News | December 02, 2013

Rehabilitation Device Improves Motor Skills After Stroke

December 2, 2013 — Using a stroke rehabilitation device that converts an individual's thoughts to electrical impulses to move upper extremities, stroke patients reported improvements in their motor function and ability to perform everyday activities. Results of the study were presented at the Radiological Society of North America Annual Meeting (RSNA 2013).
 
"Each year, nearly 800,000 people suffer a new or recurrent stroke in the United States and 50 percent of those have some degree of upper extremity disability," said Vivek Prabhakaran, M.D., Ph.D. and director of functional neuroimaging in radiology, University of Wisconsin-Madison. "Rehabilitation sessions with our device allow patients to achieve an additional level of recovery and a higher quality of life."
 
Prabhakaran, along with Justin Williams, Ph.D. and co-principal investigator, and a multidisciplinary team, built the new rehabilitation device by pairing a functional electrical stimulation (FES) system, which is currently used to help stroke patients recover limb function, and a brain control interface (BCI), which provides a direct communication pathway between the brain and this peripheral stimulation device.
 
In an FES system, electrical currents are used to activate nerves in paralyzed extremities. Using a computer and an electrode cap placed on the head, the new BCI-FES device (called the Closed-Loop Neural Activity-Triggered Stroke Rehabilitation Device) interprets electrical impulses from the brain and transmits the information to the FES.
 
"FES is a passive technique in that the electrical impulses move the patients' extremities for them," said Prabhakaran. "When a patient using our device is asked to imagine or attempt to move his or her hand, the BCI translates that brain activity to a signal that triggers the FES. Our system adds an active component to the rehabilitation by linking brain activity to the peripheral stimulation device, which gives the patients direct control over their movement."
 
The Wisconsin team conducted a small clinical trial of their rehabilitation device, enlisting eight patients with one hand affected by stroke. The patients were also able to serve as a control group by using their normal, unaffected hand. Patients in the study represented a wide range of stroke severity and amount of time elapsed since the stroke occurred. Despite having received standard rehabilitative care, the patients had varying degrees of residual motor deficits in their upper extremities. Each underwent nine to 15 rehabilitation sessions of two to three hours with the new device over a period of three to six weeks.
 
The patients also underwent functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) before, at the mid-point of, at the end of and one month following the rehabilitation period. fMRI is able to show which areas of the brain are activated while the patient performs a task, and DTI reveals the integrity of fibers within the white matter that connects the brain's functional areas.
 
Patients who suffered a stroke of moderate severity realized the greatest improvements to motor function following the rehabilitation sessions. Patients diagnosed with mild and severe strokes reported improved ability to complete everyday activities following rehabilitation.
 
Prabhakaran said the results captured throughout the rehabilitation process — specifically the ratio of hemispheric involvement of motor areas — related well to the behavioral changes observed in patients. A comparison of pre-rehabilitation and post-rehabilitation fMRI results revealed reorganization in the regions of the brain responsible for motor function. DTI results over the course of the rehabilitation period revealed a gradual strengthening of the integrity of the fiber tracts.
 
"Our hope is that this device not only shortens rehabilitation time for stroke patients, but also that it brings a higher level of recovery than is achievable with the current standard of care," said Prabhakaran. "We believe brain imaging will be helpful in both planning and tracking a stroke patient's therapy, as well as learning more about neuroplastic changes during recovery."
 
Other co-authors are Dorothy Farrar-Edwards, Ph.D., Justin Sattin, M.D., Mitch Tyler, Ph.D., Veena Nair, Ph.D., Svyatoslav Vergun, B.S., Leo Walton, B.S., Jie Song, M.S., and Brittany Young, B.A., B.S.
 
For more information: intranet.med.wisc.edu, www.rsna.org

Related Content

Russian Team Developing New Technology to Significantly Reduce MRI Research Costs
News | Magnetic Resonance Imaging (MRI)| January 16, 2018
January 16, 2018 — Researchers from the NUST MISIS Engineering Center for Industrial Technologies in Russia have deve
Videos | Magnetic Resonance Imaging (MRI)| December 13, 2017
Emanuel Kanal, M.D., director of MRI services and professor of radiology and neuroradiology at the University of Pitt
GE Healthcare Launches Blanket-Like Air Technology MRI Coils
Technology | Magnetic Resonance Imaging (MRI)| December 13, 2017
GE Healthcare announced U.S. FDA 510(k) clearance of its new Air Technology, what it calls an industry-first suite of...
Toshiba Vantage Galan 3T XGO Edition MRI Features New Advanced Gradient
Technology | Magnetic Resonance Imaging (MRI)| December 11, 2017
Toshiba Medical, a Canon Group company, demonstrated the Vantage Galan 3T XGO Edition with the all-new Saturn X...
Toshiba Launches Vantage Elan Zen Edition MR for Enhanced Patient Comfort
Technology | Magnetic Resonance Imaging (MRI)| December 05, 2017
Toshiba Medical, a Canon Group company, introduced its newest magnetic resonance (MR) system, the Vantage Elan/Zen...
FDA Clears Siemens Magnetom Terra 7T MRI Device

The FDA has cleared the Siemens Magnetom Terra as the first 7T MRI system in the U.S. to gain regulatory approval.

Technology | Magnetic Resonance Imaging (MRI)| October 12, 2017
The U.S. Food and Drug Administration (FDA) cleared the first 7 Tesla (7T) magnetic resonance imaging (MRI) device,...
MR Solutions Showcases Multimodality MRI Solutions on Two Continents
News | Magnetic Resonance Imaging (MRI)| October 11, 2017
MR Solutions took their cryogen-free preclinical multimodality magnetic resonance imaging (MRI) solutions on tour in...
Toshiba Showcases MRI Workflow Enhancements at RSNA 2017
News | Magnetic Resonance Imaging (MRI)| September 21, 2017
September 21, 2017 — Toshiba Medical will highlight its latest...
GE Healthcxare Signa Pioneer MAGIC six contrasts in one scan software by SyntheticMR.

The MRI software enables several different contrasts to be obtained from one scan, shortening scan times.

Feature | Magnetic Resonance Imaging (MRI)| August 31, 2017
August 31, 2017 — The U.S. Food and Drug Administration (FDA) has granted market clearance for SyntheticMR’s SyMRI.
ISMRM Issues Guidelines for MRI Gadolinium Contrast Agents
News | Magnetic Resonance Imaging (MRI)| August 15, 2017
The International Society for Magnetic Resonance in Medicine (ISMRM) has provided new guidance in the use of contrast...
Overlay Init