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1. 苏州大学附属第四医院康复医学科,苏州
2. 张家港市第一人民医院,苏州
3. 苏州大学机电工程学院,苏州
4. 苏州大学康复研究所,苏州
5. 苏州大学附属第一医院,苏州
Published:2025
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张志颖, 李春光, 苏敏. 脑机接口对缺血性脑卒中患者上肢功能影响的近红外脑功能成像研究[J]. 2025, 47(4): 300-306.
目的观察脑机接口(BCI)对缺血性脑卒中后上肢功能障碍患者上肢功能的影响
并采用近红外脑功能成像技术(fNIRS)观察BCI干预前、后患者大脑皮质激活模式的变化。方法选择符合标准的缺血性脑卒中后上肢功能障碍患者30例
按随机数字表法将其分为治疗组和对照组
每组患者15例。2组患者均进行常规上肢功能康复训练
治疗组患者在此基础上进行上肢BCI训练
每日训练1次
每次锻炼30 min
每周训练5 d
连续训练4周。于治疗前、治疗2周和4周后采用Fugl-Meyer上肢运动功能评分和改良的Barthel指数评分(MBI)评定2组患者的上肢功能和日常生活活动能力;采用fNIRS检测2组患者患侧半球和健侧半球的运动前区(PMC)、辅助运动区(SMA)和感觉运动区(SMC)的氧合血红蛋白值(HbO2);同时观察2组患者在进行上肢训练时大脑的脑网络拓扑结构的变化规律
并计算其脑网络效率特征。结果治疗2周、4周后
2组患者的Fugl-Meyer量表和MBI量表评分较组内治疗前均显著改善(P<0.05)。治疗2周、4周后
治疗组患者的Fugl-Meyer量表和MBI量表评分均显著优于对照组同时间点
差异均有统计学意义(P<0.05)。治疗前
2组患者患侧SMA区的HbO2均显著低于组内其他ROI区(P<0.05)。治疗4周后
治疗组患侧PMC区和患侧SMA区的HbO2较组内治疗前均显著增加(P<0.05)
且治疗组患者患侧PMC区的HbO2较对照组同时间点显著增加(P<0.05)。治疗4周后
治疗组的网络效率为0.18678
显著高于对照组同时间点的0.15501
差异有统计学意义(P<0.05)。结论在常规神经内科药物治疗和康复治疗的基础上增加BCI训练
不仅可以显著改善脑卒中后上肢功能障碍患者的运动功能和日常生活活动能力
还可增强患者患侧半球PMC区和SMA区的皮质激活
以及各脑区间的网络效率。
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grid.239585.0, 0000 0001 2285 2675, Department of Neuroscience, Kavli Institute for Brain Science, David Mahoney Center, Columbia University Medical Center, 10032, New York, New York, USA,grid.168010.e, 0000000419368956, Department of Electrical Engineering, Stanford University, 94305, Stanford, California, USA,grid.168010.e, 0000000419368956, Neurosciences Program, Stanford University, 94305, Stanford, California, USA,grid.4367.6, 0000 0001 2355 7002, Department of Biomedical Engineering, Washington University in St Louis, 63130, St Louis, Missouri, USA,grid.5335.0, 0000000121885934, Department of Engineering, University of Cambridge, Cambridge CB2 1PZ, UK,grid.168010.e, 0000000419368956, Department of Electrical Engineering, Stanford University, 94305, Stanford, California, USA,grid.168010.e, 0000000419368956, Neurosciences Program, Stanford University, 94305, Stanford, California, USA,grid.168010.e, 0000000419368956, Department of Electrical Engineering, Stanford University, 94305, Stanford, California, USA,grid.168010.e, 0000000419368956, Department of Bioengineering, Stanford University, 94705, Stanford, California, USA,grid.168010.e, 0000000419368956, Stanford University School of Medicine, 94305, Stanford, California, USA,grid.168010.e, 0000000419368956, Department of Electrical Engineering, Stanford University, 94305, Stanford, California, USA,grid.468196.4, 0000 0004 0543 3542, Department of Neurosurgery, Palo Alto Medical Foundation, 94301, Palo Alto, California, USA,grid.168010.e, 0000000419368956, Department of Electrical Engineering, Stanford University, 94305, Stanford, California, USA,grid.168010.e, 0000000419368956, Neurosciences Program, Stanford University, 94305, Stanford, California, USA,grid.168010.e, 0000000419368956, Department of Bioengineering, Stanford University, 94705, Stanford, California, USA,grid.168010.e, 0000000419368956, Department of Neurobiology, Stanford University School of Medicine, 94305, Stanford, California, USA.Neural population dynamics during reaching.[J].Nature,2012.
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