Summary
A medRxiv protocol describes the MINTS study, which will examine 14 home-based motor-imagery neurofeedback sessions in 21 people with chronic stroke and persistent upper-limb impairment. The study will combine mobile EEG, stationary EEG, functional MRI and repeated motor assessments.
A medRxiv preprint posted on 15 September 2026 describes the design of a clinical study that will test intensive, home-based motor-imagery neurofeedback in people living with chronic stroke. The MINTS study is a protocol rather than a report of completed results: data collection is ongoing, and the researchers have not yet reported whether the intervention changes brain activity or motor function.
The planned study will enrol 21 people who are at least six months past a stroke and have persistent upper-limb motor impairment. Participants will complete 14 training sessions at home, held every second day, while a mobile electroencephalography (EEG) system records brain activity.
Contents
How MINTS is designed
MINTS is a prospective, single-group intervention study using an across-subjects multiple-baseline design. Each participant will first complete a pre-assessment, followed by a baseline period of variable length. The intervention phase will then be followed by post-assessment and an exploratory three-month follow-up.
A multiple-baseline design uses repeated measurements before and during an intervention. In this study, the approach is intended to show whether changes in neural signals or movement begin in a pattern that corresponds with each participant’s start of training, rather than relying only on one measurement before and one measurement after the intervention.
Motor-imagery neurofeedback combines imagining a movement with feedback derived from brain activity. EEG records electrical signals from the scalp, allowing the study team to examine activity associated with motor imagery while participants train outside a laboratory. The protocol is designed to assess the intervention in an everyday home setting, where repeated sessions may be more practical than laboratory-only training.
What the researchers will measure
The study’s primary outcomes are resting-state EEG coherence, used as an index of functional connectivity, and motor-imagery-related EEG activity recorded with mobile EEG during the multiple-baseline design. Functional connectivity describes relationships in activity between brain regions or EEG signals; coherence is one way of quantifying the consistency of those relationships across signal frequencies.
Repeated baseline and training measurements will include grip strength, resting-state EEG, motor-imagery tasks performed with and without neurofeedback, and monitoring of movement in daily life. Before and after the intervention, participants will also undergo broader motor and cognitive testing, stationary EEG and functional magnetic resonance imaging (fMRI).
The secondary outcomes include motor-imagery-related activity measured with stationary EEG, fMRI measures of brain activity and connectivity, clinical measures of motor performance, and movement characteristics derived from sensors and video recordings. The protocol also lists exploratory analyses of broader motor and cognitive performance, relationships between neural and behavioural changes, effects related to stroke lesions, and whether training-related changes persist at follow-up.
Why the protocol matters
Laboratory studies have reported neural and behavioural effects associated with motor-imagery neurofeedback, but the protocol identifies limited evidence on how intensive training works in real-world settings for stroke survivors. MINTS is structured to examine both the timing of changes and the relationship between brain measurements and upper-limb function while participants train at home.
The study’s single-group design and sample of 21 participants make it an early investigation of the intervention. Its findings will be most directly relevant to people with chronic stroke and ongoing upper-limb impairment who match the study criteria. The protocol was registered in the German Clinical Trials Register under DRKS00036147 on 25 March 2025, and the University of Oldenburg’s Commission for Research Impact Assessment and Ethics approved the work under approval number 2023-151.
Because the study is still collecting data, its eventual results will determine whether the planned EEG and imaging changes are accompanied by measurable improvements in motor function and whether any changes remain at the exploratory three-month follow-up.