Contralesional Brain-Computer Interface Control of a Powered Exoskeleton for Motor Recovery in Chronic Stroke Survivors.
Contralesional Brain-Computer Interface Control of a Powered Exoskeleton for Motor Recovery in Chronic Stroke Survivors.
复制标题
慢性卒中幸存者运动恢复动力外骨骼的脑-机接口控制。
DOI：
10.1161/strokeaha.116.016304
复制
发表时间：
2017-07
期刊：
影响因子：
8.3
通讯作者：
Leuthardt EC
中科院分区：
文献类型：
--
作者：
Bundy DT;Souders L;Baranyai K;Leonard L;Schalk G;Coker R;Moran DW;Huskey T;Leuthardt EC
补充数字内容可在文本中找到。对于中风后影响上肢的运动相关残疾，目前很少有有效的治疗方法来实现功能恢复。这项可行性研究测试了由脑机接口（BCI）驱动的动力外骨骼，利用未受影响的皮质半球的神经活动，是否可以影响慢性偏瘫中风幸存者的运动恢复。这个新颖的系统被设计和配置为基于家庭的设置，以测试脑机接口驱动的神经康复在门诊环境中的可行性。10名患有中重度上肢运动障碍的慢性偏瘫中风幸存者（平均动作研究臂测试=13.4）使用动力外骨骼，利用来自未受影响半球的脑电图信号的频谱功率打开和关闭受影响的手，这些信号与麻痹肢体的想象手部运动有关。患者在家中使用该系统12周。在治疗前、治疗中和治疗后分别评估运动功能。在所有患者中，我们的bci驱动方法在行动研究臂测试中导致了统计上显著的平均6.2分的增加。这种行为改善与脑机接口控制的改善显著相关。握力、运动指数和加拿大职业表现量表的次要指标也有显著改善。研究结果证明了bci驱动的神经康复方法在慢性中风幸存者的非控制样本中使用未受影响的半球的治疗潜力。他们还证明，脑机接口驱动的神经康复可以在家庭环境中有效地进行，从而增加了未来临床转化的可能性。URL: http://www.clinicaltrials.gov。唯一标识符：NCT02552368。
Supplemental Digital Content is available in the text. There are few effective therapies to achieve functional recovery from motor-related disabilities affecting the upper limb after stroke. This feasibility study tested whether a powered exoskeleton driven by a brain–computer interface (BCI), using neural activity from the unaffected cortical hemisphere, could affect motor recovery in chronic hemiparetic stroke survivors. This novel system was designed and configured for a home-based setting to test the feasibility of BCI-driven neurorehabilitation in outpatient environments. Ten chronic hemiparetic stroke survivors with moderate-to-severe upper-limb motor impairment (mean Action Research Arm Test=13.4) used a powered exoskeleton that opened and closed the affected hand using spectral power from electroencephalographic signals from the unaffected hemisphere associated with imagined hand movements of the paretic limb. Patients used the system at home for 12 weeks. Motor function was evaluated before, during, and after the treatment. Across patients, our BCI-driven approach resulted in a statistically significant average increase of 6.2 points in the Action Research Arm Test. This behavioral improvement significantly correlated with improvements in BCI control. Secondary outcomes of grasp strength, Motricity Index, and the Canadian Occupational Performance Measure also significantly improved. The findings demonstrate the therapeutic potential of a BCI-driven neurorehabilitation approach using the unaffected hemisphere in this uncontrolled sample of chronic stroke survivors. They also demonstrate that BCI-driven neurorehabilitation can be effectively delivered in the home environment, thus increasing the probability of future clinical translation. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02552368.