背景:在临床实践中,由于其在严重运动障碍患者中的可行性,运动想象已被提议作为中风的治疗方式。基于运动图像的干预可以分为开环或闭环。闭环干预基于自愿运动意象和诱导的外周感觉传入(例如,基于脑机接口(BCI)的干预措施)。同时,开环干预包括没有自愿运动想象或感觉传入的方法。静息状态功能连接(rs-FC)定义为功能相关的大脑区域之间无任何刺激的显着时间相关信号。rs-FC是探索大脑连通性基线特征的强大工具。先前的研究报告了运动图像干预后rs-FC的变化。系统评价还报告了基于运动想象的干预措施在行为层面的影响。本研究旨在回顾和描述中风患者运动想象后运动功能改善与rs-FC变化之间的关系。
方法:文献综述基于Arksey和O'Malley的框架。PubMed,OvidMEDLINE,Cochrane中央控制试验登记册,和WebofScience被搜索到2023年9月30日。纳入的研究涵盖以下主题:没有自愿行动的幻觉,运动图像,动作模仿,以及基于BCI的干预措施。分析干预前后rs-FC与运动功能的相关性。经过两名独立研究人员的筛选,13项基于BCI的干预研究,运动意象干预,包括视觉刺激疗法引起的动觉错觉。
结论:本综述中所有与运动想象相关的研究都报告了干预后运动功能的改善。此外,所有这些研究表明,运动功能的变化与rs-FC之间存在显著关系(例如,感觉运动网络和顶叶皮层)。
In clinical practice, motor imagery has been proposed as a treatment modality for stroke owing to its feasibility in patients with severe motor impairment. Motor imagery-based interventions can be categorized as open- or closed-loop. Closed-loop intervention is based on voluntary motor imagery and induced peripheral sensory afferent (e.g., Brain Computer Interface (BCI)-based interventions). Meanwhile, open-loop interventions include methods without voluntary motor imagery or sensory afferent. Resting-state functional connectivity (rs-FC) is defined as a significant temporal correlated signal among functionally related brain regions without any stimulus. rs-FC is a powerful tool for exploring the baseline characteristics of brain connectivity. Previous studies reported changes in rs-FC after motor imagery interventions. Systematic reviews also reported the effects of motor imagery-based interventions at the behavioral level. This study aimed to
review and describe the relationship between the improvement in motor function and changes in rs-FC after motor imagery in patients with stroke.
The literature
review was based on Arksey and O\'Malley\'s framework. PubMed, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science were searched up to September 30, 2023. The included studies covered the following topics: illusion without voluntary action, motor imagery, action imitation, and BCI-based interventions. The correlation between rs-FC and motor function before and after the intervention was analyzed. After screening by two independent researchers, 13 studies on BCI-based intervention, motor imagery intervention, and kinesthetic illusion induced by visual stimulation therapy were included.
All studies relating to motor imagery in this
review reported improvement in motor function post-intervention. Furthermore, all those studies demonstrated a significant relationship between the change in motor function and rs-FC (e.g., sensorimotor network and parietal cortex).