Young Brittany M, Nigogosyan Zack, Nair Veena A, Walton Léo M, Song Jie, Tyler Mitchell E, Edwards Dorothy F, Caldera Kristin, Sattin Justin A, Williams Justin C, Prabhakaran Vivek
Department of Radiology, University of Wisconsin-Madison Madison, WI, USA ; Neuroscience Training Program, University of Wisconsin-Madison Madison, WI, USA ; Medical Scientist Training Program, University of Wisconsin-Madison Madison, WI, USA.
Department of Radiology, University of Wisconsin-Madison Madison, WI, USA.
Front Neuroeng. 2014 Jun 24;7:18. doi: 10.3389/fneng.2014.00018. eCollection 2014.
Therapies involving new technologies such as brain-computer interfaces (BCI) are being studied to determine their potential for interventional rehabilitation after acute events such as stroke produce lasting impairments. While studies have examined the use of BCI devices by individuals with disabilities, many such devices are intended to address a specific limitation and have been studied when this limitation or disability is present in isolation. Little is known about the therapeutic potential of these devices for individuals with multiple disabilities with an acquired impairment overlaid on a secondary long-standing disability. We describe a case in which a male patient with congenital deafness suffered a right pontine ischemic stroke, resulting in persistent weakness of his left hand and arm. This patient volunteer completed four baseline assessments beginning at 4 months after stroke onset and subsequently underwent 6 weeks of interventional rehabilitation therapy using a closed-loop neurofeedback BCI device with visual, functional electrical stimulation, and tongue stimulation feedback modalities. Additional assessments were conducted at the midpoint of therapy, upon completion of therapy, and 1 month after completing all BCI therapy. Anatomical and functional MRI scans were obtained at each assessment, along with behavioral measures including the Stroke Impact Scale (SIS) and the Action Research Arm Test (ARAT). Clinically significant improvements in behavioral measures were noted over the course of BCI therapy, with more than 10 point gains in both the ARAT scores and scores for the SIS hand function domain. Neuroimaging during finger tapping of the impaired hand also showed changes in brain activation patterns associated with BCI therapy. This case study demonstrates the potential for individuals who have preexisting disability or possible atypical brain organization to learn to use a BCI system that may confer some rehabilitative benefit.
涉及新技术（如脑机接口，BCI）的疗法正在进行研究，以确定其在中风等急性事件导致长期损伤后的介入性康复中的潜力。虽然已有研究考察了残疾人对BCI设备的使用情况，但许多此类设备旨在解决特定的局限性，并且是在这种局限性或残疾单独存在时进行研究的。对于这些设备对患有多种残疾且在继发性长期残疾基础上叠加后天性损伤的个体的治疗潜力，人们知之甚少。我们描述了一个案例，一名先天性耳聋男性患者发生了右侧脑桥缺血性中风，导致其左手和左臂持续无力。该患者志愿者在中风发作后4个月开始完成了四项基线评估，随后使用具有视觉、功能性电刺激和舌刺激反馈模式的闭环神经反馈BCI设备进行了6周的介入性康复治疗。在治疗中期、治疗完成时以及完成所有BCI治疗后1个月进行了额外评估。每次评估时均进行了解剖学和功能性MRI扫描，以及包括中风影响量表（SIS）和行动研究臂测试（ARAT）在内的行为测量。在BCI治疗过程中，行为测量结果出现了具有临床意义的改善，ARAT分数和SIS手部功能领域分数均提高了10分以上。对受损手进行手指敲击时的神经成像也显示了与BCI治疗相关的大脑激活模式变化。本案例研究表明，对于已有残疾或可能存在非典型脑组织结构的个体，有潜力学会使用可能带来一些康复益处的BCI系统。
