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Objective: The objective of this study was to examine the activation and functional connectivity of the prefrontal and temporal lobe in young and elder people during the Stroop test using functional near-infrared spectroscopy (fNIRS). Methods: A total of 33 healthy volunteers (20 young people, mean age: 23.7 ± 3.9 years; 13 elder people, mean age: 63.9 ± 4.0 years) participated in the study. All subjects were asked to finish the Stroop Color Word Test. The oxygenated hemoglobin concentration (Delta [HbO2]) signals and the deoxygenated hemoglobin (Delta [HbR]) signals were recorded from temporopolar area (TA), pars triangularis Broca's area (Broca), dorsolateral prefrontal cortex (DLPFC), and frontopolar area (FA) by fNIRS. The coherence between the left and right frontotemporal lobe delta [HbO2] oscillations in four frequency intervals (I, 0.6-2 Hz; II, 0.145-0.6 Hz; III, 0.052-0.145 Hz; and IV, 0.021-0.052 Hz) was analyzed using wavelet coherence analysis and wavelet phase coherent. Results: In the Stroop test, the young group was significantly better than the elder group at the responses time, whether at congruent tasks or at incongruent tasks (congruent: F = 250.295, p < 0.001; incongruent: p < 0.001). The accuracy of the two groups differed significantly when performing incongruent tasks but not when performing congruent tasks (incongruent: F = 9.498, p = 0.001; congruent: p = 0.254). Besides, only elders show significant activation in DLPFC, Broca, FA, and TA (p < 0.05) during the Stroop test, but young people did not show significant differences. In the functional connectivity of task states, younger people had stronger connections between different brain regions in both the left and right brain compared with the elderly (p < 0.05). In particular, the left and right DLPFC showed stronger connection strength in most of the brain areas. The result suggested that younger people had stronger functional connectivity of brain areas than older people when completing the task. Conclusion: According to these results, although the cortical activation in the elder people was higher than the young people, the young showed stronger connectivity in most of the brain areas than the elders. Both sides of DLPFC and right Broca area were the most significant cortical activation in Stroop test. It was suggested that the decrease in functional connectivity in the elder people resulted in the atrophy of white matter, to which we should pay more attention.
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Background: Upper limb impairments are one of the most common health problems of stroke, affecting both motor function and independence in daily life. It has been demonstrated that intermittent theta burst stimulation (iTBS) increases brain excitability and improves upper limb function. Our study sought to determine the role of iTBS in stroke recovery. Objective: The purpose of this study was to determine the efficacy of iTBS in individuals with upper limb impairments following stroke. Methods: The databases used included Cumulative Index to PubMed, EMBASE, ESCBOhost, The Cochrane Library, Chinese Biomedical Database, Web of Science, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), Technology Periodical Database (VIP), and WanFang Database. Studies published before November 2021 were included. Each participant received an iTBS-based intervention aimed at improving activity levels or impairment, which was compared to usual care, a sham intervention, or another intervention. The primary outcome measure was a change in upper limb function assessment. Secondary outcomes included impairment, participation, and quality of life measures. Result: A total of 18 studies (n = 401 participants) that met the inclusion criteria were included in this study. There was a slight change in the upper limb function of the iTBS group compared with the control group, as measured by the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) score (mean difference 2.70, 95% CI -0.02 to 5.42, p = 0.05). Significant improvement in resting motor threshold (RMT) and motor-evoked potential (MEP) was also observed in the meta-analysis of iTBS (MD 3.46, 95% CI 2.63 to 4.28, p < 0.00001); (MD 1.34, 95% CI 1.17 to 1.51, P < 0.00001). In addition, we got similar results when the studies were using the Modified Barthel Index (MBI) assessment (mean difference of 7.34, 95% CI 0.47 to 14.21, p = 0.04). Conclusion: Our study established the efficacy of iTBS in improving motor cortical plasticity, motor function, and daily functioning in stroke patients. However, the review requires evidence from additional randomized controlled trials and high-quality research. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/.
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Several studies have shown the positive clinical effect of brain computer interface (BCI) training for stroke rehabilitation. This study investigated the efficacy of the sensorimotor rhythm (SMR)-based BCI with audio-cue, motor observation and multisensory feedback for post-stroke rehabilitation. Furthermore, we discussed the interaction between training intensity and training duration in BCI training. Twenty-four stroke patients with severe upper limb (UL) motor deficits were randomly assigned to two groups: 2-week SMR-BCI training combined with conventional treatment (BCI Group, BG, n = 12) and 2-week conventional treatment without SMR-BCI intervention (Control Group, CG, n = 12). Motor function was measured using clinical measurement scales, including Fugl-Meyer Assessment-Upper Extremities (FMA-UE; primary outcome measure), Wolf Motor Functional Test (WMFT), and Modified Barthel Index (MBI), at baseline (Week 0), post-intervention (Week 2), and follow-up week (Week 4). EEG data from patients allocated to the BG was recorded at Week 0 and Week 2 and quantified by mu suppression means event-related desynchronization (ERD) in mu rhythm (8-12 Hz). All functional assessment scores (FMA-UE, WMFT, and MBI) significantly improved at Week 2 for both groups (p < 0.05). The BG had significantly higher FMA-UE and WMFT improvement at Week 4 compared to the CG. The mu suppression of bilateral hemisphere both had a positive trend with the motor function scores at Week 2. This study proposes a new effective SMR-BCI system and demonstrates that the SMR-BCI training with audio-cue, motor observation and multisensory feedback, together with conventional therapy may promote long-lasting UL motor improvement. Clinical Trial Registration: [http://www.chictr.org.cn], identifier [ChiCTR2000041119].
