Zich Catharina, Debener Stefan, Schweinitz Clara, Sterr Annette, Meekes Joost, Kranczioch Cornelia
1 Neuropsychology Lab, Department of Psychology, European Medical School, University of Oldenburg, Oldenburg, Germany.
2 Department of Experimental Psychology, University of Oxford, Oxford, UK.
Clin EEG Neurosci. 2017 Nov;48(6):403-412. doi: 10.1177/1550059417717398. Epub 2017 Jul 5.
Motor imagery (MI) with neurofeedback has been suggested as promising for motor recovery after stroke. Evidence suggests that regular training facilitates compensatory plasticity, but frequent training is difficult to integrate into everyday life. Using a wireless electroencephalogram (EEG) system, we implemented a frequent and efficient neurofeedback training at the patients' home. Aiming to overcome maladaptive changes in cortical lateralization patterns we presented a visual feedback, representing the degree of contralateral sensorimotor cortical activity and the degree of sensorimotor cortex lateralization. Three stroke patients practiced every other day, over a period of 4 weeks. Training-related changes were evaluated on behavioral, functional, and structural levels. All 3 patients indicated that they enjoyed the training and were highly motivated throughout the entire training regime. EEG activity induced by MI of the affected hand became more lateralized over the course of training in all three patients. The patient with a significant functional change also showed increased white matter integrity as revealed by diffusion tensor imaging, and a substantial clinical improvement of upper limb motor functions. Our study provides evidence that regular, home-based practice of MI neurofeedback has the potential to facilitate cortical reorganization and may also increase associated improvements of upper limb motor function in chronic stroke patients.
有证据表明，结合神经反馈的运动想象（MI）对中风后的运动恢复很有前景。有证据表明，定期训练有助于代偿性可塑性，但频繁训练难以融入日常生活。我们使用无线脑电图（EEG）系统，在患者家中实施了频繁且高效的神经反馈训练。为了克服皮质偏侧化模式的适应不良变化，我们呈现了一种视觉反馈，代表对侧感觉运动皮质活动程度和感觉运动皮质偏侧化程度。三名中风患者每隔一天训练一次，为期4周。在行为、功能和结构层面评估与训练相关的变化。所有三名患者均表示他们喜欢训练，并且在整个训练过程中积极性很高。在所有三名患者的训练过程中，患侧手的运动想象诱发的脑电图活动变得更加偏侧化。功能有显著变化的患者还表现出弥散张量成像显示的白质完整性增加，以及上肢运动功能的实质性临床改善。我们的研究提供了证据，表明定期在家进行运动想象神经反馈训练有可能促进皮质重组，也可能增加慢性中风患者上肢运动功能的相关改善。
