Cognitive and Motor Learning Research Program, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Ohio, USA.
J Neurol Phys Ther. 2009 Dec;33(4):203-11. doi: 10.1097/NPT.0b013e3181c1fc0b.
BACKGROUND/PURPOSE: A large proportion of individuals with stroke have persistent deficits for which current interventions have not restored normal motor behavior. Noninvasive brain computer interfaces (BCIs) have potential advantages for restoration of function. There are also potential advantages for combining BCI with functional electrical stimulation (FES). We tested the feasibility of combined BCI + FES for motor learning after stroke.
The participant was a 43-year-old woman who was 10 months post-stroke. She was unable to produce isolated movement of any of the digits of her involved hand. With effort she exhibited simultaneous mass hyperextension of metacarpal phalangeal joints of all four fingers and thumb with simultaneous flexion of proximal interphalangeal and distal interphalangeal joints of all fingers.
Brain signals from the lesioned hemisphere were used to trigger FES for movement practice. The BCI + FES intervention consisted of trials of either attempted finger movement and relax conditions or imagined finger movement and relax conditions. The training was performed three times per week for three weeks (nine sessions total).
: The participant exhibited highly accurate control of brain signal in the first session for attempted movement (97%), imagined movement (83%), and some difficulties with attempted relaxation (65%). By session 6, control of relaxation (deactivation of brain signal) improved to >80%. After nine sessions (three per week) of BCI + FES intervention, the participant demonstrated recovery of volitional isolated index finger extension.
BCI + FES training for motor learning after stroke was feasible. A highly accurate brain signal control was achieved, and this signal could be reliably used to trigger the FES device for isolated index finger extension. With training, volitional control of isolated finger extension was attained in a small number of sessions. The source of motor recovery could be attributable to BCI, FES, combined BCI + FES, or whole arm or hand motor task practice.
背景/目的：很大一部分中风患者存在持续性缺陷，而目前的干预措施尚未恢复其正常运动功能。非侵入性脑机接口（BCI）在功能恢复方面具有潜在优势。BCI 与功能性电刺激（FES）相结合也具有潜在优势。我们测试了联合 BCI+FES 用于中风后运动学习的可行性。
参与者是一位 43 岁的女性，中风后 10 个月。她无法单独移动患手的任何一个手指。她费力地表现出所有四个手指的掌指关节同时过度伸展，拇指同时弯曲，所有手指的近节指间关节和远节指间关节同时弯曲。
来自损伤半球的脑信号用于触发 FES 以进行运动练习。BCI+FES 干预包括尝试手指运动和放松条件或想象手指运动和放松条件的试验。训练每周进行三次，共进行三周（九次）。
在第一次尝试运动（97%）、想象运动（83%）和尝试放松（65%）的试验中，参与者表现出高度准确的脑信号控制。到第 6 次试验时，放松（脑信号去激活）的控制提高到>80%。在接受了 BCI+FES 干预的九次（每周三次）治疗后，参与者展示了对自愿单独食指伸展的恢复。
中风后运动学习的 BCI+FES 训练是可行的。实现了高度准确的脑信号控制，并且该信号可以可靠地用于触发 FES 设备以实现单独食指伸展。经过训练，在少数几次试验中就实现了对单独食指伸展的自主控制。运动恢复的来源可能归因于 BCI、FES、联合 BCI+FES 或整个手臂或手运动任务的练习。
