Can Children With Perinatal Stroke Use a Simple Brain Computer Interface?
Zeanna Jadavji1,2,3, Jack Zhang1,2,3, Brett Paffrath1,2,3
1Calgary Pediatric Stroke Program (Z.J., J.Z., B.P., E.Z., A.K.), Cumming School of Medicine, University of Calgary, Canada.
Insights
Children with perinatal stroke can effectively use brain-computer interfaces (BCIs) for basic tasks. This finding opens new avenues for rehabilitation technologies for hemiparetic cerebral palsy.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Perinatal stroke is a primary cause of hemiparetic cerebral palsy, leading to significant lifelong disability.
- Current motor rehabilitation options are limited, particularly for severely affected children.
- Brain-computer interfaces (BCIs) offer a novel approach by translating brain activity into device control.
Purpose of the Study:
- To evaluate the capability of children with perinatal stroke to operate a simple brain-computer interface (BCI).
- To assess BCI competence using specific mental imagery strategies and tasks.
Main Methods:
- Twenty-one children with perinatal stroke and 24 typically developing controls were enrolled.
- Participants underwent two training sessions on an EEG-based BCI, using motor or goal-oriented imagery for two distinct tasks.
- BCI competence was measured using Cohen Kappa, with a score >0.40 indicating proficiency.
Main Results:
- BCI performance was comparable between children with perinatal stroke (mean Kappa=0.39) and controls (mean Kappa=0.42).
- No significant performance differences were found based on stroke type (venous vs. arterial).
- Over 90% of stroke participants achieved competency in at least one task-strategy combination.
Conclusions:
- Children with perinatal stroke can attain proficiency with simple BCI systems.
- This research supports the potential of BCIs for future rehabilitation strategies.
- Exploration of BCI-functional electrical stimulation systems is a promising direction for treating hemiparesis and cerebral palsy.
Background And Purpose:
Perinatal stroke is the leading cause of hemiparetic cerebral palsy resulting in lifelong disability for millions of people worldwide. Options for motor rehabilitation are limited, especially for the most severely affected children. Brain computer interfaces (BCIs) sample brain activity to allow users to control external devices. Functional electrical stimulation enhances motor recovery after stroke, and BCI-activated functional electrical stimulation was recently shown to improve upper extremity function in adult stroke. We aimed to determine the ability of children with perinatal stroke to operate a simple BCI.
Methods:
Twenty-one children with magnetic resonance imaging–confirmed perinatal stroke (57% male, mean [SD] 13.5 [2.6] years, range 9–18) were compared with 24 typically developing controls (71% male, mean age [SD] 13.7 [3.7] years, range 6–18). Participants trained on a simple EEG-based BCI over 2 sessions (10 trials each) utilizing 2 different mental imagery strategies: (1) motor imagery (imagine opening and closing of hands) and (2) goal oriented (imagine effector object moving toward target) to complete 2 tasks: (1) drive a remote controlled car to a target and (2) move a computer cursor to a target. Primary outcome was Cohen Kappa with a score >0.40 suggesting BCI competence.
Results:
BCI performance was comparable between stroke and control participants. Mean scores were 0.39 (0.18) for stroke versus 0.42 (0.18) for controls (t[42]=0.478, P=0.94). No difference in performance between venous (M=0.45, SD=0.29) and arterial (M=0.34, SD=0.22) stroke (t[82]=1.89, P=0.090) was observed. No effect of task or strategy was observed in the stroke participants. Over 90% of stroke participants demonstrated competency on at least one of the 4 task-strategy combinations.
Conclusions:
Children with perinatal stroke can achieve proficiency in basic tasks using simple BCI systems. Future directions include exploration of BCI-functional electrical stimulation systems for rehabilitation for children with hemiparesis and other forms of cerebral palsy.
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