IEEE Trans Neural Syst Rehabil Eng. 2019 Aug;27(8):1654-1664. doi: 10.1109/TNSRE.2019.2924742. Epub 2019 Jun 24.
With the availability of multiple rehabilitative interventions, identifying the one that elicits the best motor outcome based on the unique neuro-clinical profile of the stroke survivor is a challenging task. Predicting the potential of recovery using biomarkers specific to an intervention hence becomes important. To address this, we investigate intervention-specific prognostic and monitory biomarkers of motor function improvements using quantitative electroencephalography (QEEG) features in 19 chronic stroke patients following two different upper extremity rehabilitative interventions viz. Brain-computer interface (BCI) and transcranial direct current stimulation coupled BCI (tDCS-BCI). Brain symmetry index was found to be the best prognostic QEEG for clinical gains following BCI intervention ( r = -0.80 , p = 0.02 ), whereas power ratio index (PRI) was observed to be the best predictor for tDCS-BCI ( r = -0.96 , p = 0.004 ) intervention. Importantly, statistically significant between-intervention differences observed in the predictive capabilities of these features suggest that intervention-specific biomarkers can be identified. This approach can be further pursued to distinctly predict the expected response of a patient to available interventions. The intervention with the highest predicted gains may then be recommended to the patient, thereby enabling a personalized rehabilitation regime.
有多种康复干预措施可供选择,根据中风幸存者独特的神经临床特征,确定哪种干预措施能产生最佳的运动效果是一项具有挑战性的任务。因此,使用特定于干预措施的生物标志物来预测恢复的潜力变得尤为重要。为了解决这个问题,我们使用定量脑电图 (QEEG) 特征研究了 19 名慢性中风患者在两种不同的上肢康复干预措施(脑机接口 (BCI) 和经颅直流电刺激耦合 BCI (tDCS-BCI) )后,针对运动功能改善的干预特异性预后和监测生物标志物。脑对称指数被发现是 BCI 干预后临床获益的最佳 QEEG 预后指标(r = -0.80,p = 0.02),而功率比指数(PRI)被观察到是 tDCS-BCI 干预的最佳预测指标(r = -0.96,p = 0.004)。重要的是,这些特征的预测能力存在明显的干预间差异,表明可以确定干预特异性生物标志物。可以进一步采用这种方法来明确预测患者对现有干预措施的预期反应。然后可以向患者推荐预测增益最高的干预措施,从而为患者提供个性化的康复方案。