Development and Validation of an Adaptive Neurofeedback Interface Using Transcranial Magnetic Stimulation to Modulate Cortical Excitability in Stroke Patients

What this Trial Is About

Researchers are investigating a new neurofeedback system combining transcranial magnetic stimulation TMS with functional near-infrared spectroscopy fNIRS to improve neuromodulation therapy for stroke patients. This study aims to address the variability in current open-loop TMS treatments by developing a closed-loop interface that precisely controls TMS timing based on brain hemodynamic signals. The study will first test this systems accuracy in healthy adults and then evaluate its effectiveness in post-acute stroke patients to enhance motor control and brain excitability after stroke. The study includes two groups one where TMS pulses are triggered based on individualized fNIRS signals during motor imagination, and another where TMS is triggered by an operator following a set protocol. The researchers will compare these methods to assess the neurofeedback interfaces ability to modulate brain activity. This interventional trial uses a randomized design and single masking to evaluate the devices impact on stroke recovery. Participants will undergo assessments including motor evoked potentials to measure brain response before and after treatment. The study involves monitoring motor function and cortical excitability, with safety assessments to exclude those with contraindications to TMS or cognitive impairments. The total participation age range is 18 to 80 years, and participants must be able to consent and communicate in Chinese. The trial is sponsored by The Hong Kong Polytechnic University and plans to complete by the end of 2028.

A Neurofeedback Interface in Poststroke Neuromodulation Using TMS-fNIRS