脑卒中后功能障碍基于运动想象脑机接口应用处方研究  

Application Prescription of Brain-Computer Interface Based on Motor Imagery in Post-Stroke Dysfunction

作　　者：姜山杉 邱芷晴 尤婷婷 付欣瑜 陈冠州 李昊达 梁柏源 于佳妮 欧海宁 JIANG Shanshan;QIU Zhiqing;YOU Tingting;FU Xinyu;CHEN Guanzhou;LI Haoda;LIANG Boyuan;YU Jiani;OU Haining(The Fifth Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510700,China;The Fifth Clinical College of Guangzhou Medical University,Guangzhou,Guangdong 510700,China;The First Affiliated Hospital of Hunan University of Chinese Medicine,Huaihua,Hunan 422001,China;The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou,Guangdong 510120,China)

机构地区：[1]广州医科大学附属第五医院,广东广州510700 [2]广州医科大学第五临床学院,广东广州510700 [3]湖南医药学院第一附属医院,湖南怀化422001 [4]广州中医药大学第二附属医院,广东广州510120

出　　处：《康复学报》2025年第2期212-220,共9页Rehabilitation Medicine

基　　金：广东省普通高校重点领域专项(2021ZDZX2063);广东省中医院中医康复人才培养项目(01020184);广东省中医院国家自然科学基金培育项目(E57977)。

摘　　要：脑机接口(BCI)是一种不依赖于外周神经肌肉系统,组成大脑输出通路的对外交互控制系统,近年来在神经康复领域备受关注。基于运动想象的脑机接口(MI-BCI)在脑卒中后运动功能障碍、认知功能障碍、吞咽功能障碍康复中具有良好疗效。但是,由于缺乏MI-BCI针对脑卒中后功能障碍康复的确切应用处方,极大地限制了其治疗效果和应用推广。本研究综述MI-BCI在脑卒中后上肢/下肢运动功能障碍、认知功能障碍和吞咽功能障碍中的应用处方,重点探讨了治疗频率、疗程、单次治疗时间等因素对康复效果的影响;并分析提高MI-BCI疗效的非侵入性干预因素(如视/听觉反馈、本体感受和触觉反馈、虚拟现实反馈以及非侵入性脑刺激技术)。MI-BCI在脑卒中康复中治疗处方的关键参数设定(如治疗频率、总疗程、单次治疗时间)与增效手段的标准化等还不统一,也存在一些技术瓶颈,应通过优化应用处方,解决MI-BCI系统的疗效差异问题,提高MI-BCI治疗体系的规范化和稳定性,为MI-BCI在脑卒中康复领域的应用提供参考。Brain-computer interface(BCI)establishes a direct communication pathway between the brain and external devices,bypassing the peripheral neuromuscular system.This technology has attracted increasing attention in neurorehabilitation research.Particularly,motor imagery-based BCI(MI-BCI)has demonstrated therapeutic potential in post-stroke rehabilitation targeting motor dysfunction,cognitive impairment,and swallowing disorders.However,the lack of standardized treatment protocols significantly hampers clinical efficacy and widespread implementation of MI-BCI interventions.This review examines existing application protocols of MI-BCI in treating post-stroke upper/lower limb motor dysfunction,cognitive impairment,and dysphagia,with emphasis on the impact of treatment frequency,total intervention duration,and single-session time allocation on rehabilitation outcomes.Furthermore,it explores non-invasive interventions to enhance MI-BCI efficacy,such as visual/auditory feedback,proprioceptive and tactile feedback,virtual reality feedback,and non-invasive brain stimulation techniques.Current limitations in MI-BCI-based stroke rehabilitation include a lack of standardized protocols for parameter settings(e.g.,treatment frequency,total course duration,single-session duration)and augmenting therapeutic effects,and technical challenges in signal processing.Future directions should prioritize optimizing application protocols to reduce variability in treatment outcomes,improving system standardization and stability,thereby providing a reference for MI-BCI clinical translation in stroke rehabilitation.

关 键 词：脑卒中 功能障碍 神经康复 脑机接口 运动想象 应用处方 

分 类 号：R743.3[医药卫生—神经病学与精神病学]