STROKE REHABILITATION
Stroke is the commonest cause of adult complex disability in the world. A major opportunity for improving outcomes is to target the mechanisms of brain recovery and repair. I currently work on biomarkers for motor recovery early post stroke. In the past, used motor imagery in combination with neurofeedback in chronic stroke patients.
BIOMARKERS FOR MOTOR RECOVERY
EARLY POST STROKE
Currently, together with Prof. Nick Ward and funded by Brain Research UK, I focus on the question: Why do some stroke patients recover motor function, whilst others do not. We will take advantage of the observation that in patients with initially severe upper limb impairment, about half have good early recovery whilst the other half do not. We hypothesise that failure of subsequent early recovery is due to (i) failure of early post-stroke plasticity mechanisms and/or (ii) damage to key brain regions important for learning. To answer this question I acquire E/MEG data in the acute stage post-stroke. Further, I collaborate with Dr. Chih-Wei Tang (Far Eastern Memorial Hospital, Taiwan) as well as Prof. Nina Forss and Dr. Kristina Laaksonen (University of Helsinki, Helsinki).
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Related Publications:​
Kuo IJ, Tang CW, Tsai YA, Tang SC, Lin CJ, Hsu SP, Liang WK, Juan CH, Zich C, Stagg C, Lee IH, 2020
Neurophysiological signatures of hand motor response to dual-transcranial direct current stimulation in subacute stroke: a TMS and MEG study
J of Neuroeng Rehabil 17(72): 1-12, ​https://doi.org/10.1186/s12984-020-00706-1
MOTOR IMAGERY IN CHRONIC STROKE
Motor impairment after stroke has previously been associated with decreased laterality of motor cortex activity. We used motor imagery in combination with EEG-based neurofeedback and movement execution in combination with fMRI-based neurofeedback to investigate to probe changes in motor performance and on brain structure and function.
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While motor imagery has been suggested as a promising add-on rehabilitation approach, not much is known about how well stroke patients are able to perform motor imagery. We applied three different motor imagery tasks: mental chronometry task, mental rotation task, and EEG-based neurofeedback task (Braun et al., 2017). Although motor imagery abilities may be impaired after stroke, most patients retain their ability for motor imagery EEG-based neurofeedback. Further, using mobile EEG, I we administered frequent training (i.e., every second day) in chronic stroke survivors at their homes and evaluated the training using multimodal neuroimaging (Zich et al., 2017).
Recently we carried out a randomized, double-blind, sham-controlled trial whether chronic stroke survivors were able to use real-time fMRI neurofeedback to increase laterality of motor cortex activity and found that training is associated with improvements in hand motor performance and with white matter structural changes (Sanders et al., medRxiv).
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Related Publications:​
Zich C, Debener S, Schweinitz C, Sterr A, Meekes J, Kranczioch C, 2017
High intensity chronic stroke motor imagery neurofeedback training at home – three case reports
Clin EEG Neurosci 48 (6): 403-412, https://doi.org/10.1177/1550059417717398
Braun N, Kranczioch C, Liepert J, Dettmers C, Zich C, Büsching I, Debener S, 2017
Motor imagery impairment in post-acute stroke patients
Neural Plast 2017 (4653256), https://doi.org/10.1155/2017/4653256
Sanders ZB, Fleming MK, Smejka T, Marzolla M, Zich C, Rieger S, Lührs M, Goebel R, Sampaio-Baptista C, Johansen-Berg H
Self-modulation of motor cortex activity after stroke alters behavior and corticospinal tract structure: a randomized controlled trial
