Think to move: a neuromagnetic brain-computer interface (BCI) system for chronic stroke
Think to move: a neuromagnetic brain-computer interface (BCI) system for chronic stroke
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DOI：
10.1161/strokeaha.107.505313
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发表时间：
2008-03-01
期刊：
影响因子：
8.3
通讯作者：
Birbaumer, Niels
中科院分区：
文献类型：
--
作者：
Buch, Ethan;Weber, Cornelia;Birbaumer, Niels
背景和目的-中风是成年人长期运动障碍的主要原因。目前的康复干预在改善最严重的运动损伤病例方面大多不成功，特别是与手功能有关的病例。在这里，我们检验了这样的假设，即至少1年前发生的单一、单侧皮质下、皮质或混合中风导致的手瘫患者，可以通过脑机接口(BCI)接受操作机械手矫形器的训练。方法：8例中风所致慢性手瘫患者(残指伸展功能按医学研究理事会评分=0/5)来自卒中神经康复诊所、美国国立神经疾病与卒中研究所(NINDS)人类皮质生理学分部(n=5)和图宾根大学神经病学诊所(n=3)。诊断性MRI显示所有患者均有单发、单侧皮质下、皮质或混合性病变。本研究使用的是基于脑磁图的脑机接口系统。患者参加了13至22次训练，旨在随意调节源于大脑皮层感觉运动区的MU节律幅度，这反过来又通过BCI界面在屏幕上显示的目标方向上升高或降低屏幕光标。实时直观地提供了绩效反馈。成功的试验(其中光标与目标接触)导致连接到瘫痪手的矫形器的打开/关闭。结果：在8名患者中，有6名患者在训练中成功地控制了BCI。这种对照与阵列中央偏侧(4名患者)或对侧(2名患者)区域上的传感器记录的MU节律调制的范围和特异性增加有关。临床评定手功能的量表在训练后没有明显改善。结论--这些结果表明，中风后通过脑机接口训练可以实现对记录在中央头皮区的神经磁性活动特征的意志控制，并通过机械手矫形器来控制抓握动作。
Background and Purpose - Stroke is a leading cause of long-term motor disability among adults. Present rehabilitative interventions are largely unsuccessful in improving the most severe cases of motor impairment, particularly in relation to hand function. Here we tested the hypothesis that patients experiencing hand plegia as a result of a single, unilateral subcortical, cortical or mixed stroke occurring at least 1 year previously, could be trained to operate a mechanical hand orthosis through a brain-computer interface (BCI).Methods - Eight patients with chronic hand plegia resulting from stroke (residual finger extension function rated on the Medical Research Council scale = 0/5) were recruited from the Stroke Neurorehabilitation Clinic, Human Cortical Physiology Section of the National Institute for Neurological Disorders and Stroke (NINDS) (n = 5) and the Clinic of Neurology of the University of Tubingen (n = 3). Diagnostic MRIs revealed single, unilateral subcortical, cortical or mixed lesions in all patients. A magnetoencephalography-based BCI system was used for this study. Patients participated in between 13 to 22 training sessions geared to volitionally modulate mu rhythm amplitude originating in sensorimotor areas of the cortex, which in turn raised or lowered a screen cursor in the direction of a target displayed on the screen through the BCI interface. Performance feedback was provided visually in real-time. Successful trials (in which the cursor made contact with the target) resulted in opening/closing of an orthosis attached to the paralyzed hand.Results - Training resulted in successful BCI control in 6 of 8 patients. This control was associated with increased range and specificity of mu rhythm modulation as recorded from sensors overlying central ipsilesional (4 patients) or contralesional (2 patients) regions of the array. Clinical scales used to rate hand function showed no significant improvement after training.Conclusions - These results suggest that volitional control of neuromagnetic activity features recorded over central scalp regions can be achieved with BCI training after stroke, and used to control grasping actions through a mechanical hand orthosis.