Characterization of Functional Connectivity in Chronic Stroke Subjects after Augmented Reality Training

Abstract

Augmented reality (AR) tools have been investigated with promising outcomes in rehabilitation. Recently, some studies have addressed the neuroplasticity effects induced by this type of therapy using functional connectivity obtained from resting-state functional magnetic resonance imaging (rs-fMRI). This work aims to perform an initial assessment of possible changes in brain functional connectivity associated with the use of NeuroR, an AR system for upper limb motor rehabilitation of poststroke participants. An experimental study with a case series is presented. Three chronic stroke participants with left hemiparesis were enrolled in the study. They received eight sessions with NeuroR to provide shoulder rehabilitation exercises. Measurements of range of motion (ROM) were obtained at the beginning and end of each session, and rs-fMRI data were acquired at baseline (pretest) and after the last training session (post-test). Functional connectivity analyses of the rs-fMRI data were performed using a seed placed at the noninjured motor cortex. ROM increased in two patients who presented spastic hemiparesis in the left upper limb, with a change in muscle tone, and stayed the same (at zero angles) in one of the patients, who had the highest degree of impairment, showing flaccid hemiplegia. All participants had higher mean connectivity values in the ipsilesional brain regions associated with motor function at post-test than at pretest. Our findings show the potential of the NeuroR system to promote neuroplasticity related to AR-based therapy for motor rehabilitation in stroke participants.