EEG-fMRI neurofeedback versus motor imagery after stroke, a randomized controlled trial.
Simon Butet, Mathis Fleury, Quentin Duché and 7 others
PMID 40134017WHAT IT FOUND
Stroke survivors with partial upper limb impairment who trained with EEG-fMRI neurofeedback improved more on arm function scores than those doing motor imagery alone.
The gains held at one month, but the study was small and the neurofeedback felt harder.
Key findings
01The neurofeedback group showed a significant increase in upper limb Fugl-Meyer scores from pre-intervention to post-intervention, which persisted at one-month follow-up, while the motor imagery group did not.
02A significant between-group difference was observed in the change of upper limb Fugl-Meyer scores, favouring the neurofeedback group.
03Patients in the neurofeedback group perceived the task as more challenging and tiring than those in the motor imagery group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study had a reduced sample size (30 analyzed vs 36 planned), lowering statistical power. The trial was suspended for several months due to the COVID-19 pandemic. The neurofeedback protocol was complex and resource-intensive, requiring MRI access for 5 sessions. Patients found the neurofeedback task significantly more challenging and tiring than motor imagery. Secondary brain outcome measures (fMRI activity, FA asymmetry) did not show significant group differences, limiting mechanistic conclusions.
Declared interests
The paper does not list specific conflicts of interest or funding sources in the provided text.
The easy way to misread this
Do not assume this protocol is widely available or easy to implement; it requires specialized bimodal EEG-fMRI equipment and MRI access for half the sessions, which is not standard in most clinical settings.