Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Department of Biomedical Engineering, College of Medicine, Keimyung University, 1095, Dalgubeol-daero, Dalseo-gu, Daegu, Republic of Korea.
Sci Rep. 2023 Aug 2;13(1):12514. doi: 10.1038/s41598-023-38749-8.
We investigated the activation pattern of the motor cortex (M1) and parietal cortex during immersive virtual reality (VR)-based mirror visual feedback (MVF) of the upper limb in 14 patients with chronic stroke and severe upper limb hemiparesis and in 21 healthy controls. Participants performed wrist extension with unaffected wrists (dominant side in controls). In the MVF condition, movement of the affected hand was synchronized with that of the unaffected hand. In the no-MVF condition, only the movement of unaffected hand was shown. Mu suppression in bilateral M1 and parietal cortex and mu coherence were analyzed. In patients with stroke, MVF induced significant mu suppression in both the ipsilesional M1 and parietal lobes (p = 0.006 and p = 0.009, respectively), while mu suppression was observed in the bilateral M1 (p = 0.003 for ipsilesional and p = 0.041 for contralesional M1, respectively) and contralesional parietal lobes in the controls (p = 0.036). The ipsilesional mu coherence between the M1 and parietal cortex in patients with stroke was stronger than controls, regardless of MVF condition (p < 0.001), while mu coherence between interhemispheric M1 cortices was significantly weaker in patients with stroke (p = 0.032). Our findings provide evidence of the neural mechanism of MVF using immersive VR in patients with stroke.
我们研究了 14 名慢性卒中伴严重上肢偏瘫患者和 21 名健康对照者在沉浸式虚拟现实（VR）上肢镜像视觉反馈（MVF）中运动皮层（M1）和顶叶皮层的激活模式。参与者使用未受影响的手腕（对照组中的优势侧）进行腕部伸展。在 MVF 条件下，受影响的手的运动与未受影响的手的运动同步。在无 MVF 条件下，仅显示未受影响的手的运动。分析双侧 M1 和顶叶皮层的 mu 抑制和 mu 相干性。在卒中患者中，MVF 诱导同侧 M1 和顶叶（分别为 p = 0.006 和 p = 0.009）以及双侧 M1（同侧 M1 为 p = 0.003，对侧 M1 为 p = 0.041）中均明显抑制 mu 活动，而对照组仅在双侧 M1（同侧 M1 为 p = 0.036）和对侧顶叶中观察到 mu 抑制。卒中患者 M1 和顶叶之间的同侧 mu 相干性强于对照组，无论 MVF 条件如何（p < 0.001），而卒中患者的大脑半球间 M1 皮质的 mu 相干性明显较弱（p = 0.032）。我们的研究结果为使用沉浸式 VR 治疗卒中患者的 MVF 的神经机制提供了证据。
