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Updated: Mar 28, 2026
Author Spotlight: Using Motor Imagery Brain-Computer Interface to Improve Motor and Cognitive Function in Stroke Patients
Published on: September 1, 2023
Improving Motor Corticothalamic Communication After Stroke Using Real-Time fMRI Connectivity-Based Neurofeedback
Sook-Lei Liew1, Mohit Rana2, Sonja Cornelsen3
1Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA Chan Division of Occupational Science and Occupational Therapy, Division of Physical Therapy and Biokinesiology, Department of Neurology, University of Southern California, Los Angeles, CA, USA sliew@usc.edu.
Stroke survivors can improve motor function by learning to enhance brain connectivity. Real-time neurofeedback using functional magnetic resonance imaging (fMRI) shows promise for stroke rehabilitation.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Medical Imaging
Background:
- Motor impairment affects two-thirds of stroke survivors, often due to disrupted cortico-subcortical pathways.
- Re-establishing cortico-subcortical communication is hypothesized to be key for functional recovery after stroke.
Purpose of the Study:
- To investigate a novel training protocol for augmenting ipsilesional cortico-subcortical connectivity in chronic stroke patients.
- To assess the feasibility and safety of using real-time fMRI neurofeedback for self-regulation of brain connectivity.
Main Methods:
- A novel training protocol using real-time fMRI neurofeedback was applied to chronic stroke patients with severe motor impairment.
- Patients received online feedback on blood-oxygen-level-dependent (BOLD) signal connectivity between motor-related cortical and subcortical regions.
Main Results:
- Three out of four patients successfully learned to voluntarily modulate their cortico-subcortical connectivity as intended.
- The study demonstrated proof of principle for the training protocol's effectiveness.
Conclusions:
- This study is the first to document the feasibility and safety of using real-time fMRI neurofeedback for self-regulation of ipsilesional cortico-subcortical connectivity in chronic stroke survivors.
- The findings support neurofeedback as a potential therapeutic approach for stroke rehabilitation aimed at improving motor function.
