Tani Marina, Ono Yumie, Matsubara Miku, Ohmatsu Satoko, Yukawa Yoshihiro, Kohno Masashi, Tominaga Takanori
Murata Hospital, 4-2-1, Tajima, Ikuno-ku, Osaka 544-0011, Japan.
Health Science and Medical Engineering Laboratory, Department of Electronics and Bioinformatics, School of Science and Technology, Meiji University, 1-1-1 Higashi-mita, Tama-ku, Kawasaki, Kanagawa 213-8571, Japan.
Neurosci Res. 2018 Aug;133:7-14. doi: 10.1016/j.neures.2017.10.002. Epub 2017 Oct 12.
Motor imagery (MI) is a mental practice that reproduces the visual- and/or kinesthetic-modality brain activations accompanying movement. It is a useful rehabilitation technique as the affected motor cortex can be stimulated in patients with stroke and hemiplegia. However, most patients with stroke have difficulty with MI owing to advanced age and/or higher-cognitive dysfunction, thus impairing their ability to internally simulate the action. We therefore investigated whether action observation (AO), an alternative form of motor stimulation that works via the mirror-neuron system, could facilitate motor cortical activity in such patients. Combined AO and physical training of the observed actions has been reported to have a positive impact on motor deficits after stroke. Eleven patients with stroke and hemiplegia affecting the hand performed MI and AO with verbal and video instructions under 19 channels of electroencephalogram (EEG) recording. The event-related desynchronization (ERD) was measured as an electroencephalographic marker of motor cortical activity. The ERD power in the AO condition (30.0±5.0%) was significantly higher than that in the MI condition (12.2±3.9%). These results suggest that AO could be a good option for patients with stroke who have difficulty using MI to effectively stimulate and reestablish cortical-peripheral motor pathways.
运动想象（MI）是一种心理练习，它能再现伴随运动的视觉和/或动觉模态的大脑激活。它是一种有用的康复技术，因为中风和偏瘫患者的受影响运动皮层可以受到刺激。然而，大多数中风患者由于年龄较大和/或存在更高认知功能障碍而难以进行运动想象，从而损害了他们在内心模拟动作的能力。因此，我们研究了动作观察（AO），一种通过镜像神经元系统起作用的运动刺激替代形式，是否能促进此类患者的运动皮层活动。据报道，将动作观察与对观察到的动作进行身体训练相结合，对中风后的运动缺陷有积极影响。11名手部受影响的中风偏瘫患者在19通道脑电图（EEG）记录下，通过言语和视频指导进行运动想象和动作观察。事件相关去同步化（ERD）被作为运动皮层活动的脑电图标记进行测量。动作观察条件下的ERD功率（30.0±5.0%）显著高于运动想象条件下的（12.2±3.9%）。这些结果表明，对于难以使用运动想象来有效刺激和重建皮层-外周运动通路的中风患者，动作观察可能是一个不错的选择。
