Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong, China; National Innovation Center for Advanced Medical Devices, Shenzhen, China.
Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong, China.
Comput Biol Med. 2021 Oct;137:104801. doi: 10.1016/j.compbiomed.2021.104801. Epub 2021 Aug 25.
Neuromuscular electrical stimulation (NMES) has been widely utilized in post-stroke motor restoration. However, its impact on the closed-loop sensorimotor control process remains largely unclear. This is the first study to investigate the directional changes in cortico-muscular interactions after repetitive rehabilitation training by measuring the noninvasive electroencephalogram (EEG) and electromyography (EMG) signals. In this study, 10 subjects with chronic stroke received 20 sessions of NMES-pedaling interventions, and each training session included three 10-min NMES-driven pedaling trials. In addition, pre- and post-intervention assessments of lower limb isometric contraction were conducted before and after the whole NMES-pedaling interventions. The EEG (128 channels) and EMG (3 bilateral lower limb sensors) signals were collected during the isometric contraction tasks for the paretic and non-paretic lower limbs. Both the cortico-muscular coherence (CMC) and generalized partial directed coherence (GPDC) values were analyzed between eight selected EEG channels in the central primary motor cortex and EMG channels. The results revealed significant clinical improvements. Additionally, rehabilitation training facilitated cortico-muscular interaction of the ipsilesional brain and paretic lower limbs (p = 0.004). Moreover, both the descending and ascending cortico-muscular pathways were altered after NMES-training (p = 0.001, p < 0.001). Therefore, the results implied potential applications of EEG-EMG in understanding neuromuscular changes during the post-stroke motor rehabilitation process.
神经肌肉电刺激（NMES）已广泛应用于脑卒中后的运动功能恢复。然而，其对闭环感觉运动控制过程的影响在很大程度上仍不清楚。这是第一项通过测量非侵入性脑电图（EEG）和肌电图（EMG）信号来研究重复康复训练后皮质-肌肉相互作用的方向变化的研究。在这项研究中，10 名慢性脑卒中患者接受了 20 次 NMES 蹬踏干预，每次训练包括 3 次 10 分钟的 NMES 驱动蹬踏试验。此外，在整个 NMES 蹬踏干预前后，对下肢等长收缩进行了干预前和干预后的评估。在等长收缩任务期间，采集了患侧和非患侧下肢的 EEG（128 通道）和 EMG（3 个双侧下肢传感器）信号。在中央初级运动皮层的 8 个选定 EEG 通道和 EMG 通道之间分析了皮质-肌肉相干性（CMC）和广义部分定向相干性（GPDC）值。结果显示出显著的临床改善。此外，康复训练促进了同侧大脑和患侧下肢的皮质-肌肉相互作用（p=0.004）。此外，NMES 训练后，下行和上行皮质-肌肉通路都发生了改变（p=0.001，p<0.001）。因此，结果表明 EEG-EMG 在理解脑卒中后运动康复过程中的神经肌肉变化方面具有潜在的应用价值。
