MyoCI + Memory Reactivation for Stroke Recovery

Overseen By Marc W Slutzky, MD/PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Northwestern University

Must not be taking: Spasticity treatment

Disqualifiers: Visual impairment, Aphasia, Arm pain, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 6 weeks

70 Participants Needed

Trial Summary

What is the purpose of this trial?

This study will examine the combination of myoelectric computer interface (MyoCI) training with targeted memory reactivation (TMR) in chronic stroke survivors. The study aims to determine whether this training-plus-sleep combination will generalize to improve arm motor function over an extended training protocol in stroke survivors.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it does exclude those who have had spasticity treatment with medications or Botox in the last 3 months.

What data supports the effectiveness of the treatment MyoCI + Memory Reactivation for Stroke Recovery?

Research shows that Myoelectric Computer Interface (MyoCI) training helps stroke survivors improve arm function by reducing abnormal muscle co-activation, which is a common issue after a stroke. Studies found that participants who underwent MyoCI training experienced improvements in arm movement and function, suggesting that this treatment could be beneficial for stroke recovery. ^{1 2 3 4 5}

Is MyoCI training safe for humans?

The studies on MyoCI training for stroke recovery do not report any safety concerns, suggesting it is generally safe for human use. ^{1 3 4 6 7}

How is the MyoCI treatment different from other stroke recovery treatments?

MyoCI is unique because it uses a myoelectric computer interface to provide feedback on muscle activation patterns, helping stroke survivors reduce abnormal muscle co-activation and improve arm movement. This approach focuses on retraining muscle activation patterns, which is different from traditional physical therapies that may not specifically target muscle co-activation. ^{1 2 3 4 6}

Research Team

Marc W Slutzky, MD/PhD

Principal Investigator

Northwestern University

Eligibility Criteria

This trial is for chronic stroke survivors aged 21 or older with severe to moderate arm motor impairment, who had their first stroke at least 6 months ago. Participants must have some voluntary shoulder and elbow movement but can't join if they have ferromagnetic implants, are in other studies, struggle with English due to aphasia, suffer from substantial pain or visual impairments that affect screen viewing, or have received spasticity treatment recently.

Inclusion Criteria

I can move my shoulder and elbow muscles on my own.

I am 21 years old or older.

I have severe to moderate difficulty moving my arms.

Exclusion Criteria

You have anesthesia or neglect in your affected arm, or difficulty paying attention to things on one side of your vision.

I have a visual impairment that prevents me from seeing the entire screen.

Inability to understand or follow commands in English due to aphasia or other reason

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo MyoCI training combined with TMR to improve arm motor function

6 weeks

Multiple sessions per week

Follow-up

Participants are monitored for changes in motor function and spasticity

4 weeks

Treatment Details

Interventions

• MyoCI
• Targeted Memory Reactivation (TMR)

Trial Overview The study tests whether combining myoelectric computer interface (MyoCI) training with targeted memory reactivation (TMR) during sleep can improve arm function in people who've had a stroke. It looks at the effects of this combination over an extended period.

Participant Groups

Group I: Slow-wave sleep (SWS) only TMR Experimental Treatment 1 Intervention

TMR during slow-wave sleep only

Group II: Reduced frequency TMR Experimental Treatment 1 Intervention

TMR during only subset of sessions

Group III: All phase TMR Experimental Treatment 1 Intervention

TMR during every stage of sleep

Group IV: Sham TMR Placebo Group 1 Intervention

Patients receive no TMR

Who Is Running the Clinical Trial?

Northwestern University

Lead Sponsor

Trials

1,674

Recruited

989,000+

Findings from Research

Myoelectric computer interface (MCI) training effectively reduced abnormal muscle coactivation in both healthy participants and stroke survivors, indicating its potential as a rehabilitation tool.

Among the stroke survivors, 3 out of 5 showed a measurable improvement in arm function, as evidenced by a 3-point increase in the Fugl-Meyer Motor Assessment score, highlighting the efficacy of MCI in retraining muscle activation patterns.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reducing Abnormal Muscle Coactivation After Stroke Using a Myoelectric-Computer Interface: A Pilot Study. Wright, ZA., Rymer, WZ., Slutzky, MW.[2021]

A pilot study using a myoelectric-computer interface (MCI) showed that both healthy individuals and stroke survivors could learn to reduce muscle co-contraction, which is a barrier to improved motor function after a stroke.

Three out of five stroke survivors demonstrated some improvement in arm function after MCI training, indicating that this approach could be a promising and cost-effective method for stroke rehabilitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Myoelectric computer interfaces to reduce co-contraction after stroke. Wright, ZA., Rymer, WZ., Slutzky, MW.[2021]

Myoelectric computer interface (MCI) training significantly reduced abnormal co-activation of arm muscles in 32 chronic stroke survivors, leading to improved arm function and kinematics after 6 weeks of training.

The benefits of MCI training persisted for at least one month after the training ended, indicating its potential as a lasting intervention for enhancing arm function post-stroke.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of myoelectric computer interface training on arm kinematics and function after stroke. Tomic, G., Mugler, EM., Singh, A., et al.[2020]

The MyoCI training paradigm significantly reduced arm impairment in stroke survivors, with improvements observed in the Fugl-Meyer Assessment scores after 6 and 10 weeks of training, indicating its efficacy in enhancing motor recovery.

MyoCI was well-tolerated with no adverse events reported, and it effectively decreased abnormal muscle co-activation, leading to improvements in spasticity and elbow range-of-motion, benefiting both moderately and severely impaired patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Myoelectric Computer Interface Training for Reducing Co-Activation and Enhancing Arm Movement in Chronic Stroke Survivors: A Randomized Trial. Mugler, EM., Tomic, G., Singh, A., et al.[2020]

The study demonstrated that combining a brain-computer interface (BCI) with functional electrical stimulation (FES) is feasible for motor learning in a 43-year-old woman who was 10 months post-stroke, leading to significant improvements in her ability to control finger movements.

After nine training sessions, the participant achieved volitional control of isolated index finger extension, indicating that this combined approach may effectively aid in motor recovery after stroke.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of a new application of noninvasive Brain Computer Interface (BCI): a case study of training for recovery of volitional motor control after stroke. Daly, JJ., Cheng, R., Rogers, J., et al.[2016]

A study involving 32 stroke survivors who underwent 6 weeks of MyoCI training showed that the training effectively reduced abnormal muscle co-activation in targeted arm muscles, leading to improved motor function.

While the overall number and composition of muscle synergies did not change significantly, the training increased the disparity of muscle weights within synergies for those who responded, indicating a more refined control of muscle coordination in the affected arm.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Myoelectric interface training enables targeted reduction in abnormal muscle co-activation. Seo, G., Kishta, A., Mugler, E., et al.[2023]

BCI-triggered functional electrical stimulation therapy (BCI-FEST) was found to be a safe and feasible method for improving upper limb function in a 57-year-old man with severe hemiplegia after a stroke, with 80 therapy sessions conducted over several weeks.

Significant clinical improvements were observed, including notable increases in scores on various functional tests, indicating that BCI-FEST can effectively enhance motor function and daily task performance in individuals with neurological injuries.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Restoration of Upper Limb Function After Chronic Severe Hemiplegia: A Case Report on the Feasibility of a Brain-Computer Interface-Triggered Functional Electrical Stimulation Therapy. Jovanovic, LI., Kapadia, N., Lo, L., et al.[2021]

References

1. United States pubmed.ncbi.nlm.nih.gov

Reducing Abnormal Muscle Coactivation After Stroke Using a Myoelectric-Computer Interface: A Pilot Study. [2021]

2. United States pubmed.ncbi.nlm.nih.gov

Myoelectric computer interfaces to reduce co-contraction after stroke. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

The effect of myoelectric computer interface training on arm kinematics and function after stroke. [2020]

4. United States pubmed.ncbi.nlm.nih.gov

Myoelectric Computer Interface Training for Reducing Co-Activation and Enhancing Arm Movement in Chronic Stroke Survivors: A Randomized Trial. [2020]

5. United States pubmed.ncbi.nlm.nih.gov

Feasibility of a new application of noninvasive Brain Computer Interface (BCI): a case study of training for recovery of volitional motor control after stroke. [2016]

6. England pubmed.ncbi.nlm.nih.gov

Myoelectric interface training enables targeted reduction in abnormal muscle co-activation. [2023]

7. United States pubmed.ncbi.nlm.nih.gov

Restoration of Upper Limb Function After Chronic Severe Hemiplegia: A Case Report on the Feasibility of a Brain-Computer Interface-Triggered Functional Electrical Stimulation Therapy. [2021]