基于运动想象的脑机接口训练改善脑卒中患者上肢及脑功能的研究  

Improvement of upper limb and brain function in stroke patients through motor imagery-brain computer interface training

作　　者：侯思言 汪丽丽 王春方[2,3] Hou Siyan;Wang Lili;Wang Chunfang(The First Clinical Medical College,Nanjing Medical University,Nanjing 211166,China;不详)

机构地区：[1]南京医科大学第一临床医学院,南京211166 [2]天津市人民医院康复医学科,天津300121 [3]天津市康复医学研究所,天津300121

出　　处：《中国康复》2024年第11期643-648,共6页Chinese Journal of Rehabilitation

基　　金：国家自然科学基金(82102652);天津市卫健委青年人才项目(TJWJ2021QN020)。

摘　　要：目的:探究基于运动想象的脑机接口(MI-BCI)电刺激联合常规康复训练对缺血性脑卒中患者上肢功能障碍及脑功能的改善情况。方法:选择缺血性脑卒中后上肢功能障碍患者60例,随机分为对照组和研究组,每组30例。2组患者均给予常规康复治疗,在此基础上,对照组进行神经肌肉电刺激治疗,研究组进行MI-BCI治疗。治疗前、中(治疗2周后)、后(治疗4周后)采用Fugl-Meyer评定量表上肢部分(FMA-UE)和Wolf运动功能评定量表(WMFT)评价患侧上肢运动功能;并对患者进行脑电图检查,通过运动相关脑区α节律绝对功率值评价患者脑功能可塑性,探究脑电指标与上肢康复评分之间的关系。结果:治疗前,2组FMA-UE、WMFT评分、各导联α节律功率值差异均无统计学意义;治疗中,2组FMA-UE、WMFT评分和研究组的α节律功率值均高于治疗前(P<0.01,0.05),2组FMA-UE评分差异无统计学意义,研究组WMFT评分高于对照组(P<0.01),研究组部分导联(C4、FC1、FC2、FC4)功率值高于对照组(P<0.05);治疗后,2组FMA-UE、WMFT评分及α节律功率值均高于治疗前(P<0.05,0.01),2组FMA-UE、WMFT评分及研究组α节律功率值均高于治疗中(P<0.05),研究组FMA-UE、WMFT评分及α节律功率值均高于对照组(P<0.05,0.01),对照组α节律功率值与治疗前及治疗中比较差异无统计学意义;研究组α节律律功率值与康复量表呈显著正相关(P<0.05)。结论:与常规神经肌肉电刺激相比,基于MI-BCI的电刺激训练可以更加有效地改善患者上肢运动功能及脑电α节律,且上肢功能评分与运动相关脑区脑电α节律绝对功率相关。Objective:To investigate the improvement of upper limb dysfunction and brain function in patients with ischemic stroke through the combination of electrostimulation training based on motor imagery-brain computer interface(MI-BCI)and conventional rehabilitation.Methods:A total of 60patients with upper limb dysfunction after ischemic stroke were selected and randomly divided into a control group(30cases)and an experimental group(30cases).Both groups received conventional rehabilitation therapy.The control group received neuromuscular electrical stimulation therapy based on conventional rehabilitation therapy,while the experimental group received BCI therapy based on conventional rehabilitation therapy.Before and 2weeks and 4weeks after treatment,the Fugl-Meyer assessment upper extremity scale(FMA-UE)and the Wolf motor function test(WMFT)were used to evaluate the motor function of the affected upper limb and the ability to perform activities of daily living.EEG examination was also conducted on the patients,and the plasticity of brain function was evaluated by the absolute power value ofαrhythm in motor-related brain regions.The relationship between EEG indicators and upper limb rehabilitation scores was explored.Results:Before treatment,the differences in FMA-UE,WMFT scores,andαrhythm power values in each lead were not statistically significant in the 2groups.During treatment,the FMA-UE,WMFT scores in the two groups,andαrhythm power values in the experimental group were higher than those before treatment(P<0.01,0.05),The differences in the FMA-UE scores in the 2groups were not statistically significant.The WMFT scores in the experimental group were higher than those in the control group(P<0.01),and the power values of some leads(C4,FC1,FC2,FC4)in the experimental group were higher than those in the control group(P<0.05).After treatment,the FMA-UE,WMFT scores andαrhythm power values of the 2groups were higher than those before the treatment(P<0.05,0.01),and the FMA-UE,WMFT scores in both groups andαrhythm power

关 键 词：脑卒中 运动想象 脑机接口 脑电图 脑功能 Α节律 上肢功能 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]