Remsik Alexander B, Williams Leroy, Gjini Klevest, Dodd Keith, Thoma Jaclyn, Jacobson Tyler, Walczak Matt, McMillan Matthew, Rajan Shruti, Young Brittany M, Nigogosyan Zack, Advani Hemali, Mohanty Rosaleena, Tellapragada Neelima, Allen Janerra, Mazrooyisebdani Mohsen, Walton Leo M, van Kan Peter L E, Kang Theresa J, Sattin Justin A, Nair Veena A, Edwards Dorothy Farrar, Williams Justin C, Prabhakaran Vivek
Department of Radiology, University of Wisconsin-Madison, Madison, WI, United States.
Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, United States.
Front Neurosci. 2019 Mar 6;13:53. doi: 10.3389/fnins.2019.00053. eCollection 2019.
Loss of motor function is a common deficit following stroke insult and often manifests as persistent upper extremity (UE) disability which can affect a survivor's ability to participate in activities of daily living. Recent research suggests the use of brain-computer interface (BCI) devices might improve UE function in stroke survivors at various times since stroke. This randomized crossover-controlled trial examines whether intervention with this BCI device design attenuates the effects of hemiparesis, encourages reorganization of motor related brain signals (EEG measured sensorimotor rhythm desynchronization), and improves movement, as measured by the Action Research Arm Test (ARAT). A sample of 21 stroke survivors, presenting with varied times since stroke and levels of UE impairment, received a maximum of 18-30 h of intervention with a novel electroencephalogram-based BCI-driven functional electrical stimulator (EEG-BCI-FES) device. Driven by spectral power recordings from contralateral EEG electrodes during cued attempted grasping of the hand, the user's input to the EEG-BCI-FES device modulates horizontal movement of a virtual cursor and also facilitates concurrent stimulation of the impaired UE. Outcome measures of function and capacity were assessed at baseline, mid-therapy, and at completion of therapy while EEG was recorded only during intervention sessions. A significant increase in r-squared values [reflecting Mu rhythm (8-12 Hz) desynchronization as the result of attempted movements of the impaired hand] presented post-therapy compared to baseline. These findings suggest that intervention corresponds with greater desynchronization of Mu rhythm in the ipsilesional hemisphere during attempted movements of the impaired hand and this change is related to changes in behavior as a result of the intervention. BCI intervention may be an effective way of addressing the recovery of a stroke impaired UE and studying neuromechanical coupling with motor outputs. ClinicalTrials.gov, identifier NCT02098265.
运动功能丧失是中风损伤后常见的缺陷，通常表现为上肢持续残疾，这会影响幸存者参与日常生活活动的能力。最近的研究表明，使用脑机接口（BCI）设备可能会在中风后的不同时间改善中风幸存者的上肢功能。这项随机交叉对照试验研究了使用这种BCI设备设计进行干预是否能减轻偏瘫的影响，促进与运动相关的脑信号重组（通过脑电图测量的感觉运动节律去同步化），并改善运动功能，运动功能通过动作研究臂测试（ARAT）进行测量。21名中风幸存者参与了该研究，他们中风后的时间和上肢损伤程度各不相同，接受了最多18至30小时的新型基于脑电图的BCI驱动功能性电刺激器（EEG-BCI-FES）设备干预。在提示尝试抓握手部时，根据对侧脑电图电极的频谱功率记录，用户对EEG-BCI-FES设备的输入会调节虚拟光标的水平移动，并同时促进对受损上肢的刺激。在基线、治疗中期和治疗结束时评估功能和能力的结果指标，而脑电图仅在干预期间记录。与基线相比，治疗后反映患侧手尝试运动导致的μ节律（8-12赫兹）去同步化的r平方值显著增加。这些发现表明，干预与患侧手尝试运动时同侧半球μ节律的更大去同步化相关联，并且这种变化与干预导致的行为变化有关。BCI干预可能是解决中风后受损上肢恢复问题以及研究神经机械与运动输出耦合的有效方法。ClinicalTrials.gov标识符：NCT02098265。
