基于功能性近红外光谱探讨脑机接口对脑卒中患者上肢运动功能障碍的效果

doi:10.3969/j.issn.1006-9771.2025.09.010

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (9): 1066-1073.doi: 10.3969/j.issn.1006-9771.2025.09.010

基于功能性近红外光谱探讨脑机接口对脑卒中患者上肢运动功能障碍的效果

高云汉¹^,², 侯闪闪¹^,², 汪鑫煜¹^,², 朱崇田¹^,²()

¹ 山东第二医科大学附属临沂市人民医院，山东临沂市 276000
² 山东第二医科大学康复医学院，山东潍坊市 261053

收稿日期:2025-07-11 修回日期:2025-09-11 出版日期:2025-09-25 发布日期:2025-10-10
通讯作者: 朱崇田(1972-)，男，汉族，硕士，主任医师，硕士研究生导师，主要研究方向：神经康复，E-mail： zhuchongtian@sohu.com。
作者简介:高云汉(1999-)，男，汉族，山东菏泽市人，硕士研究生，主要研究方向：神经康复。
基金资助:
1.山东省重点研发计划项目(2024CXGC010603);2.临沂市重点研发计划项目(2024YX0027)

Effect of brain-computer interface on upper limb motor dysfunction in stroke patients based on functional near-infrared spectroscopy

GAO Yunhan¹^,², HOU Shanshan¹^,², WANG Xinyu¹^,², ZHU Chongtian¹^,²()

¹ Linyi People's Hospital Affiliated to Shandong Second Medical University, Linyi, Shandong 276000, China
² School of Rehabilitation Medicine, Shandong Second Medical University, Weifang, Shandong 261053, China

Received:2025-07-11 Revised:2025-09-11 Published:2025-09-25 Online:2025-10-10
Contact: ZHU Chongtian, E-mail: zhuchongtian@sohu.com
Supported by:
Key Research and Development Program of Shandong Province(2024CXGC010603);Linyi Key Research and Development Program(2024YX0027)

摘要/Abstract

摘要：

目的基于功能性近红外光谱(fNIRS)观察脑机接口(BCI)治疗上肢运动功能障碍脑卒中患者任务态脑区激活的变化。

方法 2024年4月至10月，临沂市人民医院40例脑卒中患者随机分为对照组和BCI组，每组20例。两组均采用常规康复治疗，对照组在常规治疗前进行低频电疗法，BCI组在常规治疗前进行BCI治疗，共4周。治疗前后分别采用Fugl-Meyer评定量表上肢部分(FMA-UE)和改良Barthel指数(MBI)进行评价，并设计“动手腕任务”，检测任务态感兴趣区(ROI)氧合血红蛋白(HbO₂)浓度。

结果治疗后，两组MBI和FMA-UE评分均显著提高(|t| > 8.904, P < 0.001)，且BCI组均高于对照组(|t| > 2.584, P < 0.05)；BCI组前运动区/运动辅助区(PMC/SMA)的HbO₂浓度明显升高(t = -3.965, P < 0.01)，且明显高于对照组(t = -3.630, P < 0.01)。患者治疗前后PMC/SMA脑区HbO₂均值差值与MBI评分差值(r = 0.498, P < 0.05)和FMA-UE评分差值(r = 0.799, P < 0.001)均相关。

结论 BCI可以在常规治疗基础上进一步改善脑卒中患者上肢运动功能，并提高PMC/SMA脑区的皮质激活。

关键词: 脑卒中, 脑机接口, 上肢, 运动功能, 功能性近红外光谱

Abstract:

Objective To explore the changes in task-state brain region activation of stroke patients using functional near-infrared spectroscopy (fNIRS) in the treatment of upper limb motor function with brain-computer interfaces (BCI).

Methods From April to October, 2024, 40 stroke patients in Linyi People's Hospital were randomly divided into control group and BCI group, with 20 cases in each group. Both groups received conventional rehabilitation therapy. The control group underwent low-frequency electrotherapy before conventional treatment, while BCI group received BCI therapy before conventional treatment, for four weeks. Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index were used to evaluate the upper limbs motor function before and after treatment. A "wrist movement task" was designed to detect the level of oxyhemoglobin (HbO₂) in the regions of interest (ROI) during the task.

Results After treatment, the scores of MBI and FMA-UE increased in both groups (|t| > 8.904, P< 0.001), and were higher in BCI group than in the control group (|t| > 2.584, P < 0.05). The HbO₂ level in the premotor cortex/supplementary motor area (PMC/SMA) increased after treatment in BCI group (t = -3.965, P < 0.01), and was higher in BCI group than in the control group (t = -3.630, P < 0.01). The difference of HbO₂ level in PMC/SMA before and after treatment correlated with both the difference of MBI score (r = 0.498, P < 0.05) and the difference of FMA-UE score (r = 0.799, P < 0.001).

Conclusion BCI can further improve the upper limb motor function of stroke patients on the basis of conventional treatment and enhance the cortical activation of PMC/SMA.

Key words: stroke, brain-computer interface, upper limb, motor function, functional near-infrared spectroscopy

中图分类号:

R743.3

高云汉, 侯闪闪, 汪鑫煜, 朱崇田. 基于功能性近红外光谱探讨脑机接口对脑卒中患者上肢运动功能障碍的效果[J]. 《中国康复理论与实践》, 2025, 31(9): 1066-1073.

GAO Yunhan, HOU Shanshan, WANG Xinyu, ZHU Chongtian. Effect of brain-computer interface on upper limb motor dysfunction in stroke patients based on functional near-infrared spectroscopy[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(9): 1066-1073.

图/表 7

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组别	n	性别(男/女)/n	年龄/岁	病程/月	卒中类型 (出血/梗死)/n	偏瘫侧 (左/右)/n	Brunstrom评定(Ⅱ/Ⅲ/Ⅳ/Ⅴ期)
组别	n	性别(男/女)/n	年龄/岁	病程/月	卒中类型 (出血/梗死)/n	偏瘫侧 (左/右)/n	手	上肢
对照组	20	18/2	55.16±15.99	5.63±3.70	7/13	12/8	6/11/2/1	8/8/2/2
BCI组	20	17/3	52.55±13.38	4.90±3.97	6/14	13/7	6/8/4/2	10/5/3/2
χ²/t值		0.229	0.553	0.594	0.114	0.107	1.474	1.115
P值		1.000	0.583	0.556	1.000	1.000	0.688	0.774

变量	组别	n	测试	$\stackrel{-}{x}\pm s$	t值	P值
MBI评分	对照组	20	前测	49.75±14.19	-8.904	< 0.001
			后测	55.25±13.91
	BCI组	20	前测	46.25±12.66	-11.174	< 0.001
			后测	64.50±7.93
	治疗前两组均值差			3.50±4.25	0.823	0.415
	治疗后两组均值差			-9.25±3.58	-2.584	0.014
FMA-UE评分	对照组	20	前测	26.75±6.03	-9.566	< 0.001
			后测	30.85±5.80
	BCI组	20	前测	27.35±7.10	-10.705	< 0.001
			后测	40.25±6.74
	治疗前两组均值差			-0.60±2.08	-0.288	0.775
	治疗后两组均值差			-9.40±1.99	-4.728	< 0.001

ROI	组别	n	测试	$\stackrel{-}{x}\pm s$	t值	P值
PMC/SMA	对照组	20	前测	0.013±0.023	-0.599	0.564
			后测	0.016±0.015
	BCI组	20	前测	0.023±0.032	-3.965	0.003
			后测	0.051±0.027
	治疗前两组均值差			-0.010±0.012	-0.777	0.447
	治疗后两组均值差			-0.035±0.010	-3.630	0.002
PSC	对照组	20	前测	0.025±0.024	-0.647	0.534
			后测	0.032±0.030
	BCI组	20	前测	0.051±0.048	1.196	0.259
			后测	0.027±0.053
	治疗前两组均值差			-0.026±0.017	-1.529	0.143
	治疗后两组均值差			0.004±0.019	0.229	0.821
M1	对照组	20	前测	0.036±0.032	1.162	0.275
			后测	0.019±0.026
	BCI组	20	前测	0.048±0.025	1.108	0.294
			后测	0.032±0.050
	治疗前两组均值差			-0.012±0.013	-0.974	0.342
	治疗后两组均值差			-0.013±0.018	-0.725	0.478

ROI	MBI		FMA-UE
ROI	r值	P值	r值	P值
PMC/SMA	0.498	0.022	0.799	< 0.001
PSC	0.291	0.201	-0.510	0.018
M1	0.405	0.068	-0.123	0.594

基于功能性近红外光谱探讨脑机接口对脑卒中患者上肢运动功能障碍的效果

Effect of brain-computer interface on upper limb motor dysfunction in stroke patients based on functional near-infrared spectroscopy

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