Effects of motor imagery-based neurofeedback training after bilateral repetitive transcranial magnetic stimulation on post-stroke upper limb motor function: an exploratory crossover clinical trial.

Objective: To examine the clinical effects of combining motor imagery-based neurofeedback training with bilateral repetitive transcranial magnetic stimulation for upper limb motor function in subacute and chronic stroke. Design: Clinical trial following an AB/BA crossover design with counterbalanced...

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Bibliographic Details
Authors: Sánchez Cuesta, Francisco José, González Zamorano, Yeray, Moreno Verdú, Marcos, Vourvopoulos, Athanasios, Serrano, Ignacio J., Del Castillo-Sobrino, Maria Dolores, Figueiredo, Patrícia, Romero Muñoz, Juan Pablo
Format: article
Publication Date:2024
Country:España
Institution:Universidad Francisco de Vitoria
Repository:DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria
Language:English
OAI Identifier:oai:ddfv.ufv.es:10641/5206
Online Access:https://hdl.handle.net/10641/5206
Access Level:Open access
Keyword:Repetitive transcranial magnetic stimulation
Motor imagery
Neurofeedback
Stroke
Motor cortex
Upper limb
Description
Summary:Objective: To examine the clinical effects of combining motor imagery-based neurofeedback training with bilateral repetitive transcranial magnetic stimulation for upper limb motor function in subacute and chronic stroke. Design: Clinical trial following an AB/BA crossover design with counterbalanced assignment. Subjects: Twenty individuals with subacute (n = 4) or chronic stroke (n = 16). Methods: Ten consecutive sessions of bilateral repetitive transcranial magnetic stimulation alone (therapy A) were compared vs a combination of10 consecutive sessions of bilateral repetitive transcranial magnetic stimulation with 12 non-consecutive sessions of motor imagery-based neurofeedback training (therapy B). Patients received both therapies (1-month washout period), in sequence AB or BA. Participants were assessed before and after each therapy and at 15-days follow-up, using the Fugl-Meyer Assessment-upper limb, hand-grip strength, and the Nottingham Sensory Assessment as primary outcome measures. Results: Both therapies resulted in improved functionality and sensory function. Therapy B consistently exhibited superior effects compared with therapy A, according to Fugl-Meyer Assessment and tactile and kinaesthetic sensory function across multiple time-points, irrespective of treatment sequence. No statistically significant differences between therapies were found for hand-grip strength. Conclusion: Following subacute and chronic stroke, integrating bilateral repetitive transcranial magnetic stimulation and motor imagery-based neurofeedback training has the potential to enhance functional performance compared with using bilateral repetitive transcranial magnetic stimulation alone in upper limb recovery.