Zhan Gege, Chen Shugeng, Ji Yanyun, Xu Ying, Song Zuoting, Wang Junkongshuai, Niu Lan, Bin Jianxiong, Kang Xiaoyang, Jia Jie
Laboratory for Neural Interface and Brain Computer Interface, State Key Laboratory of Medical Neurobiology, Engineering Research Center of AI and Robotics, Ministry of Education, Shanghai Engineering Research Center of AI and Robotics, MOE Frontiers Center for Brain Science, Institute of AI and Robotics, Academy for Engineering and Technology, Fudan University, Shanghai, China.
Department of Rehabilitation Medicine, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Front Hum Neurosci. 2022 Jun 27;16:909610. doi: 10.3389/fnhum.2022.909610. eCollection 2022.
Traditional rehabilitation strategies become difficult in the chronic phase stage of stroke prognosis. Brain-computer interface (BCI) combined with external devices may improve motor function in chronic stroke patients, but it lacks comprehensive assessments of neurological changes regarding functional rehabilitation. This study aimed to comprehensively and quantitatively investigate the changes in brain activity induced by BCI-FES training in patients with chronic stroke. We analyzed the EEG of two groups of patients with chronic stroke, one group received functional electrical stimulation (FES) rehabilitation training (FES group) and the other group received BCI combined with FES training (BCI-FES group). We constructed functional networks in both groups of patients based on direct directed transfer function (dDTF) and assessed the changes in brain activity using graph theory analysis. The results of this study can be summarized as follows: (i) after rehabilitation training, the Fugl-Meyer assessment scale (FMA) score was significantly improved in the BCI-FES group ( < 0.05), and there was no significant difference in the FES group. (ii) Both the global and local graph theory measures of the brain network of patients with chronic stroke in the BCI-FES group were improved after rehabilitation training. (iii) The node strength in the contralesional hemisphere and central region of patients in the BCI-FES group was significantly higher than that in the FES group after the intervention ( < 0.05), and a significant increase in the node strength of C4 in the contralesional sensorimotor cortex region could be observed in the BCI-FES group ( < 0.05). These results suggest that BCI-FES rehabilitation training can induce clinically significant improvements in motor function of patients with chronic stroke. It can improve the functional integration and functional separation of brain networks and boost compensatory activity in the contralesional hemisphere to a certain extent. The findings of our study may provide new insights into understanding the plastic changes of brain activity in patients with chronic stroke induced by BCI-FES rehabilitation training.
在中风预后的慢性阶段，传统康复策略面临困难。脑机接口（BCI）与外部设备相结合可能会改善慢性中风患者的运动功能，但它缺乏对功能康复相关神经变化的全面评估。本研究旨在全面、定量地研究BCI - FES训练对慢性中风患者大脑活动的影响。我们分析了两组慢性中风患者的脑电图，一组接受功能性电刺激（FES）康复训练（FES组），另一组接受BCI与FES联合训练（BCI - FES组）。我们基于直接定向传递函数（dDTF）构建了两组患者的功能网络，并使用图论分析评估大脑活动的变化。本研究结果可总结如下：（i）康复训练后，BCI - FES组的Fugl - Meyer评估量表（FMA）评分显著提高（<0.05），而FES组无显著差异。（ii）BCI - FES组慢性中风患者大脑网络的全局和局部图论指标在康复训练后均有所改善。（iii）干预后，BCI - FES组患者对侧半球和中央区域的节点强度显著高于FES组（<0.05），且BCI - FES组对侧感觉运动皮层区域的C4节点强度显著增加（<0.05）。这些结果表明，BCI - FES康复训练可使慢性中风患者的运动功能在临床上得到显著改善。它可以改善大脑网络的功能整合和功能分离，并在一定程度上增强对侧半球的代偿活动。我们的研究结果可能为理解BCI - FES康复训练引起的慢性中风患者大脑活动的可塑性变化提供新的见解。
