Functional magnetic resonance imaging of brain activity during hybrid assistive limb intervention in a chronic spinal cord injury patient with C4 quadriplegia
Functional magnetic resonance imaging of brain activity during hybrid assistive limb intervention in a chronic spinal cord injury patient with C4 quadriplegia
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DOI：
10.1016/j.jocn.2022.02.027
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发表时间：
2022-02
影响因子：
2
通讯作者：
K. Saotome;A. Matsushita;Fumihiko Eto;Yukiyo Shimizu;S. Kubota;H. Kadone;Akira Ikumi;A. Marushima;T. Masumoto;M. Koda;Hiroshi Takahashi;Kosei Miura;A. Matsumura;Y. Sankai;M. Yamazaki
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文献类型：
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作者：
K. Saotome;A. Matsushita;Fumihiko Eto;Yukiyo Shimizu;S. Kubota;H. Kadone;Akira Ikumi;A. Marushima;T. Masumoto;M. Koda;Hiroshi Takahashi;Kosei Miura;A. Matsumura;Y. Sankai;M. Yamazaki
混合辅助肢体(HAL)是一种可穿戴的机器人，最近已被用于治疗包括脊髓损伤(SCI)在内的运动障碍患者。虽然一些研究已经表明HAL对脊髓损伤患者的有效性，但HAL干预期间脑活动的变化还没有得到充分的表征。一名19岁的男性慢性脊髓损伤导致完全性C4四肢瘫痪，接受了为期五周的HAL训练，共十次。在第四次、第六次和第十次HAL治疗后，我们使用任务诱导功能磁共振成像(FMRI)评估了他的大脑活动。我们还使用改良的Ashworth评分(MAS)评估了这位患者的痉挛状态。作为任务诱发功能磁共振成像的对照，我们检测了两名健康受试者的大脑活动。功能磁共振成像的结果表明，与对照组相比，患者大脑皮层对运动想象任务的反应增强。此外，在HAL干预的五周期间，他大脑皮层的激活模式发生了变化。我们观察到他的初级运动皮质的大脑偏侧化增加。我们还发现，在HAL治疗过程中，为中央前回计算的偏侧指数与MAS总分呈显著负相关。我们的结果表明，目前脊髓损伤患者的大脑皮层在表象任务中高度活跃，随着HAL治疗的进展，大脑皮层的激活减少。
Hybrid assistive limb (HAL) is a wearable robot, which has recently been used for the treatment of patients with movement disorders including spinal cord injury (SCI). Although several studies have indicated the effectiveness of HAL for SCI patients, changes in brain activity during the HAL intervention have not yet been fully characterized. A 19-year-old man with a chronic SCI resulting in complete C4 quadriplegia underwent five weeks of HAL training for a total of ten sessions. We evaluated his brain activity using task-induced functional MRI (fMRI) after the fourth, sixth and tenth HAL sessions. We also assessed the spasticity of this patient using the modified Ashworth scale (mAs). As controls for the task-induced fMRI, we examined the brain activity in two healthy subjects. The fMRI findings indicated an increased response to a motor imagery task in the patient's cerebral cortex compared to controls. In addition, the activation pattern in his cortex changed during the five weeks of HAL intervention. We observed increased cerebral lateralization in his primary motor cortex. We also found that the laterality index calculated for the precentral gyrus had a significant negative correlation with the total mAs score over the course of the HAL treatment. Our results indicate that the cerebral cortex of the present SCI patient was hyperactive during the imagery task, and the cortical activation was reduced with progression of the HAL treatment.