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Updated: May 31, 2025

Electroencephalography Network Indices as Biomarkers of Upper Limb Impairment in Chronic Stroke
Published on: July 14, 2023
Exploring Machine Learning Classification of Movement Phases in Hemiparetic Stroke Patients: A Controlled EEG-tDCS
Rishishankar E Suresh1,2, M S Zobaer2,3, Matthew J Triano1,3
1College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
Background/Objectives:
Noninvasive brain stimulation (NIBS) can boost motor recovery after a stroke. Certain movement phases are more responsive to NIBS, so a system that auto-detects these phases would optimize stimulation timing. This study assessed the effectiveness of various machine learning models in identifying movement phases in hemiparetic individuals undergoing simultaneous NIBS and EEG recordings. We hypothesized that transcranial direct current stimulation (tDCS), a form of NIBS, would enhance EEG signals related to movement phases and improve classification accuracy compared to sham stimulation.
Methods:
EEG data from 10 chronic stroke patients and 11 healthy controls were recorded before, during, and after tDCS. Eight machine learning algorithms and five ensemble methods were used to classify two movement phases (hold posture and reaching) during each of these periods. Data preprocessing included z-score normalization and frequency band power binning.
Results:
In chronic stroke participants who received active tDCS, the classification accuracy for hold vs. reach phases increased from pre-stimulation to the late intra-stimulation period (72.2% to 75.2%, p < 0.0001). Late active tDCS surpassed late sham tDCS classification (75.2% vs. 71.5%, p < 0.0001). Linear discriminant analysis was the most accurate (74.6%) algorithm with the shortest training time (0.9 s). Among ensemble methods, low gamma frequency (30-50 Hz) achieved the highest accuracy (74.5%), although this result did not achieve statistical significance for actively stimulated chronic stroke participants.
Conclusions:
Machine learning algorithms showed enhanced movement phase classification during active tDCS in chronic stroke participants. These results suggest their feasibility for real-time movement detection in neurorehabilitation, including brain-computer interfaces for stroke recovery.
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