Brain-Computer Interface (BCI) for Enhancement of Attention in Post Stroke Patients – A Pilot Study

Author: Anita Prem, Mohan Raj K., Rajan Samuel A., Sam Thamburaj A., Prabhakaradoss D., Veronika Godwin Ajoo, Mallika S. and Chinnadurai R.

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Abstract

Attention problems after stroke are common. Attention is associated with cognitive productivity, post stroke balance, functional impairment and daily living. Improving attention is the key for learning motor skills. Previous studies have made use of methods like APT (Attention Process Training) for enhancement of attention in post stroke subjects. But these approaches have failed to provide real-time feedbacks. This study explores the possibility of BCI-based attention training in improving attention levels and thereby improving the quality of life among post stroke patients. This is a pilot study with an experimental group and a control group with 10 subjects in each group. Participants were 20 survivors of anterior and middle cerebral artery ischemic stroke in the late subacute stage, both right and left hemiplegics, diagnosed for stroke by WHO criteria. The baseline values -- the e sense attention meter score, Bells Test score, and Trail Making Test (TMT) Parts A & B score along with the Stroke Specific Quality of Life scale (SS-QOL) -- were taken before intervention. The intervention involved 3 sessions per week of BCI based attention training for 8 weeks, followed by a maintenance training of 3 sessions per month for the next 12 weeks for the experimental group. Both groups were given standardized physical therapy care for 3 sessions per week through all the 20 weeks. The post intervention assessment values were taken with the same tools used for baseline values at the end of 20 weeks of intervention and at one month follow up. The results of this pilot study confirm that BCI based attention training along with standardized physical therapy care for stroke enhances attention levels in post-stroke subjects. BCI-based attention training for post-stroke patients faces challenges like small sample size, blinding, ethical considerations, and safety.

Keywords

Brain Computer Interface, Stroke, Attention, Bells Test, Trail Making Test, Stroke Specific quality of Life

Conclusion

The results of this pilot study confirm that BCI based attention training along with standardized physical therapy care for stroke enhances attention levels in post-stroke subjects compared to those post-stroke subjects given only standardized physical therapy care. The readings after following up show that the benefits of the intervention in attention in the experimental group were sustained even after a gap of one month. As several factors are involved in improving quality of life in stroke patients, the standardized physical therapy protocol given to both groups has enhanced their quality of life, and increased attention adds to it. However, a valid conclusion cannot be arrived at, since the sample size is too small. A larger trial is needed to better evaluate the efficacy of the BCI-based attention training programme.

References

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How to cite this article

Anita Prem, Mohan Raj K., Rajan Samuel A., Sam Thamburaj A., Prabhakaradoss D., Veronika Godwin Ajoo, Mallika S. and Chinnadurai R. (2023). Brain-Computer Interface (BCI) for Enhancement of Attention in Post Stroke Patients – A Pilot Study. Biological Forum – An International Journal, 15(5): 1375-1381.