Resting State Changes in Functional Connectivity Correlate With Movement Recovery for BCI and Robot-Assisted Upper-Extremity Training After Stroke
Resting State Changes in Functional Connectivity Correlate With Movement Recovery for BCI and Robot-Assisted Upper-Extremity Training After Stroke
复制标题
DOI：
10.1177/1545968312445910
复制
发表时间：
2013-01-01
影响因子：
4.2
通讯作者：
Sitaram, Ranganathan
中科院分区：
文献类型：
--
作者：
Varkuti, Balint;Guan, Cuntai;Sitaram, Ranganathan
背景。机器人辅助训练可以改善一些中风后偏瘫患者的运动功能，但没有可靠的康复进展的生理预测指标。静息状态功能磁共振成像（RS-fMRI）可以作为一种评估和预测运动网络变化的方法。目标。作者检查了上肢机器人辅助康复（MANUS）与基于脑电图的脑机接口设置与运动成像（MI EEG-BCI）的效果，并比较了治疗前和治疗后的RS-fMRI。方法。总共有9名上肢神经麻痹的成年人接受了为期4周的MANUS肩肘机器人康复训练。在3名参与者中，如果在2秒内没有主动运动，机器人辅助运动开始。在6名参与者中，如果检测到运动意象，则会启动基于mi - bci的运动。训练前后分别进行RS-fMRI和Fugl-Meyer （FM）上肢运动评分评估。结果。基于RS-fMRI测量前后差异的功能连接变化（FCCs）可以预测个体在12周内的FM评分增加。MI-BCI组FM增益和FCC数值均较高。辅助运动区、对侧和同侧运动皮层以及视觉空间系统部分（主要是联合皮层区域和小脑）的FC增加与个体上肢功能改善相关。结论。FCC可以预测单个电机增益的陡峭程度。因此，未来的训练可以集中在直接诱导这些有益的FC增加上。对治疗组的评估表明心肌梗死是这种神经可塑性的潜在促进者。
Background. Robot-assisted training may improve motor function in some hemiparetic patients after stroke, but no physiological predictor of rehabilitation progress is reliable. Resting state functional magnetic resonance imaging (RS-fMRI) may serve as a method to assess and predict changes in the motor network. Objective. The authors examined the effects of upper-extremity robot-assisted rehabilitation (MANUS) versus an electroencephalography-based brain computer interface setup with motor imagery (MI EEG-BCI) and compared pretreatment and posttreatment RS-fMRI. Methods. In all, 9 adults with upper-extremity paresis were trained for 4 weeks with a MANUS shoulder-elbow robotic rehabilitation paradigm. In 3 participants, robot-assisted movement began if no voluntary movement was initiated within 2 s. In 6 participants, MI-BCI-based movement was initiated if motor imagery was detected. RS-fMRI and Fugl-Meyer (FM) upper-extremity motor score were assessed before and after training. Results. The individual gain in FM scores over 12 weeks could be predicted from functional connectivity changes (FCCs) based on the pre-post differences in RS-fMRI measurements. Both the FM gain and FCC were numerically higher in the MI-BCI group. Increases in FC of the supplementary motor area, the contralesional and ipsilesional motor cortex, and parts of the visuospatial system with mostly association cortex regions and the cerebellum correlated with individual upper-extremity function improvement. Conclusion. FCC may predict the steepness of individual motor gains. Future training could therefore focus on directly inducing these beneficial increases in FC. Evaluation of the treatment groups suggests that MI is a potential facilitator of such neuroplasticity.