Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany.
Neurorehabil Neural Repair. 2012 Mar-Apr;26(3):256-65. doi: 10.1177/1545968311418345. Epub 2011 Sep 8.
Despite the availability of various options for movement restoration in stroke patients, there is no effective treatment for patients who show little or no functional recovery of upper limb motor function.
The present study explored the feasibility of real-time functional magnetic resonance imaging brain-computer interface (fMRI-BCI) as a new tool for rehabilitation of this patient population.
Healthy adults and chronic subcortical stroke patients with residual movement were trained for 3 days to regulate the blood oxygenation level dependent (BOLD) response in the ventral premotor cortex (PMv), a secondary motor area with extensive anatomic connections with the primary motor cortex. Effect of learned modulation of the PMv was evaluated with BOLD signal changes across training sessions, transcranial magnetic stimulation (TMS), and a visuomotor task.
fMRI-BCI feedback training showed learning with a significantly increasing BOLD signal in the PMv over sessions. Participants' capability to learn self-regulation was found to depend linearly on intracortical facilitation and correlated negatively with intracortical inhibition measured by TMS prior to feedback training. After training, intracortical inhibition decreased significantly with the volitional increase of the BOLD response in the PMv, indicating a beneficial effect of self-regulation training on motor cortical output.
The study provides first evidence for the therapeutic potential of fMRI-BCI in stroke rehabilitation.
尽管有多种选择可用于恢复脑卒中患者的运动功能，但对于上肢运动功能恢复甚微或无恢复的患者，尚无有效的治疗方法。
本研究探讨了实时功能磁共振成像脑-机接口（fMRI-BCI）作为一种新的康复治疗工具对这一患者群体的可行性。
健康成年人和有残余运动的慢性皮质下脑卒中患者接受了 3 天的训练，以调节腹侧运动前皮质（PMv）的血氧水平依赖（BOLD）反应，PMv 是与初级运动皮质有广泛解剖连接的次级运动区。通过 BOLD 信号在训练过程中的变化、经颅磁刺激（TMS）和视觉运动任务来评估 PMv 习得调节的效果。
fMRI-BCI 反馈训练显示出随着训练次数的增加，PMv 中的 BOLD 信号显著增加的学习效果。研究发现，参与者习得自我调节的能力与 TMS 测量的皮质内易化呈线性相关，与皮质内抑制呈负相关，而皮质内抑制是在反馈训练前测量的。训练后，PMv 的 BOLD 反应的随意增加显著降低了皮质内抑制，表明自我调节训练对运动皮质输出有有益的影响。
该研究为 fMRI-BCI 在脑卒中康复治疗中的治疗潜力提供了初步证据。
