A Novel Synchronized Stimulation Method to Improve the Tactile Localization Ability of Post-Stroke Patients

Document Type : Original Research

Authors
M. Rostami 1
M. Ahmadi 1
M. Barzegar 2
M. Mehrpour 3
Z. Nasimi 4
F. Attari 5
A. Shakeripour 1
H. Saeedi 1
Z. Bahmani 1
1 Faculty of Electrical & Computer Engineering, Tarbiat Modares University, Tehran, Iran
2 National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation, Doha, QatarBrain Mapping Foundation, Los Angeles, California, USA Intelligent Quantitative bio-medical imaging (IQBMI), Tehran, Iran
3 Medical Faculty, Iran University of Medical Sciences, Tehran, Iran
4 Islamic Azad University, Science and Research Branch, Tehran, Iran
5 Department of Neuroscience, School of Advanced Technologies, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Introduction: Transcranial electrical stimulation (tES) has shown promise in enhancing post-stroke patients' neural plasticity and functional abilities. However, determining the optimal protocol for this method remains an open question. Our study proposes a novel approach: synchronized stimulation that combines mechanical and electrical stimuli. We hypothesize that this approach will enhance tactile localization ability in post-stroke patients.

Methods: We recruited a total of 23 patients and conducted four different types of experiments involving periodic mechanical stimulation on their fingertips. The primary objective was to assess the participant's ability to localize the location of the mechanical stimulation accurately. In one experiment, only mechanical stimulation was administered. Electrical stimulations were combined with mechanical stimulation in the remaining three experiments. The electrical stimulations comprised of one of the following protocols: (1) (tES) pulses administered solely for the initial five seconds of the session, (2) continuous (tES) pulses throughout the entire duration of the mechanical stimulation, and (3) (tES) pulses synchronized precisely with the timing of the mechanical stimulation.

Results: A noteworthy enhancement in tactile localization ability was observed when the electrical and mechanical stimulations were synchronized.

Conclusion: Our findings demonstrate that the integration of electrical brain stimulation with simultaneous mechanical stimulation of the fingertips resulted in enhanced neural activities. This synchronized integration holds the potential to improve perception and may serve as a vital approach in the treatment of post-stroke patients.

Keywords

Subjects

1. Lodha N, Harrell J, Eisenschenk S, Christou EA. Motor impairments in transient ischemic attack increase the odds of a subsequent stroke: a meta-analysis. Frontiers in neurology. 2017;8:243.
2. Takeda K, Tanino G, Miyasaka H. Review of devices used in neuromuscular electrical stimulation for stroke rehabilitation. Medical devices (Auckland, NZ). 2017;10:207.
3. Orrù G, Conversano C, Hitchcott PK, Gemignani A. Motor stroke recovery after tDCS: a systematic review. Reviews in the Neurosciences. 2020;31(2):201-218.
4. Young W. Electrical stimulation and motor recovery. Cell transplantation. 2015;24(3):429-446.
5. Hummel F, Cohen LG. Improvement of motor function with noninvasive cortical stimulation in a patient with chronic stroke. Neurorehabilitation and neural repair. 2005;19(1):14-19.
6. Kang N, Summers JJ, Cauraugh JH. Transcranial direct current stimulation facilitates motor learning post-stroke: a systematic review and meta-analysis. Journal of Neurology, Neurosurgery & Psychiatry. 2016;87(4):345-355.
7. Gomez Palacio Schjetnan A, Faraji J, Metz GA, Tatsuno M, Luczak A. Transcranial direct current stimulation in stroke rehabilitation: a review of recent advancements. Stroke research and treatment. 2013;2013.
8. Leite J, Morales-Quezada L, Carvalho S, et al. Surface EEG-transcranial direct current stimulation (tDCS) closed-loop system. International journal of neural systems. 2017;27(06):1750026.
9. Fischer DB, Fried PJ, Ruffini G, et al. Multifocal tDCS targeting the resting state motor network increases cortical excitability beyond traditional tDCS targeting unilateral motor cortex. Neuroimage. 2017;157:34-44.
10. Penfield W, Boldrey E. Somatic motor and sensory representation in the cerebral cortex of man as studied by electrical stimulation. Brain. 1937;60(4):389-443.
11. Kaas JH, Nelson RJ, Sur M, Lin C-S, Merzenich MM. Multiple representations of the body within the primary somatosensory cortex of primates. Science. 1979;204(4392):521-523.
12. Harris JA, Karlov L, Clifford CW. Localization of tactile stimuli depends on conscious detection. Journal of Neuroscience. 2006;26(3):948-952.
13. Halligan PW, Hunt M, Marshall JC, Wade DT. Sensory detection without localization. Neurocase. 1995;1(3):259-266.
14. Anema HA, van Zandvoort MJ, de Haan EH, et al. A double dissociation between somatosensory processing for perception and action. Neuropsychologia. 2009;47(6):1615-1620.
15. Volpe BT, LeDoux JE, Gazzaniga MS. Spatially oriented movements in the absence of proprioception. Neurology. 1979;29(9 Part 1):1309-1309.
16. Rostami M, Nasimi Z, Mehrpour M, et al. P148 Faster recovery of stroke patients through alternative electrical stimulation and rehabilitation movement frequency matching. Clinical Neurophysiology. 2020;131(4):e97.
17. Koganemaru S, Kitatani R, Fukushima-Maeda A, et al. Gait-synchronized rhythmic brain stimulation improves poststroke gait disturbance: a pilot study. Stroke. 2019;50(11):3205-3212.
18. Karabanov AN, Saturnino GB, Thielscher A, Siebner HR. Can transcranial electrical stimulation localize brain function? Frontiers in psychology. 2019;10:213.
19. Hogg RV, Tanis EA, Zimmerman DL. Probability and statistical inference. Vol 993: Macmillan New York; 1977.
20. Woodman F. Robert MG Reinhart, Josh D. Cosman, Keisuke Fukuda & Geoffrey.
21. Wang Y, Shi L, Dong G, Zhang Z, Chen R. Effects of transcranial electrical stimulation on human auditory processing and behavior—a review. Brain Sciences. 2020;10(8):531.
22. Sandrini M, Caronni A, Corbo M. Modulating reconsolidation with non-invasive brain stimulation—where we stand and future directions. Frontiers in psychology. 2018;9:1430.
23. Boroda E, Sponheim SR, Fiecas M, Lim KO. Transcranial direct current stimulation (tDCS) elicits stimulus-specific enhancement of cortical plasticity. Neuroimage. 2020;211:116598.
24. Babakhani B, Tabatabaei NH, Elisevich K, Sadeghbeigi N, Barzegar M, Mobarakeh NM, Eyvazi F, Khazaeipour Z, Taheri A, Nazem-Zadeh MR. A Preliminary Study of the Efficacy of Transcranial Direct Current Stimulation in Trigeminal Neuralgia. Frontiers in Human Neuroscience. 2022;16
25. Cavaleiro C, Martins J, Gonçalves J, Castelo-Branco M. Memory and cognition-related neuroplasticity enhancement by transcranial direct current stimulation in rodents: a systematic review. Neural plasticity. 2020;2020.
Pathobiology Reserach
Volume 26, Issue 3
September 2023
Pages 57-65