Why we should systematically assess, control and report somatosensory impairments in BCI-based motor rehabilitation after stroke studies

Léa Pillette, Fabien Lotte, Bernard N’Kaoua, Pierre-Alain Joseph, Camille Jeunet, Bertrand Glize
NeuroImage: Clinical. 2020-01-01; 28: 102417
DOI: 10.1016/j.nicl.2020.102417

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Pillette L(1), Lotte F(2), N’Kaoua B(3), Joseph PA(4), Jeunet C(5), Glize B(6).

Author information:
(1)Inria, 200 av.de la Vieille Tour, 33400 Talence, France; LaBRI (Univ.Bordeaux,
CNRS, Bordeaux-INP), 351, cours de la Libération, 33405 Talence, France.
Electronic address: .
(2)Inria, 200 av.de la Vieille Tour, 33400 Talence, France; LaBRI (Univ.Bordeaux,
CNRS, Bordeaux-INP), 351, cours de la Libération, 33405 Talence, France.
Electronic address: .
(3)Handicap, Activity, Cognition, Health, Inserm/University of Bordeaux, 146 rue
Léo Saignat, 33076 Bordeaux cedex, France. Electronic address:
.
(4)Handicap, Activity, Cognition, Health, Inserm/University of Bordeaux, 146 rue
Léo Saignat, 33076 Bordeaux cedex, France; Service MPR Pôle de Neurosciences
Cliniques CHU, University of Bordeaux, Place Amélie Raba-Léon, 33000 Bordeaux
cedex, France. Electronic address: .
(5)CLLE (CNRS, Univ.Toulouse Jean Jaurès), 5 Allées Antonio Machado, 31058
Toulouse cedex 9, France. Electronic address: .
(6)Handicap, Activity, Cognition, Health, Inserm/University of Bordeaux, 146 rue
Léo Saignat, 33076 Bordeaux cedex, France; Service MPR Pôle de Neurosciences
Cliniques CHU, University of Bordeaux, Place Amélie Raba-Léon, 33000 Bordeaux
cedex, France. Electronic address: .

The neuronal loss resulting from stroke forces 80% of the patients to undergo
motor rehabilitation, for which Brain-Computer Interfaces (BCIs) and
NeuroFeedback (NF) can be used. During the rehabilitation, when patients attempt
or imagine performing a movement, BCIs/NF provide them with a synchronized
sensory (e.g., tactile) feedback based on their sensorimotor-related brain
activity that aims at fostering brain plasticity and motor recovery. The
co-activation of ascending (i.e., somatosensory) and descending (i.e., motor)
networks indeed enables significant functional motor improvement, together with
significant sensorimotor-related neurophysiological changes. Somatosensory
abilities are essential for patients to perceive the feedback provided by the BCI
system. Thus, somatosensory impairments may significantly alter the efficiency of
BCI-based motor rehabilitation. In order to precisely understand and assess the
impact of somatosensory impairments, we first review the literature on
post-stroke BCI-based motor rehabilitation (14 randomized clinical trials). We
show that despite the central role that somatosensory abilities play on BCI-based
motor rehabilitation post-stroke, the latter are rarely reported and used as
inclusion/exclusion criteria in the literature on the matter. We then argue that
somatosensory abilities have repeatedly been shown to influence the motor
rehabilitation outcome, in general. This stresses the importance of also
considering them and reporting them in the literature in BCI-based rehabilitation
after stroke, especially since half of post-stroke patients suffer from
somatosensory impairments. We argue that somatosensory abilities should
systematically be assessed, controlled and reported if we want to precisely
assess the influence they have on BCI efficiency. Not doing so could result in
the misinterpretation of reported results, while doing so could improve (1) our
understanding of the mechanisms underlying motor recovery (2) our ability to
adapt the therapy to the patients’ impairments and (3) our comprehension of the
between-subject and between-study variability of therapeutic outcomes mentioned
in the literature.

Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.

 

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