Pathway-specific modulatory effects of neuromuscular electrical stimulation during pedaling in chronic stroke survivors
Abstract Background Neuromuscular electrical stimulation (NMES) is extensively used in stroke motor rehabilitation. How it promotes motor recovery remains only partially understood. NMES could change muscular properties, produce altered sensory inputs, and modulate fluctuations of cortical activitie...
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| Format: | Article |
| Language: | English |
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BMC
2019-11-01
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| Series: | Journal of NeuroEngineering and Rehabilitation |
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| Online Access: | http://link.springer.com/article/10.1186/s12984-019-0614-9 |
| _version_ | 1819294495468945408 |
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| author | Shi-Chun Bao Wing-Cheong Leung Vincent C. K. Cheung Ping Zhou Kai-Yu Tong |
| author_facet | Shi-Chun Bao Wing-Cheong Leung Vincent C. K. Cheung Ping Zhou Kai-Yu Tong |
| author_sort | Shi-Chun Bao |
| collection | DOAJ |
| description | Abstract Background Neuromuscular electrical stimulation (NMES) is extensively used in stroke motor rehabilitation. How it promotes motor recovery remains only partially understood. NMES could change muscular properties, produce altered sensory inputs, and modulate fluctuations of cortical activities; but the potential contribution from cortico-muscular couplings during NMES synchronized with dynamic movement has rarely been discussed. Method We investigated cortico-muscular interactions during passive, active, and NMES rhythmic pedaling in healthy subjects and chronic stroke survivors. EEG (128 channels), EMG (4 unilateral lower limb muscles) and movement parameters were measured during 3 sessions of constant-speed pedaling. Sensory-level NMES (20 mA) was applied to the muscles, and cyclic stimulation patterns were synchronized with the EMG during pedaling cycles. Adaptive mixture independent component analysis was utilized to determine the movement-related electro-cortical sources and the source dipole clusters. A directed cortico-muscular coupling analysis was conducted between representative source clusters and the EMGs using generalized partial directed coherence (GPDC). The bidirectional GPDC was compared across muscles and pedaling sessions for post-stroke and healthy subjects. Results Directed cortico-muscular coupling of NMES cycling was more similar to that of active pedaling than to that of passive pedaling for the tested muscles. For healthy subjects, sensory-level NMES could modulate GPDC of both ascending and descending pathways. Whereas for stroke survivors, NMES could modulate GPDC of only the ascending pathways. Conclusions By clarifying how NMES influences neuromuscular control during pedaling in healthy and post-stroke subjects, our results indicate the potential limitation of sensory-level NMES in promoting sensorimotor recovery in chronic stroke survivors. |
| first_indexed | 2024-12-24T04:27:14Z |
| format | Article |
| id | doaj.art-ee0916a68eb243a0a75fc54d37184b9d |
| institution | Directory Open Access Journal |
| issn | 1743-0003 |
| language | English |
| last_indexed | 2024-12-24T04:27:14Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of NeuroEngineering and Rehabilitation |
| spelling | doaj.art-ee0916a68eb243a0a75fc54d37184b9d2022-12-21T17:15:33ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032019-11-0116111510.1186/s12984-019-0614-9Pathway-specific modulatory effects of neuromuscular electrical stimulation during pedaling in chronic stroke survivorsShi-Chun Bao0Wing-Cheong Leung1Vincent C. K. Cheung2Ping Zhou3Kai-Yu Tong4Department of Biomedical Engineering, The Chinese University of Hong KongDepartment of Biomedical Engineering, The Chinese University of Hong KongSchool of Biomedical Sciences, and The Gerald Choa Neuroscience Centre, The Chinese University of Hong KongDepartment of Physical Medicine and Rehabilitation, The University of Texas Health Science Center at HoustonDepartment of Biomedical Engineering, The Chinese University of Hong KongAbstract Background Neuromuscular electrical stimulation (NMES) is extensively used in stroke motor rehabilitation. How it promotes motor recovery remains only partially understood. NMES could change muscular properties, produce altered sensory inputs, and modulate fluctuations of cortical activities; but the potential contribution from cortico-muscular couplings during NMES synchronized with dynamic movement has rarely been discussed. Method We investigated cortico-muscular interactions during passive, active, and NMES rhythmic pedaling in healthy subjects and chronic stroke survivors. EEG (128 channels), EMG (4 unilateral lower limb muscles) and movement parameters were measured during 3 sessions of constant-speed pedaling. Sensory-level NMES (20 mA) was applied to the muscles, and cyclic stimulation patterns were synchronized with the EMG during pedaling cycles. Adaptive mixture independent component analysis was utilized to determine the movement-related electro-cortical sources and the source dipole clusters. A directed cortico-muscular coupling analysis was conducted between representative source clusters and the EMGs using generalized partial directed coherence (GPDC). The bidirectional GPDC was compared across muscles and pedaling sessions for post-stroke and healthy subjects. Results Directed cortico-muscular coupling of NMES cycling was more similar to that of active pedaling than to that of passive pedaling for the tested muscles. For healthy subjects, sensory-level NMES could modulate GPDC of both ascending and descending pathways. Whereas for stroke survivors, NMES could modulate GPDC of only the ascending pathways. Conclusions By clarifying how NMES influences neuromuscular control during pedaling in healthy and post-stroke subjects, our results indicate the potential limitation of sensory-level NMES in promoting sensorimotor recovery in chronic stroke survivors.http://link.springer.com/article/10.1186/s12984-019-0614-9NMESPedalingCortico-muscular couplingGeneralized partial directed coherenceStrokeEEG/EMG |
| spellingShingle | Shi-Chun Bao Wing-Cheong Leung Vincent C. K. Cheung Ping Zhou Kai-Yu Tong Pathway-specific modulatory effects of neuromuscular electrical stimulation during pedaling in chronic stroke survivors Journal of NeuroEngineering and Rehabilitation NMES Pedaling Cortico-muscular coupling Generalized partial directed coherence Stroke EEG/EMG |
| title | Pathway-specific modulatory effects of neuromuscular electrical stimulation during pedaling in chronic stroke survivors |
| title_full | Pathway-specific modulatory effects of neuromuscular electrical stimulation during pedaling in chronic stroke survivors |
| title_fullStr | Pathway-specific modulatory effects of neuromuscular electrical stimulation during pedaling in chronic stroke survivors |
| title_full_unstemmed | Pathway-specific modulatory effects of neuromuscular electrical stimulation during pedaling in chronic stroke survivors |
| title_short | Pathway-specific modulatory effects of neuromuscular electrical stimulation during pedaling in chronic stroke survivors |
| title_sort | pathway specific modulatory effects of neuromuscular electrical stimulation during pedaling in chronic stroke survivors |
| topic | NMES Pedaling Cortico-muscular coupling Generalized partial directed coherence Stroke EEG/EMG |
| url | http://link.springer.com/article/10.1186/s12984-019-0614-9 |
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