Non-Invasive Brain Signal Training to Induce Motor Control Recovery After Stroke

The financial burden and human suffering are devastating after stroke due to the lack of
rehabilitation protocols that can restore normal brain and motor function. Conventional
treatment does not restore normal motor function to many stroke survivors. The majority of
available treatments are directed at the peripheral nervous system (arms/legs). Since stroke
occurs in the brain and results in brain damage and dysfunction, a more direct approach may
be to re-train the brain by directly treating the activation of brain signals that control
movement.

The purposes of this study are to determine if motor learning, functional electrical
stimulation (FES), and brain computer interface (BCI) training are beneficial for restoring
arm function in people who have had a stroke, and to determine if the surface-acquired brain
signal [electroencephalography (EEG)] can be re-trained to provide more normal motor
function in stroke survivors. The primary purpose of this study is to determine the efficacy
of the motor learning tasks in stroke recovery.

In the study, scientists will use two different and complimentary brain signal training
components to restore more normal motor control of a motor task (elbow, wrist, or finger
movement task). Specifically targeting, invoking, and training the surface-acquired EEG
brain signal, and integrating brain signal training into motor learning training of upper
limb motor tasks, may result in greater motor restoration when compared to a comprehensive
motor learning intervention without EEG brain signal training.

Thirty six people who have had a stroke will be enrolled in the experimental group. They
will receive brain signal training and be assigned to one of three groups: elbow
coordination impairment; wrist impairment; or finger coordination impairment. The BCI
training will focus on the movement impairment for each group, respectively. Treatment will
be 5 hours a day, 5 days a week, for 12 weeks, based on prior established motor learning
protocols. A single day—5-hour session—will be composed of the following: up to 1 hour of
brain signal training; up to 1.5 hours of FES-assisted movement practice; and up to 2.5
hours of motor learning.

Up to an additional 30 healthy adults will be enrolled in order to study their ability to
acquire brain signal control and the characteristics of their brain signal during the tasks
that the stroke participants will attempt.

Directly and effectively treating the brain (where the stroke occurred) has the potential to
shorten rehabilitation time, reduce therapist/patient ratio, more completely restore motor
function, restore motor function to a higher percentage of patients after stroke, and the
method may possibly be applicable to other neurological diagnoses.

Inclusion Criteria:

- medically stable and >/= 6 months post stroke

- difficulty using upper limb for functional tasks

- >21 years old

Exclusion Criteria:

- chronic, progressive medical condition (i.e. Parkinson's disease)