基于脑电图连接预测慢性中风后上肢运动功能的改善。
Predicting upper extremity motor improvement following therapy using EEG-based connectivity in chronic stroke.
机构信息
Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
Department of Healthcare Leadership and Management, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
出版信息
NeuroRehabilitation. 2022;50(1):105-113. doi: 10.3233/NRE-210171.
BACKGROUND
Uncertain prognosis presents a challenge for therapists in determining the most efficient course of rehabilitation treatment for individual patients. Cortical Sensorimotor network connectivity may have prognostic utility for upper extremity motor improvement because the integrity of the communication within the sensorimotor network forms the basis for neuroplasticity and recovery.
OBJECTIVE
To investigate if pre-intervention sensorimotor connectivity predicts post-stroke upper extremity motor improvement following therapy.
METHODS
Secondary analysis of a pilot triple-blind randomized controlled trial. Twelve chronic stroke survivors underwent 2-week task-practice therapy, while receiving vibratory stimulation for the treatment group and no stimulation for the control group. EEG connectivity was obtained pre-intervention. Motor improvement was quantified as change in the Box and Block Test from pre to post-therapy. The association between ipsilesional sensorimotor connectivity and motor improvement was examined using regression, controlling for group. For negative control, contralesional/interhemispheric connectivity and conventional predictors (initial clinical motor score, age, time post-stroke, lesion volume) were examined.
RESULTS
Greater ipsilesional sensorimotor alpha connectivity was associated with greater upper extremity motor improvement following therapy for both groups (p < 0.05). Other factors were not significant.
CONCLUSION
EEG connectivity may have a prognostic utility for individual patients' upper extremity motor improvement following therapy in chronic stroke.
背景
对于治疗师来说，不确定的预后是确定个体患者最有效的康复治疗方案的一个挑战。皮质感觉运动网络连接可能对上肢运动功能的改善具有预后价值，因为感觉运动网络内的通讯完整性是神经可塑性和恢复的基础。
目的
研究治疗前的感觉运动连接是否可以预测卒中后上肢运动功能的改善。
方法
对一项试点性三盲随机对照试验进行二次分析。12 名慢性卒中幸存者接受了 2 周的任务练习治疗，治疗组接受振动刺激，对照组则不接受刺激。在干预前获得了脑电图连接。通过 Box and Block 测试，从治疗前到治疗后，量化运动改善的情况。使用回归来检查患侧感觉运动连接与运动改善之间的关联，同时控制组的影响。作为负对照，检查对侧/半球间连接和常规预测因子（初始临床运动评分、年龄、卒中后时间、病灶体积）。
结果
对于两个组，更大的患侧感觉运动α连接与治疗后上肢运动功能的改善呈正相关（p<0.05）。其他因素则不显著。
结论
脑电图连接可能对慢性卒中患者治疗后上肢运动功能的改善具有个体预后价值。
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