Dr. Sitaram researches stroke rehabilitation with the help of EU-Indian collaboration grant

Congratulations to Dr. Ranganatha Sitaram who recently received an EU-India collaboration grant to research stroke rehabiliation!


Originally published by New Indigo


Regain mobility in a stroke!


Stroke is one of the leading causes of mortality and morbidity worldwide. Developing countries account for 85% of global death from stroke. Worldwide over the past four decades, the annual stroke incidence rate has decreased by 1.1% in high-income countries but has increased by 5.3% in low to middle income counties. Stroke is also a leading cause of functional impairments. 20% of survivors requiring institutional care after 3 months suffer from very limited motor recovery and are unable to use extremities.


Movement recovery after stroke happens due to brain plasticity and functional reorganisation of motor cortex and associated regions. Brain-Computer Interfaces (BCIs) are a relatively novel technology with the potential to restore, substitute, or augment lost motor behaviours in patients as they allow for motor imagery with contingent feedback that results in neural plasticity. Recently, real-time functional magnetic resonance imaging (rtFMRI) based BCI as a potential method for rehabilitation was demonstrated. However, FMRI represents a sophisticated tool for research, its high cost and complexity of use presents several hindrances for use as a bedside or home-based treatment method, especially in a developing country like India. Functional Near Infrared Spectroscopy (FNIRS), on the other hand, is relatively inexpensive, potentially portable and easy to use, yet measures the blood oxygenation-level signal (BOLD) that FMRI measures. Despite this, to date, there is no FNIRS based BCI targeted for stroke rehabilitation.


The goal of project is the integration of a noninvasive fNIRS-based BCI with a noninvasive functional electrical stimulation (FES) system that enables the direct brain control of lower limb movements that is expected to promote neuroplastic changes leading to recovery. The usefulness of fNIRS for clinical application will be investigated for selected clinical groups in need of an effective and side-effect-free rehabilitation program. For the experiments to be maximally effective, a robotic device for assisting and walking in stroke patients would be used target the most impaired joint(s), provide clinically important feedback to both therapy participants and clinicians, simulate or allow motion patterns similar to those seen in over-ground walking, be comfortable and safe to use, and train persons with stroke in task-specific, massed practice of repetitive motions highly similar to over-ground gait.  The movement sensors will be used to measure movement amplitude, speed and joint angles to provide more sensitive evaluation of the effect of fNIRS-BCI-FES training to motor recovery. In addition, a number of other MR measures will be performed: DTI, ASL and resting state BOLD to evaluate functional and anatomical connectivity changes.