1 University of Tubingen, Tübingen, Germany.
2 TECNALIA Health Technologies, Neurotechnology Laboratory, San Sebastian, Spain.
Neurorehabil Neural Repair. 2019 Mar;33(3):188-198. doi: 10.1177/1545968319827573. Epub 2019 Feb 5.
Brain-machine interfaces (BMIs) have been recently proposed as a new tool to induce functional recovery in stroke patients.
Here we evaluated long-term effects of BMI training and physiotherapy in motor function of severely paralyzed chronic stroke patients 6 months after intervention.
A total of 30 chronic stroke patients with severe hand paresis from our previous study were invited, and 28 underwent follow-up assessments. BMI training included voluntary desynchronization of ipsilesional EEG-sensorimotor rhythms triggering paretic upper-limb movements via robotic orthoses (experimental group, n = 16) or random orthoses movements (sham group, n = 12). Both groups received identical physiotherapy following BMI sessions and a home-based training program after intervention. Upper-limb motor assessment scores, electromyography (EMG), and functional magnetic resonance imaging (fMRI) were assessed before (Pre), immediately after (Post1), and 6 months after intervention (Post2).
The experimental group presented with upper-limb Fugl-Meyer assessment (cFMA) scores significantly higher in Post2 (13.44 ± 1.96) as compared with the Pre session (11.16 ± 1.73; P = .015) and no significant changes between Post1 and Post2 sessions. The Sham group showed no significant changes on cFMA scores. Ashworth scores and EMG activity in both groups increased from Post1 to Post2. Moreover, fMRI-BOLD laterality index showed no significant difference from Pre or Post1 to Post2 sessions.
BMI-based rehabilitation promotes long-lasting improvements in motor function of chronic stroke patients with severe paresis and represents a promising strategy in severe stroke neurorehabilitation.
脑机接口（BMI）最近被提出作为一种新的工具，以诱导中风患者的功能恢复。
在此，我们评估了 BMI 训练和物理疗法对干预后 6 个月严重瘫痪慢性中风患者运动功能的长期影响。
共邀请了 30 名来自我们之前研究的患有严重手部瘫痪的慢性中风患者，其中 28 名进行了随访评估。BMI 训练包括同侧 EEG-运动感觉节律的自愿去同步，通过机器人矫形器触发瘫痪的上肢运动（实验组，n = 16）或随机矫形器运动（假手术组，n = 12）。两组在 BMI 治疗后都接受了相同的物理治疗，以及干预后的家庭训练计划。在干预前（Pre）、干预后即刻（Post1）和干预后 6 个月（Post2）评估上肢运动评估评分、肌电图（EMG）和功能磁共振成像（fMRI）。
实验组在 Post2 时上肢 Fugl-Meyer 评估（cFMA）评分显著高于 Pre 时（13.44 ± 1.96 比 11.16 ± 1.73；P =.015），而 Post1 与 Post2 时无显著变化。假手术组在 cFMA 评分上无显著变化。两组的 Ashworth 评分和 EMG 活性均从 Post1 增加到 Post2。此外，fMRI-BOLD 偏侧性指数从 Pre 或 Post1 到 Post2 无显著差异。
基于 BMI 的康复促进了严重瘫痪慢性中风患者运动功能的长期改善，是严重中风神经康复的一种有前途的策略。
