脑电图作为脊髓损伤患者功能恢复的生物标志物
Electroencephalography as a Biomarker for Functional Recovery in Spinal Cord Injury Patients.
作者信息
Simis Marcel, Doruk Camsari Deniz, Imamura Marta, Filippo Thais Raquel Martins, Rubio De Souza Daniel, Battistella Linamara Rizzo, Fregni Felipe
机构信息
Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States.
出版信息
Front Hum Neurosci. 2021 Apr 9;15:548558. doi: 10.3389/fnhum.2021.548558. eCollection 2021.
BACKGROUND
Functional changes after spinal cord injury (SCI) are related to changes in cortical plasticity. These changes can be measured with electroencephalography (EEG) and has potential to be used as a clinical biomarker.
METHOD
In this longitudinal study participants underwent a total of 30 sessions of robotic-assisted gait training (RAGT) over a course of 6 weeks. The duration of each session was 30 min. Resting state EEG was recorded before and after 30-session rehabilitation therapy. To measure gait, we used the Walking Index for Spinal Cord Injury Scale, 10-Meter- Walking Test, Timed-Up-and-Go, and 6-Min-Walking Test. Balance was measured using Berg Balance Scale.
RESULTS
Fifteen participants with incomplete SCI who had AIS C or D injuries based on American Spinal Cord Injury Association Impairment Scale classification were included in this study. Mean age was 35.7 years (range 17-51) and the mean time since injury was 17.08 (range 4-37) months. All participants showed clinical improvement with the rehabilitation program. EEG data revealed that high beta EEG activity in the central area had a negative correlation with gait ( = 0.049; β coefficient: -0.351; and adj- : 0.23) and balance ( = 0.043; β coefficient: -0.158; and adj- :0.24) measured at baseline, in a way that greater high beta EEG power was related to worse clinical function at baseline. Moreover, improvement in gait and balance had negative correlations with the change in alpha/theta ratio in the parietal area (Gait: = 0.049; β coefficient: -0.351; adj- : 0.23; Balance: = 0.043; β coefficient: -0.158; and adj- : 0.24).
CONCLUSION
In SCI, functional impairment and subsequent improvement following rehabilitation therapy with RAGT correlated with the change in cortical activity measured by EEG. Our results suggest that EEG alpha/theta ratio may be a potential surrogate marker of functional improvement during rehabilitation. Future studies are necessary to improve and validate these findings as a neurophysiological biomarker for SCI rehabilitation.
背景
脊髓损伤（SCI）后的功能变化与皮质可塑性的改变有关。这些变化可以通过脑电图（EEG）测量，并且有潜力用作临床生物标志物。
方法
在这项纵向研究中，参与者在6周的时间里总共接受了30次机器人辅助步态训练（RAGT）。每次训练时长为30分钟。在30次康复治疗前后记录静息状态脑电图。为了测量步态，我们使用了脊髓损伤步行指数量表、10米步行测试、计时起立行走测试和6分钟步行测试。使用伯格平衡量表测量平衡。
结果
本研究纳入了15名根据美国脊髓损伤协会损伤量表分类为AIS C或D级损伤的不完全性SCI患者。平均年龄为35.7岁（范围17 - 51岁），受伤后的平均时间为17.08个月（范围4 - 37个月）。所有参与者在康复计划中均表现出临床改善。脑电图数据显示，中央区域的高β脑电图活动与基线时测量的步态（p = 0.049；β系数： - 0.351；调整后R²：0.23）和平衡（p = 0.043；β系数： - 0.158；调整后R²：0.24）呈负相关，即更高的高β脑电图功率与基线时更差的临床功能相关。此外，步态和平衡的改善与顶叶区域α/θ比值的变化呈负相关（步态：p = 0.049；β系数： - 0.351；调整后R²：0.23；平衡：p = 0.043；β系数： - 0.158；调整后R²：0.24）。
结论
在SCI中，RAGT康复治疗后的功能损害及随后的改善与脑电图测量的皮质活动变化相关。我们的结果表明，脑电图α/θ比值可能是康复期间功能改善的潜在替代标志物。未来有必要进行研究以改进和验证这些发现，使其成为SCI康复的神经生理学生物标志物。
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