PDF(Pubmed)
Abstract：
Functional electrical stimulation (FES) can support functional restoration of a paretic limb post-stroke. Hebbian plasticity depends on temporally coinciding pre- and post-synaptic activity. A tight temporal relationship between motor cortical (MC) activity associated with attempted movement and FES-generated visuo-proprioceptive feedback is hypothesized to enhance motor recovery. Using a brain-computer interface (BCI) to classify MC spectral power in electroencephalographic (EEG) signals to trigger FES-delivery with detection of movement attempts improved motor outcomes in chronic stroke patients. We hypothesized that heightened neural plasticity earlier post-stroke would further enhance corticomuscular functional connectivity and motor recovery. We compared subcortical non-dominant hemisphere stroke patients in BCI-FES and Random-FES (FES temporally independent of MC movement attempt detection) groups. The primary outcome measure was the Fugl-Meyer Assessment, Upper Extremity (FMA-UE). We recorded high-density EEG and transcranial magnetic stimulation-induced motor evoked potentials before and after treatment. The BCI group showed greater: FMA-UE improvement; motor evoked potential amplitude; beta oscillatory power and long-range temporal correlation reduction over contralateral MC; and corticomuscular coherence with contralateral MC. These changes are consistent with enhanced post-stroke motor improvement when movement is synchronized with MC activity reflecting attempted movement.
摘要：
功能性电刺激（FES）可以支持中风后瘫痪肢体的功能恢复。Hebbian可塑性取决于突触前和突触后活动的时间重合。假设与尝试运动相关的运动皮层（MC）活动与FES生成的视觉本体感受反馈之间存在紧密的时间关系，以增强运动恢复。使用脑机接口（BCI）对脑电图（EEG）信号中的MC频谱功率进行分类，以通过检测运动尝试来触发FES传递，从而改善了慢性中风患者的运动结果。我们假设卒中后早期神经可塑性增强将进一步增强皮质醇功能连接和运动恢复。我们比较了BCI-FES和Random-FES（在时间上与MC运动尝试检测无关的FES）组中的皮质下非优势半球中风患者。主要结果指标是Fugl-Meyer评估，上肢（FMA-UE）。我们记录了治疗前后的高密度脑电图和经颅磁刺激诱发的运动诱发电位。BCI组显示更大：FMA-UE改善；运动诱发电位幅度；β振荡功率和对侧MC的长期时间相关性降低；以及与对侧MC的皮质粒相干性。当运动与反映尝试运动的MC活动同步时，这些变化与增强的行程后运动改善相一致。
