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CompletedNCT04376138Updated Dec 13, 2024

Longitudinal Validation of Neurofeedback in Stroke Motor Rehabilitation Through Brain Imaging

An interventional study of BCI intervention and Conventional Therapy in Stroke, sponsored by Universidade da Madeira. Completed at 1 site in Portugal. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2024-12-13.

Sponsored by Universidade da Madeira · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 7 months after the study started (first participant enrolled Aug 2019, registered Apr 2020).
Phase
Not applicable
Study type
Interventional
Enrollment
15
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

With the main goal of generalising findings into Virtual Reality-Neurofeedback-Motor imagery (VR-NF-MI) system, this project aims to develop a new motor rehabilitation tool, for the upper limb, allied to the use of rising of information and communication technologies (ICT). By identifying correlations on the neural activity, during motor imagery and through brain imaging (fMRI), with distinct training protocols and feedback, these protocols are developed to create user-specific models that later can be used in NF-MI rehabilitation sessions.

Read the detailed description

Every year millions of people worldwide suffer from stroke, being one of the leading causes of death and longterm disability. This leads to cognitive and motor impairments, resulting in loss of independence in their daily life together with an additional psychological impact in mood disorders and depression. Evolving to a chronic condition, stroke requires continuous rehabilitation and therapy. Personalised Virtual-Reality (VR) approaches have been shown to accelerate the recovery process compared to non-Information and communication technologies (ICT) based interventions. However, most of these novel VR approaches are suitable only for a reduced subset of patients, generally those with better recovery prognostics and better motor control. Thus, the idea of training the central nervous system was established, through EEG-based neurofeedback (NF) and motor-imagery (MI). Although the benefits of MI-NF have been illustrated in a plethora of studies, the reduced ability for stroke patients to use NF does not allow an accurate control, reducing the capabilities of MI-NF systems. The aim of this project is to develop a novel and more inclusive rehabilitation system with the use of novel ICT technologies, in order to overcome current limitations. This will be achieved by identifying the neural correlates of motor action during motor imagery through brain imaging (fMRI), and differences in brain activation with different training feedback protocols for formulating user-specific models that will be used later in NF-MI rehabilitation sessions. This will facilitate the use of neural interfaces to train the central nervous system; specifically, the investigators will develop a personalized EEG-based immersive NF through VR for MI training. The ultimate goal is to generalize the findings into a VR-NF-MI training paradigm for both admitted and ambulatory patients as well as continued domestic care.

02

Conditions studied

  • Stroke

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Keywords

  • Brain Computer Interface
  • Virtual Reality
  • Stroke rehabilitation
  • Electroencephalography
  • Motor Imagery
03

In context

Stroke

7,286 studies on the registry are indexed under Stroke; 2,007 are open to participants now.

This study's enrollment of 15 is below the median of 50 across 5,369 interventional studies indexed under Stroke.

Browse Stroke studies →

Lead sponsor

Universidade da Madeira is the lead sponsor of 9 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • First stroke episode
  • More than six months after stroke
  • Stroke hemiplegia/hemiparesis, (Fugl Meyer below or equal to 47)
  • Capacity to understand and complete simple tasks
  • Know how to read and write
  • Motivation to participate

Exclusion criteria

Exclusion Criteria:

  • Hemi spatial neglect
  • Depressive symptoms, moderate to severe
  • Presence of other neurological or orthopaedic problems
  • Severe eyesight problems
  • Claustrophobia
  • Presence of ferromagnetic materials
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
15 participants (actual)

Study arms

  • Experimental
    Motor Imagery

    A Brain-Computer Interaction (BCI) based intervention while receiving conventional therapy. Use of motor imagery training, allied with brain-computer interaction, as a solution to promote motor and cognitive gains in stroke survivors.

    Other: BCI intervention

  • Active comparator
    Conventional Therapy

    Extra Occupational Therapy sessions while receiving conventional therapy. Use of conventional therapy techniques and tools for motor rehabilitation, following the original therapeutic intervention plan of the participants.

    Other: Conventional Therapy

Interventions

  • OtherBCI intervention

    30 minutes intervention that occurs 3 times per week, with a goal of 12 sessions total.

    Also known as: Brain Computer Interaction (BCI) and neurofeedback for stroke rehabilitation

  • OtherConventional Therapy

    30 minutes intervention that occurs 3 times per week, with a goal of 12 sessions total.

    Also known as: Traditional motor rehabilitation for the upper limb

06

What researchers measure

Primary outcomes

  1. Change from the baseline in the functional magnetic resonance imaging (fMRI)

    Analyze cortical activation, during motor imagery exercises, and cortical structure.

    Time frame: Baseline, Final (4 weeks) and 1 month follow up

  2. Change from the baseline in the Fugl Meyer Motor Assessment

    Evaluates the motor function of the affected upper limb. This section has a maximum score of 66 and changes to a higher score means an evolution on motor recovery.

    Time frame: Baseline, Final (4 weeks) and 1 month follow up

Secondary outcomes

  1. Change from the baseline in the electroencephalography (EEG) data

    Analyze brain activity during motor imagery training to identify the best EEG features that better correlate with the brain activity in motor areas of each participant using Common Spatial Pattern filters. Examine different modulation rhythms focusing on Alpha and Beta rhythms, during Motor imagery for each BCI session, aiming to find changes in brain activity, in motor and cognitive areas that are related to motor imagery. Some feature candidates are, Power, Connectivity and Event-Related Synchronization/Desynchronization (ERS/ERD) maps.

    Time frame: In all 12 sessions for 4 weeks

  2. Change from the baseline in the Kinesthetic and Visual Imagery Questionnaire (KVIQ)

    Assess the motor imagery capacity of the stroke participants. The maximum score is 100 and a high score reflects a greater ability to visualize and feel imaginary movements.

    Time frame: Baseline, Final (4 weeks) and 1 month follow up

  3. Change from the baseline in the Montreal Cognitive Assessment (MoCA)

    The screening test used to assess different cognitive domains. The test has a total of 30 points; the higher the score the lesser the probability of cognitive impairment.

    Time frame: Baseline, Final (4 weeks) and 1 month follow up

  4. Change from the baseline in the Modified Ashworth Scale (MAS)

    Assess muscle tone during movement, in the elbow joint. The score is valued from 0 to 4 (0, 1, 1+, 2, 3 and 4), a higher score is related to higher spasticity and muscle tone.

    Time frame: Baseline, Final (4 weeks) and 1 month follow up

  5. Change from the baseline in the Geriatric Depression Scale (GDS)

    Self-report assessment to measure depression symptoms in the elderly. It has a maximum score of 30 points where a score superior to 21 is indicative of the presence of severe depression. From 11 to 20 points is indicative of mild depression and a score equal or inferior to 10, to the absence of depression.

    Time frame: Baseline, Final (4 weeks) and 1 month follow up

07

Study locations

1 site
  • Serviço de Saúde da Região Autónoma da Madeira
    Funchal, Madeira 9004-514, Portugal
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 13, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT04376138
Lead sponsor
Universidade da Madeira
Collaborators
Serviço de Saúde da Região Autónoma da Madeira (SESARAM), E.P.E.
Responsible party
Sergi Bermúdez i Badia (Associate Professor, Universidade da Madeira) — Principal investigator
First posted
May 6, 2020
Start date
Aug 17, 2019
Primary completion
Dec 30, 2023
Completion
Dec 31, 2023
Last update
Dec 13, 2024

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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