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C1: Motor restoration with brain-machine interface systems in chronic stroke

Niels BirbaumerZ, Surjo Soekadar, Cornelius Weiller#

Z = Institute of Medical Psychology and Behavioral Neurobiology
# = Neurology Centre, University Medical Center
 


Scientific background

Stroke is a common disorder that produces a major burden to society, largely through long-lasting motor disability in survivors. Birbaumer & Cohen developed a BMI-system based on magnetoencephalography (MEG) and showed that chronic stroke patients with no residual movement are able to move a completely paralyzed hand fixed to a flexible peripheral orthosis by imagining these movements: the movement commands originating from non-invasive MEG-recordings moves the peripheral orthosis according to the voluntary intention. BMI-use was accompanied by vast cortical reorganization. Recent work strongly implies that the combination of BMI-technology, neurostimulation and physiotherapy may have beneficial effects on motor recovery, even in patients with chronic stroke and no residual motor function.


Objectives

Together with the industrial partners Motorika (Cesarea, Israel), Localite, Mag&More and Schwarzer, an integrated physical rehabilitation robot system shall be combined with a BMI-system, physiotherapy and neuronavigated non-invasive brain stimulation (transcranial magnetic (TMS) and DC (tDCS) electrical stimulation). Three-dimensional movements of the robot and the paralyzed hand placed on the robot are driven by the patients’ voluntary intentions and motor imagery recorded from cortical regions close to the lesion. The project will investigate the transfer from magnetic voluntary control of the paralyzed hand to portable non-invasive EEG- and invasive ECoG-based devices. Neuronavigated brain stimulation is used to improve cortical plasticity and strengthen beneficial cortical reorganization patterns during the BMI-training. In cooperation with C2 (Tatagiba, Gharabagi) the system will be used in selected patients with implanted electrodes placed above a brain area near the lesion. Mechanisms underlying motor recovery in chronic stroke patients will be elucidated and directly transferred into clinical practise. Innovative non-invasive and invasive BMI-devices will be developed and applied.

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