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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Applied Neuroimaging
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1449667
This article is part of the Research Topic Advanced fNIRS Applications in Neuroscience and Neurological Disorders View all 9 articles

Altered Cortical Activation Patterns in Post-Stroke Patients During Walking with Two-Channel Functional Electrical Stimulation: A Functional Near-Infrared Spectroscopy Observational Study

Provisionally accepted
Shizhe Zhu Shizhe Zhu 1Lan Zhu Lan Zhu 2Sheng Xu Sheng Xu 3Tianjiao Zhang Tianjiao Zhang 1Qinglei Wang Qinglei Wang 1Youxin Sui Youxin Sui 1Ying Shen Ying Shen 2Kan Chaojie Kan Chaojie 1,3Ren Zhuang Ren Zhuang 3Chuan Guo Chuan Guo 2*Tong Wang Tong Wang 1,2
  • 1 School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu Province, China
  • 2 Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
  • 3 Department of Rehabilitation Medicine, Changzhou Dean Hospital, Changzhou, China

The final, formatted version of the article will be published soon.

    Restoration of independent walking ability is the primary objective of stroke rehabilitation; however, not all patients achieve this goal due to diverse impairments in the paretic lower limb and compensatory mechanisms that lead to an asymmetrical and mechanically inefficient gait. This investigation aimed to examine alterations in cortical activation in post-stroke patients while walking with a wearable twochannel functional electrical stimulation (FES) in comparison to walking without FES. This observational study was conducted to discern distinct activation patterns in 19 stroke patients during sessions with and without FES, while using functional near-infrared spectroscopy (fNIRS) to monitor changes in blood oxygen levels. Our findings revealed only a significant reduction in ΔOxy-Hb in the contralesional pre-motor cortex (z = -2.803, p = 0.005) during the FES-on walking sessions compared to the FES-off sessions. Furthermore, all regions in the FES-on session exhibited lower ΔOxy-Hb. Conversely, no significant differences were observed in ΔDeoxy-Hb. Moreover, a significant correlation was found between decrease in cPMC and the reduced cost time of walking under FES-on condition. The fNIRS analysis revealed diminished activation in the contralesional pre-motor cortex when walking with FES, implying that FES may facilitate a more automatic gait pattern while reducing a patient's reliance on contralesional cortical resources. The findings of this study lay the groundwork for long-term neural rehabilitation.

    Keywords: functional electrical stimulation, fNIRS, Stroke, Walk, cortical activation

    Received: 15 Jun 2024; Accepted: 24 Dec 2024.

    Copyright: © 2024 Zhu, Zhu, Xu, Zhang, Wang, Sui, Shen, Chaojie, Zhuang, Guo and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Chuan Guo, Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China

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