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近红外光谱介导的神经反馈增强了基于运动想象的脑卒中后患者训练的疗效:一项初步研究。

Near-infrared spectroscopy-mediated neurofeedback enhances efficacy of motor imagery-based training in poststroke victims: a pilot study.

机构信息

Neurorehabilitation Research Institute, Morinomiya Hospital, Osaka, Japan.

出版信息

Stroke. 2013 Apr;44(4):1091-8. doi: 10.1161/STROKEAHA.111.674507. Epub 2013 Feb 12.

Abstract

BACKGROUND AND PURPOSE

Despite the findings that motor imagery and execution are supposed to share common neural networks, previous studies using imagery-based rehabilitation have revealed inconsistent results. In the present study, we investigated whether feedback of cortical activities (neurofeedback) using near-infrared spectroscopy could enhance the efficacy of imagery-based rehabilitation in stroke patients.

METHODS

Twenty hemiplegic patients with subcortical stroke received 6 sessions of mental practice with motor imagery of the distal upper limb in addition to standard rehabilitation. Subjects were randomly allocated to REAL and SHAM groups. In the REAL group, cortical hemoglobin signals detected by near-infrared spectroscopy were fed back during imagery. In the SHAM group, irrelevant randomized signals were fed back. Upper limb function was assessed using the finger and arm subscales of the Fugl-Meyer assessment and the Action Research Arm Test.

RESULTS

The hand/finger subscale of the Fugl-Meyer assessment showed greater functional gain in the REAL group, with a significant interaction between time and group (F(2,36)=15.5; P<0.001). A significant effect of neurofeedback was revealed even in severely impaired subjects. Imagery-related cortical activation in the premotor area was significantly greater in the REAL group than in the SHAM group (T(58)=2.4; P<0.05).

CONCLUSIONS

Our results suggest that near-infrared spectroscopy-mediated neurofeedback may enhance the efficacy of mental practice with motor imagery and augment motor recovery in poststroke patients with severe hemiparesis.

摘要

背景与目的

尽管运动想象和执行被认为共享共同的神经网络,但先前使用基于想象的康复的研究显示出不一致的结果。在本研究中,我们调查了使用近红外光谱的皮层活动反馈(神经反馈)是否可以增强中风患者基于想象的康复的效果。

方法

20 名皮质下中风偏瘫患者在标准康复治疗的基础上接受了 6 次远端上肢运动想象的心理练习。患者被随机分配到 REAL 和 SHAM 组。在 REAL 组中,近红外光谱检测到的皮层血红蛋白信号在想象过程中被反馈。在 SHAM 组中,反馈的是不相关的随机信号。上肢功能使用 Fugl-Meyer 评估的手指和手臂子量表以及动作研究手臂测试进行评估。

结果

Fugl-Meyer 评估的手/手指子量表在 REAL 组中显示出更大的功能增益,时间和组之间存在显著的交互作用(F(2,36)=15.5;P<0.001)。即使在严重受损的患者中,也显示出神经反馈的显著效果。REAL 组的运动前区想象相关皮层激活明显大于 SHAM 组(T(58)=2.4;P<0.05)。

结论

我们的结果表明,近红外光谱介导的神经反馈可能增强运动想象的心理练习的效果,并增强严重偏瘫中风患者的运动恢复。

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