Brain–Machine Interface-Driven Post-Stroke Upper-Limb Functional Recovery Correlates With Beta-Band Mediated Cortical Networks

Brain-machine interface (BMI)-driven robot-assisted neurorehabilitation intervention has demonstrated improvement in upper-limb (UL) motor function, specifically, with post-stroke hemiparetic patients. However, neurophysiological patterns related to such interventions are not well understood. This paper examined the longitudinal changes in band-limited resting-state (RS) functional connectivity (FC) networks in association with post-stroke UL functional recovery achieved by a multimodal intervention involving motor attempt (MA)-based BMI and robotic hand-exoskeleton. Four adults were rehabilitated with the intervention for a period lasting up to six weeks. RS magnetoencephalography (MEG) signals, Action Research Arm Test (ARAT), and grip strength (GS) measures were recorded at five equispaced sessions over the intervention period. An average post-interventional increase of 100.0% (p = 0.00028) and 88.0% was attained for ARAT and GS, respectively. A cluster-based statistical test involving correlation estimates between beta-band (15-26 Hz) RS-MEG FCs and UL functional recovery provided the positively correlated sub-networks in both the contralesional and ipsilesional motor cortices. The frontoparietal FC exhibited hemispheric lateralization wherein the majority of the positively and negatively correlated connections were found in contralesional and ipsilesional hemispheres, respectively. Our findings are consistent with the theory of bilateral motor cortical association with UL recovery and predict novel FC patterns that can be important for higher level cognitive functions.