Abstract
Stroke is one of the leading causes for severe adult long-term disability. The number of people who depend on assistance in their daily life activities has drastically increased over the last years and will further accumulate due to demographic factors. Besides impact on cognitive and affective brain function, motor paralysis is the heaviest burden of stroke. While recent studies demonstrated the human brain’s remarkable capacity to reorganize and restore function under effective learning conditions, most rehabilitation strategies require residual movements that, however, are lacking in up to 30–50 % of stroke survivors. For these patients, there is currently no standardized or accepted treatment strategy. Recently it was shown that brain–machine interfaces (BMI) translating electric or metabolic brain signals into control signals of computers or machines provide two strategies that play an increasing role for the recovery of these stroke survivors’ motor function: first, assistive BMIs striving for continuous high-dimensional brain control of robotic devices or functional electric stimulation (FES) to assist in performing daily life activities and, second, rehabilitative BMIs aiming at augmentation of neuroplasticity facilitating recovery of brain function. Recent demonstrations of such assistive and rehabilitative BMI system’s clinical applicability, safety, and efficacy suggest that BMIs will play a substantial role in rehabilitation strategies for severe motor paralysis after stroke.
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Acknowledgments
This work was supported by the Intramural Research Program (IRP) of the National Institute of Neurological Disorders and Stroke (NINDS), USA; the German Federal Ministry of Education and Research (BMBF, grant number 01GQ0831, 16SV5838K to SRS and NB); the BMBF to the German Center for Diabetes Research (DZD e.V., grand number 01GI0925), the Deutsche Forschungsgemeinschaft (DFG, grant number SO932-2 to SRS and Reinhart Koselleck support to NB); the European Commission under the project WAY (grant number 288551 to SRS and NB); and the Volkswagenstiftung (VW) and the Baden-Württemberg Stiftung, Germany. This chapter is an updated and shortened version of “Brain–Computer Interfaces in the Rehabilitation of Stroke and Neurotrauma” published in the first edition of Systems Neuroscience and Rehabilitation and the most recent review article on this topic [79] by the same authors.
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Soekadar, S.R., Silvoni, S., Cohen, L.G., Birbaumer, N. (2015). Brain–Machine Interfaces in Stroke Neurorehabilitation. In: Kansaku, K., Cohen, L., Birbaumer, N. (eds) Clinical Systems Neuroscience. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55037-2_1
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