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

Abstract

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

CLC Number:

R743.3

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.

Figures/Tables 7

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References 32

[1]	LI S, JIANG D, ROSENKRANS Z T, et al. Aptamer-conjugated framework nucleic acids for the repair of cerebral ischemia-reperfusion injury[J]. Nano Lett, 2019, 19(10): 7334-7341. doi: 10.1021/acs.nanolett.9b02958 pmid: 31518140
[2]	YI X, ZHU L, SUI G, et al. Inflammation and endothelial function relevant genetic polymorphisms and carotid plaque in Chinese population[J]. J Atheroscler Thromb, 2020, 27(9): 978-994. doi: 10.5551/jat.53074 pmid: 31956237
[3]	SUN X, WANG D, ZHANG T, et al. Eugenol attenuates cerebral ischemia-reperfusion injury by enhancing autophagy via AMPK-mTOR-P70S6K pathway[J]. Front Pharmacol, 2020, 11: 84.
[4]	HANNAN M A, DASH R, SOHAG A A M, et al. Neuroprotection against oxidative stress: phytochemicals targeting TrkB signaling and the Nrf2-ARE antioxidant system[J]. Front Mol Neurosci, 2020, 13: 116. doi: 10.3389/fnmol.2020.00116 pmid: 32714148
[5]	WEI P, WANG P, LI B, et al. Divergence and convergence of cerebral ischemia pathways profile deciphers differential pure additive and synergistic mechanisms[J]. Front Pharmacol, 2020, 11: 80. doi: 10.3389/fphar.2020.00080 pmid: 32161541
[6]	XU L, JI H, JIANG Y, et al. Exosomes derived from CircAkap7-modified adipose-derived mesenchymal stem cells protect against cerebral ischemic injury[J]. Front Cell Dev Biol, 2020, 8: 569977.
[7]	RODGERS H, BOSOMWORTH H, KREBS H I, et al. Robot assisted training for the upper limb after stroke (RATULS): a multicentre randomised controlled trial[J]. Lancet, 2019, 394(10192): 51-62. doi: S0140-6736(19)31055-4 pmid: 31128926
[8]	REYNOLDS C, OSUAGWU B A, VUCKOVIC A. Influence of motor imagination on cortical activation during functional electrical stimulation[J]. Clin Neurophysiol, 2015, 126(7): 1360-1369. doi: 10.1016/j.clinph.2014.10.007 pmid: 25454278
[9]	CARINO-ESCOBAR R I, CARRILLO-MORA P, VALDÉS-CRISTERNA R, et al. Longitudinal analysis of stroke patients' brain rhythms during an intervention with a brain-computer interface[J]. Neural Plast, 2019, 2019: 7084618.
[10]	LIU Z, TANG J, GAO B, et al. Neural signal analysis with memristor arrays towards high-efficiency brain-machine interfaces[J]. Nat Commun, 2020, 11(1): 4234.
[11]	PICHIORRI F, MATTIA D. Brain-computer interfaces in neurologic rehabilitation practice[J]. Handb Clin Neurol, 2020, 168: 101-116. doi: B978-0-444-63934-9.00009-3 pmid: 32164846
[12]	MIAO Y, CHEN S, ZHANG X, et al. BCI-based rehabilitation on the stroke in sequela stage[J]. Neural Plast, 2020, 2020: 8882764.
[13]	GUERRA Z F, LUCCHETTI A L G, LUCCHETTI G. Motor imagery training after stroke: a systematic review and meta-analysis of randomized controlled trials[J]. J Neurol Phys Ther, 2017, 41(4): 205-214. doi: 10.1097/NPT.0000000000000200 pmid: 28922311
[14]	SINHA A M, NAIR V A, PRABHAKARAN V. Brain-computer interface training with functional electrical stimulation: facilitating changes in interhemispheric functional connectivity and motor outcomes post-stroke[J]. Front Neurosci, 2021, 15: 670953.
[15]	LEE S H, KIM S S, LEE B H. Action observation training and brain-computer interface controlled functional electrical stimulation enhance upper extremity performance and cortical activation in patients with stroke: a randomized controlled trial[J]. Physiother Theory Pract, 2022, 38(9): 1126-1134.
[16]	PINTI P, TACHTSIDIS I, HAMILTON A, et al. The present and future use of functional near-infrared spectroscopy (fNIRS) for cognitive neuroscience[J]. Ann N Y Acad Sci, 2020, 1464(1): 5-29.
[17]	刘佳琪, 侯闪闪, 汪鑫煜, 等. 不同吞咽时期大脑皮质激活特征:基于功能性近红外光谱技术[J]. 中国康复理论与实践, 2024, 30(6) : 709-718. doi: 10.3969/j.issn.1006-9771.2024.06.011
	LIU J Q, HOU S S, WANG X Y, et al. Characteristics of cerebral cortex activation in different swallowing periods based on near-infrared spectroscopy[J]. Chin J Rehabil Theory Pract, 2024, 30(6): 709-718.
[18]	李晁金子, 黄富表, 杜晓霞, 等. 功能性近红外光谱技术在利手、非利手主动抓握-释放任务下脑区激活研究中的应用[J]. 中国康复理论与实践, 2021, 27(9): 1066-1071. doi: 10.3969/j.issn.1006-9771.2021.09.010
	LI C J Z, HUANG F B, DU X X, et al. Application of functional near-infrared spectroscopy in brain area activation research: dominant and non-dominant hand under active grasp-release task[J]. Chin J Rehabil Theory Pract, 2021, 27(9): 1066-1071.
[19]	中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组. 中国各类主要脑血管病诊断要点2019[J]. 中华神经科杂志, 2019, 52(9): 710-715.
	Chinese Society of Neurology, Chinese Stroke Society. Diagnostic criteria of cerebrovascular diseases in China (version 2019)[J]. Chin J Neurol, 2019, 52(9): 710-715.
[20]	ANG K K, CHUA K S, PHUA K S, et al. A randomized controlled trial of EEG-based motor imagery brain-computer interface robotic rehabilitation for stroke[J]. Clin EEG Neurosci, 2015, 46(4): 310-320. doi: 10.1177/1550059414522229 pmid: 24756025
[21]	XUE J, REN F, SUN X, et al. A multifrequency brain network-based deep learning framework for motor imagery decoding[J]. Neural Plast, 2020, 2020: 8863223.
[22]	RAMOS-MURGUIALDAY A, BROETZ D, REA M, et al. Brain-machine interface in chronic stroke rehabilitation: a controlled study[J]. Ann Neurol, 2013, 74(1): 100-108.
[23]	WANG A, TIAN X, JIANG D, et al. Rehabilitation with brain-computer interface and upper limb motor function in ischemic stroke: a randomized controlled trial[J]. Med, 2024, 5(6): 559-569.e554. doi: 10.1016/j.medj.2024.02.014 pmid: 38642555
[24]	HARRISON S J, HOUGH M, SCHMID K, et al. When coordinating finger tapping to a variable beat the variability scaling structure of the movement and the cortical BOLD signal are both entrained to the auditory stimuli[J]. Neuroscience, 2018, 392: 203-218. doi: S0306-4522(18)30436-6 pmid: 29958941
[25]	MODI H N, SINGH H, FIORENTINO F, et al. Association of residents' neural signatures with stress resilience during surgery[J]. JAMA Surg, 2019, 154(10): e192552.
[26]	BHAMBHANI Y, FAN J L, PLACE N, et al. Electromyographic, cerebral, and muscle hemodynamic responses during intermittent, isometric contractions of the biceps brachii at three submaximal intensities[J]. Front Physiol, 2014, 5: 190. doi: 10.3389/fphys.2014.00190 pmid: 24966837
[27]	WILCOX T, HASLUP J A, BOAS D A. Dissociation of processing of featural and spatiotemporal information in the infant cortex[J]. Neuroimage, 2010, 53(4): 1256-1263. doi: 10.1016/j.neuroimage.2010.06.064 pmid: 20603218
[28]	KILTENI K, ANDERSSON B J, HOUBORG C, et al. Motor imagery involves predicting the sensory consequences of the imagined movement[J]. Nat Commun, 2018, 9(1): 1617. doi: 10.1038/s41467-018-03989-0 pmid: 29691389
[29]	FORNIA L, PUGLISI G, LEONETTI A, et al. Direct electrical stimulation of the premotor cortex shuts down awareness of voluntary actions[J]. Nat Commun, 2020, 11(1): 705. doi: 10.1038/s41467-020-14517-4 pmid: 32019940
[30]	CHANG C Y, CHEN Y H, YEN N S. Nonlinear neuroplasticity corresponding to sports experience: a voxel-based morphometry and resting-state functional connectivity study[J]. Hum Brain Mapp, 2018, 39(11): 4393-4403.
[31]	BAI Z, FONG K N K, ZHANG J J, et al. Immediate and long-term effects of BCI-based rehabilitation of the upper extremity after stroke: a systematic review and meta-analysis[J]. J Neuroeng Rehabil, 2020, 17(1): 57. doi: 10.1186/s12984-020-00686-2 pmid: 32334608
[32]	SCHULZ R, BRAASS H, LIUZZI G, et al. White matter integrity of premotor-motor connections is associated with motor output in chronic stroke patients[J]. Neuroimage Clin, 2015, 7: 82-86.

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

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

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