视觉运动诱导的脑机接口技术应用于脑卒中患者上肢运动功能和认知功能的效果

doi:10.3969/j.issn.1006-9771.2023.04.013

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (4): 472-478.doi: 10.3969/j.issn.1006-9771.2023.04.013

视觉运动诱导的脑机接口技术应用于脑卒中患者上肢运动功能和认知功能的效果

杨延辉¹, 王浩冲², 董媛媛¹, 史改革², 李秋霞¹, 张洁¹, 石秀娥¹()

1.陕西省康复医院，陕西西安市 710065
2.生物医学信息工程教育部重点实验室，西安交通大学生命科学与技术学院，健康与康复科学研究所，陕西西安市 710049

收稿日期:2022-04-22 修回日期:2023-02-01 出版日期:2023-04-25 发布日期:2023-05-19
通讯作者: 石秀娥， E-mail： shixe@126.com
作者简介:杨延辉(1979-)，男，汉族，河南汝州市人，副主任治疗师，主要研究方向：脑卒中、脑外伤、骨折术后、烧伤、运动损伤等疾病的康复评估与治疗。
基金资助:
国家重点研发计划项目(2018YFC2002300);国家重点研发计划项目(2018YFC2002301)

Effect of visual motion-induced brain computer interface technology on upper limb motor and cognitive function of patients with stroke

YANG Yanhui¹, WANG Haochong², DONG Yuanyuan¹, SHI Gaige², LI Qiuxia¹, ZHANG Jie¹, SHI Xiu'e¹()

1. Shaanxi Provincial Rehabilitation Hospital, Xi'an, Shaanxi 710065, China
2. The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi 710049, China

Received:2022-04-22 Revised:2023-02-01 Published:2023-04-25 Online:2023-05-19
Contact: SHI Xiu'e, E-mail: shixe@126.com
Supported by:
National Key R & D Plan Project(2018YFC2002300);National Key R & D Plan Project(2018YFC2002301)

摘要/Abstract

摘要：

目的探讨视觉运动诱导的脑机接口(BCI)技术应用于脑卒中患者上肢运动功能和认知功能的治疗效果。
方法 2021年7月至2022年3月，陕西省康复医院患有上肢手功能障碍和认知障碍的脑卒中患者50例随机分为对照组(n = 25)和试验组(n = 25)。两组均接受常规康复，对照组进行传统被动式手功能康复训练，试验组进行视觉运动诱导的BCI康复训练，共2周。治疗前后分别比较两组Fugl-Meyer评定量表上肢部分(FMA-UE)、改良Barthel指数(MBI)和蒙特利尔认知评估量表(MoCA)评分，并对计算试验组的脑参与度。
结果治疗前，两组FMA-UE、MBI和MoCA评分比较均无显著性差异(P > 0.05)。治疗2周后，两组FMA-UE、MBI和MoCA评分均较治疗前显著提高(t > 2.481, P < 0.001)，且试验组优于对照组(t > 2.453, P < 0.05)；试验组平均脑参与度在治疗后上升21%。
结论基于视觉运动诱导的BCI康复训练有利于促进脑卒中患者上肢运动功能的恢复以及认知功能的提升。

关键词: 脑卒中, 脑机接口, 运动功能, 认知功能

Abstract:

Objective To investigate the effects of visual motion-induced brain-computer interface (BCI) technology on upper limb motor function and cognitive function of patients with stroke.
Methods From July, 2021 to March, 2022, 50 stroke patients with upper limb hand dysfunction in Shaanxi Provincial Rehabilitation Hospital were randomly divided into control group (n = 25) and experimental group (n = 25). Both groups received conventional rehabilitation therapy, in addition, the control group received passive rehabilitation training, and the experimental group received visual motion-induced BCI rehabilitation training, for two weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), modified Barthel Index (MBI) and Montreal Cognitive Assessment (MoCA) before and after treatment. Brain participation was evaluated during the whole training process of the experimental group.
Results Before treatment, there was no difference in the scores of FMA-UE, MBI and MoCA between two groups (P > 0.05). Two weeks after treatment, the scores of FMA-UE, MBI and MoCA improved in both groups (t > 2.481, P < 0.001), and were better in the exprimental group than in the control group (t > 2.453, P < 0.05); the mean brain participation of the experimental group increased 21% after treatment.
Conclusion Visual motion-induced BCI rehabilitation training could promote the recovery of motor function of upper limb, and cognitive function of patients with stroke.

Key words: stroke, brain computer interface, motor function, cognitive function

中图分类号:

R743.3

杨延辉, 王浩冲, 董媛媛, 史改革, 李秋霞, 张洁, 石秀娥. 视觉运动诱导的脑机接口技术应用于脑卒中患者上肢运动功能和认知功能的效果[J]. 《中国康复理论与实践》, 2023, 29(4): 472-478.

YANG Yanhui, WANG Haochong, DONG Yuanyuan, SHI Gaige, LI Qiuxia, ZHANG Jie, SHI Xiu'e. Effect of visual motion-induced brain computer interface technology on upper limb motor and cognitive function of patients with stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(4): 472-478.

图/表 7

表1

两组基线资料比较"

组别	n	性别 (男/女)/n	年龄/岁	病程/d	Brunnstrom分期
					上肢				手
					I期	II期	III期	IV期	I期	II期	III期	IV期
对照组	25	16/9	50.92 $±$ 10.43	83.16 $±$ 46.89	0	11	7	7	7	13	5	0
试验组	25	18/7	55.72 $±$ 11.55	66.28 $±$ 37.44	0	11	6	8	8	9	8	0
t/χ²/Z值		0.368	1.542	-1.407	0.135				0.343
P值		0.544	0.143	0.179	0.893				0.732

表1

图1

图2

表2

两组治疗前后上肢FMA-UE评分比较"

组别	n	治疗前	治疗后	t值	P值
对照组	25	34.52 $±$ 2.76	49.18 $±$ 2.65	7.568	< 0.001
试验组	25	33.28 $±$ 2.35	57.83 $±$ 3.16	20.321	< 0.001
t值		0.901	4.773
P值		0.378	< 0.001

表2

表3

两组治疗前后MBI评分比较"

组别	n	治疗前	治疗后	t值	P值
对照组	25	53.42 $±$ 3.16	71.62 $±$ 3.66	4.795	< 0.001
试验组	25	55.17 $±$ 3.35	84.72 $±$ 3.23	13.338	< 0.001
t值		0.484	5.563
P值		0.604	< 0.001

表3

表4

两组治疗前后MoCA评分比较"

组别	n	治疗前	治疗后	t值	P值
对照组	25	16.81 $±$ 4.36	20.67 $±$ 3.92	2.481	< 0.001
试验组	25	17.97 $±$ 5.83	24.14 $±$ 4.16	4.885	< 0.001
t值		0.817	2.453
P值		0.433	0.020

表4

图3

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视觉运动诱导的脑机接口技术应用于脑卒中患者上肢运动功能和认知功能的效果

Effect of visual motion-induced brain computer interface technology on upper limb motor and cognitive function of patients with stroke

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