{
  "abstract": "Introduction\n\nPost-stroke upper-limb recovery remains challenging, especially in the presence of sensory impairments. Conventional brain-computer interfaces (BCIs) are constrained by binary feedback, single-modality stimulation, and exclusion of patients with sensory deficits. We developed the Imagery Neurofeedback-based Multi-sensory System (iNems), a neurofeedback system that provides graded multisensory (visual and electrical) feedback based on ERD magnitude. This study validated iNems' efficacy in motor function, self-reported numbness, and cognitive functions using a multiple-baseline design (MBD).Methods\n\nFour participants with post-stroke upper-limb motor and sensory impairments underwent a multiple baseline design. The baseline phase (phase A) used random feedback; the intervention (phase B) used adaptive iNems. iNems quantified motor intention via sensorimotor EEG event-related desynchronization (ERD) and delivered graded visual and electrical feedback. Primary outcomes were the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and Box and Block Test (BBT). Secondary outcomes included body cognition, numbness, and neurophysiological (ERD/ERS) changes.Results\n\nAll participants demonstrated significant improvement during the intervention. FMA-UE increased by 6-16 points. The BBT showed large effects (integrated Tau-U = 0.75). Body cognition improved significantly in both sense of agency (Tau-U = 0.80) and ownership (Tau-U = 0.89). Numbness was reduced in affected cases (Tau-U = -0.85). Neurophysiological changes correlated with functional gains, with some patterns suggesting increased neural efficiency.Conclusion\n\nThis first MBD-validated demonstration shows that graded, multisensory graded neurofeedback based on ERD magnitude can improve motor, self-reported numbness, and cognitive domains after stroke. These findings support adaptive closed-loop therapy as a promising, multifaceted rehabilitation strategy.",
  "abstract_shown": true,
  "affiliations": [
    "Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto, Japan.",
    "Visiting Researcher, Kyoto Tachibana University, Kyoto, Japan.",
    "Watanabe Hospital, Zuisinkai Medical Corporation, Mihama, Aichi, Japan.",
    "Zenjokai Rehabilitation Hospital, Zenjokai Medical Foundation, Nagoya, Aichi, Japan.",
    "Sun Baden, Geriatric Health Services Facility, Mihama, Aichi, Japan.",
    "National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.",
    "CARETECH Plus Inc., Aichi, Nagoya, Japan.",
    "Faculty of Fiber Science and Engineering, Kyoto Institute of Technology, Kyoto, Japan.",
    "Graduate School of Human Development and Environment, Kobe University, Kobe, Hyogo, Japan.",
    "Research Institute for Brain Diseases, Kurume University, Fukuoka, Japan."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 20,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Takayuki Kodama"
    },
    {
      "affs": [
        0
      ],
      "name": "Ken Kitai"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Yasuhisa Mizomoto"
    },
    {
      "affs": [
        1,
        3
      ],
      "name": "Kaichi Nishigaya"
    },
    {
      "affs": [
        4
      ],
      "name": "Shoutarou Hashimoto"
    },
    {
      "affs": [
        3
      ],
      "name": "Riona Hiraga"
    },
    {
      "affs": [
        3
      ],
      "name": "Satomi Shimizu"
    },
    {
      "affs": [
        3
      ],
      "name": "Miki Kawabata"
    },
    {
      "affs": [
        3
      ],
      "name": "Yuumi Hirabayashi"
    },
    {
      "affs": [
        3
      ],
      "name": "Keita Ikesue"
    },
    {
      "affs": [
        3
      ],
      "name": "Hazime Kako"
    },
    {
      "affs": [
        3
      ],
      "name": "Syouta Yasui"
    },
    {
      "affs": [
        0
      ],
      "name": "Hiroki Ito"
    },
    {
      "affs": [
        0
      ],
      "name": "Kazuhei Nishimoto"
    },
    {
      "affs": [
        1,
        5
      ],
      "name": "Osamu Katayama"
    },
    {
      "affs": [
        1,
        6
      ],
      "name": "Hideaki Yamaguchi"
    },
    {
      "affs": [
        7
      ],
      "name": "Hikaru Nagano"
    },
    {
      "affs": [
        8
      ],
      "name": "Mari Inoue"
    },
    {
      "affs": [
        0
      ],
      "name": "Shin Murata"
    },
    {
      "affs": [
        9
      ],
      "name": "Kiichiro Morita"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1aa6ks6ch0vhn.bib",
  "cited_by": 0,
  "doi": "10.3389/fnhum.2026.1938622",
  "fulltext_url": "https://europepmc.org/articles/PMC13683578",
  "id": "1aa6ks6ch0vhn",
  "issns": [
    "1662-5161"
  ],
  "landing_url": "https://europepmc.org/article/MED/42908918",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2742|Stroke Rehabilitation and Recovery"
    ]
  ],
  "openalex": "W7220851478",
  "pdf_url": "https://europepmc.org/articles/PMC13683578?pdf=render",
  "pmcid": "PMC13683578",
  "pmid": "42908918",
  "published": "2026-10-07",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/1aa6ks6ch0vhn.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:10Z",
      "native_id": "MED:42908918",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42908918"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "journal-openalex:2805|Neural and Behavioral Psychology Studies",
      "subfield": "neuroscience"
    }
  ],
  "title": "Graded multisensory neurofeedback via the iNems system for comprehensive upper limb recovery after stroke: a multiple baseline study.",
  "title_text": "Graded multisensory neurofeedback via the iNems system for comprehensive upper limb recovery after stroke: a multiple baseline study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:10Z",
  "url": "https://research.draconitic.com/paper/1aa6ks6ch0vhn",
  "venue": "Frontiers in human neuroscience",
  "versions": []
}