Institute of Medical Psychology and Behavioral Neurobiology, MEG Center, University of Tübingen, Tübingen, Germany.
Neurorehabil Neural Repair. 2010 Sep;24(7):674-9. doi: 10.1177/1545968310368683. Epub 2010 Jun 2.
There is no accepted and efficient rehabilitation strategy to reduce focal impairments for patients with chronic stroke who lack residual movements.
A 67-year-old hemiplegic patient with no active finger extension was trained with a brain-computer interface (BCI) combined with a specific daily life-oriented physiotherapy. The BCI used electrical brain activity (EEG) and magnetic brain activity (MEG) to drive an orthosis and a robot affixed to the patient's affected upper extremity, which enabled him to move the paralyzed arm and hand driven by voluntary modulation of micro-rhythm activity. In addition, the patient practiced goal-directed physiotherapy training. Over 1 year, he completed 3 training blocks. Arm motor function, gait capacities (using Fugl-Meyer Assessment, Wolf Motor Function Test, Modified Ashworth Scale, 10-m walk speed, and goal attainment score), and brain reorganization (functional MRI, MEG) were repeatedly assessed.
The ability of hand and arm movements as well as speed and safety of gait improved significantly (mean 46.6%). Improvement of motor function was associated with increased micro-oscillations in the ipsilesional motor cortex.
This proof-of-principle study suggests that the combination of BCI training with goal-directed, active physical therapy may improve the motor abilities of chronic stroke patients despite apparent initial paralysis.
对于缺乏残留运动的慢性中风患者，目前尚无公认的有效康复策略来减少局灶性损伤。
对一名 67 岁偏瘫且手指无法主动伸展的患者，采用脑机接口（BCI）联合特定的日常生活导向物理疗法进行训练。BCI 使用脑电图（EEG）和脑磁图（MEG）驱动附在患者患侧上肢上的矫形器和机器人，使他能够通过自愿调节微节奏活动来移动瘫痪的手臂和手。此外，患者还进行了有针对性的物理治疗训练。在 1 年多的时间里，他完成了 3 个训练阶段。手臂运动功能、步态能力（采用 Fugl-Meyer 评估、Wolf 运动功能测试、改良 Ashworth 量表、10 米步行速度和目标达成评分）和大脑重组（功能磁共振成像、脑磁图）进行了反复评估。
手和手臂运动的能力以及步态的速度和安全性显著提高（平均提高 46.6%）。运动功能的改善与对侧运动皮层中微震荡的增加有关。
这项原理验证研究表明，BCI 训练与有针对性的主动物理治疗相结合，可能会改善慢性中风患者的运动能力，尽管他们最初明显瘫痪。
