Neuromodulation et interface cerveau-machine / Société de neurophysiologie

Le 17/10/2019 de 14:30 à 16:00

Président(s): Jean-pascal LEFAUCHEUR
Modérateur(s): Djamel BENSMAIL, Pierre BURBAUD, Bertrand GLIZE, Perrine SEGUIN

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Neurofeedback bimodal EEG-IRM fonctionnelle après AVC: une étude pilote

Simon Butet (Rennes Cedex 9, France), Anatole Lecuyer (Rennes, France), Giulia Lioi (Rennes, France), Isabelle Bonan (Rennes Cedex 9, France), Emilie Leveque-Le Bars (Rennes Cedex 9, France), Christian Barillot (Rennes, France), Mathis Fleury (Rennes, France)

Objective : Recent studies have revealed the potential of neurofeedback (NF) for upper limb recovery after stroke (1). The majority of Neurofeedback (NF) approaches for motor recovery have relied solely on EEG recordings. EEG advantages are practicability and high time resolution, but it suffers from a limited spatial resolution and access to deeper areas. On the contrary, fMRI NF (2) allows to more precisely identify cortical targets. Recent study (3) have revealed the potential of coupling EEG and fMRI to achieve a more specific regulation.
Four chronic stroke patients (54-76 years, 2 females) participated. The experimental protocol included an alternation of 2 bimodal EEG-fMRI NF and 3 unimodal EEG-only NF sessions. The experiment was run using a NF platform (4) performing real-time EEG-fMRI processing and bimodal NF presentation. Diffusion tensor imaging was performed and fractional anisotropy (FA) calculated to assess the asymmetry between ipsilesional and controlesional corticospinal tract (CST). The NF metaphor consisted of a ball moving on a gauge proportionally to the EEG and fMRI scores.
All the patients were able to upregulate the brain activity in the target cortical areas during the NF training. Two patients showed significant increased activation of the ipsilesional M1 at the end of the training and exhibited a larger involvement (BOLD signal) of the ipsilesional motor and premotor areas in the second NF training sessions. They also showed a better FMA-UE score at the end of the training. The analysis of the CST integrity revealed that a high degree of symmetry was preserved in this two patients.
These preliminary results confirmed the feasibility and indicate the potential of a guided, multitarget and multimodal NF training approach on chronic stroke patients. The role of the CST integrity for stroke motor recovery and its relation to functional brain regulation of the ipsilesional motor cortex seems to be critical.