Can motion capture improve task-based fMRI studies of motor function post-stroke? A systematic review

Background Variability in motor recovery after stroke represents a major challenge in its understanding and management. While functional MRI has traditionally been used to address post-stroke motor function in relation to clinical outcome, it lacks details about movement characteristics linked to observed brain activations. Combining fMRI with detailed information of motor function by using motion capture (mocap) might provide clinicians with additional information about mechanisms of motor impairment after stroke. Objectives We aimed to identify fMRI and mocap coupling approaches and to evaluate their potential contribution to the understanding of motor function post-stroke. Method A systematic literature review was performed according to PRISMA guidelines, on studies using fMRI and mocap in post-stroke individuals. We assessed the internal, external, statistical, and technological validity of each study. Data extraction included study design and analysis procedures used to couple brain activity with movement characteristics. Results Of the 404 studies found, 23 were included in the final review. The overall study quality was moderate (0.6/1). The majority of studies focused on the upper limb, using a wide variety of motor tasks. Half of the studies performed a statistical analysis between movement and brain activity by either using kinematics as variables during group or individual level regression or correlation. This permitted establishing a link between motor characteristics and brain activations. Mocap was also integrated without statistical confrontation, to compare results between fMRI and kinematics, or to incorporate real-time movement information to supply external devices, like motor feedback. Conclusion Our review suggests that the simultaneous use of fMRI and Mocap provides new insights compared with conventional fMRI analysis. It allows a better understanding of post-stroke motor function, although being still subject to practical and technological limitations. Further research is needed to optimize and standardize both data measurement and processing procedures. ### Competing Interest Statement This project was supported by the Occitanie Region (Regional Research and Innovation Platform Number 20020194- ICM - IMAGERIE CEREBRALE MOUVEMENT) and by the LabEx NUMEV (ANR-10-LABX-0020) within the I-SITE MUSE. ### Funding Statement This project was supported by the Occitanie Region (Regional Research and Innovation Platform Number 20020194- ICM - IMAGERIE CEREBRALE MOUVEMENT) and by the LabEx NUMEV (ANR-10-LABX-0020) within the I-SITE MUSE. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: As it is a systematic review, no human data were collected for this work. Data used come from scientific papers found in 4 databases: Medline, Embase, Web of Science et IEEE Xplore. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors. * fMRI : functional Magnetic Resonance Imaging Mocap : Motion capture EEG : Electroencephalography MEG : Magnetoencephalography fPET : functional Positron Emission Tomography fNIRS : functional Near-Infrared Spectroscopy TMS : Transcranial Magnetic Stimulation VR : Virtual Reality