methodist Research Institute and Rice University.
In addition to Francisco and Contreras-Vidal, who is also director of the BRAIN Center, NSF Business / University Collaborative Research Institute, researchers involved in the project include Nikunj A. Bhagat and Zachary Hernandez and UH; Nuray Yozbatiran and Rupa Paranjape with UTHealth; Dr. Zafer Keser, formerly of UTHealth; Jennifer L. Sullivan, Colin Losey and co-lead investigator Marcia K. O’Malley with Rice; and Dr. Robert Grossman with the Houston Methodist Research Institute. O’Malley is also Director of Rehabilitation Engineering at TIRR Memorial Hermann.
It was funded by the National Institute of Neurological Disorders and Stroke Connection and Mission, part of the TIRR Foundation.
“Those of us who have studied the brain for so many years have expected that its powers, along with robots and the machine-brain interface, could offer incredible benefits to the brain. stroke survivors and other patients with brain injuries, “said Grossman, a professor of neuro – surgery at Houston Methodist. “This study is just the beginning of what will be able to treat stroke, spinal injuries and other traumatic brain injuries in the future.”
The trial spanned several years, in part because it took time to find subjects who met the criteria and were interested in participating and able to meet the time commitment. necessary to do. Eventually, 10 subjects between the ages of 41 and 71 were enrolled.
The treatment took place three times a week for four weeks. The final follow-up test was performed two months after treatment ended, and Contreras-Vidal said it is unclear whether the benefits will be long-term.
That will lead to an ongoing project – Contreras-Vidal has a grant from the National Science Foundation to design a low – cost system that would allow people to continue with their home remedies.
“If we can send them home with a machine, they can use it for life,” he said.
Source:
Magazine Reference:
Bhagat, NA, et al. (2020) Modifications of TNeural activity and motor recovery after central-brain-exoskeleton interface stroke rehabilitation. NeuroImage: Clinical. doi.org/10.1016/j.nicl.2020.102502.