Non-Invasive Brain-Signal Training To Induce Motor Control Recovery after Stroke

非侵入性脑信号训练可诱导中风后运动控制恢复

• 批准号: 8045658
• 负责人: JANIS J. DALY
• 金额: $ 5.01万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-01 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8045658
• 关键词: Brain; Electrodes; Electroencephalography; Enrollment; Event; Exercise; Frequencies; Functional disorder; Intervention; Leg; Location; Measures; Methods; Modality; Motor; Movement; Neurons; Patients; Peripheral Nervous System; Protocols documentation; Recovery; Robotics; Signal Transduction; Stroke; Surface; Survivors; Testing; Training; Upper Extremity; arm; base; conventional therapy; grasp; motor control; motor learning; public health relevance; restoration

DESCRIPTION (provided by applicant): Problem. Conventional treatment does not restore normal motor function to many stroke survivors. The majority of available interventions direct treatment at the peripheral nervous system (arms/legs). Since stroke occurs in the brain and results in brain neuronal damage and dysfunction, a more direct approach would be to re-train the brain by directly treating the activation of brain signals that control movement. Purpose: Our purpose is to determine whether the surface-acquired brain signal (electroencephalography (EEG)) can feasibly be re-trained to drive more normal functional reach/grasp in stroke survivors. We will use two different and complimentary brain signal, training components. For the first component, we will train a progressively more normal brain signal (during upper limb reach components), in terms of four brain signal features: location of the signal, amplitude of the signal, wave form of the signal, and frequency content of the signal. In the second component, we will pair brain signal with the desired movement that is performed as close-to-normal as possible. Methods: Hypothesis I: Brain signal training will result in a more normal brain signal during a functional reach/grasp task. (Primary measure: EEG signal amplitude at electrode locations, C3/4 and C5/6, in the alpha frequency band (8-12Hz). Secondary measures will include: brain signal, event related desynchronization (ERD) at each of an array of electrode locations and at 1Hz frequency bins across 6- 30Hz. Hypothesis II: Specifically targeting, invoking, and training the surface-acquired EEG brain signal, and integrating brain signal training into motor learning training of the upper limb reach movement, will result in greater motor restoration versus a comparable comprehensive motor learning intervention without EEG brain signal training. (Primary measure: Arm Motor Ability Test, upper limb function). We will enroll 16 subjects who had a stroke (>6 months) and who will receive brain signal training and upper limb motor learning (8 with cortical; 8 with sub-cortical stroke). We will enroll 8 additional control subjects receiving comparable upper limb motor learning, but no brain signal training. Treatment for both groups will be 5hrs/day, 5days/wk, for 12 wks, based on prior established motor learning protocols. For the 16 subjects in the brain training group, a single 5hr daily session, will be composed of: 1.0 hr/day, brain signal training; 1.5 hrs/day, FES-assisted and robotics-assisted movement (no brain signal training included); 2.5 hrs/day, motor learning (without modalities, without brain signal training). Significance: By directly re-training brain signal, the intervention has the potential to more completely restore motor function for more severely involved patients. PUBLIC HEALTH RELEVANCE: The purpose of this study is to determine whether non-invasively acquired brain signal (electroencephalography (EEG)) can feasibly be re-trained to drive more normal motor function in stroke survivors. Compared to conventional exercise, directly treating brain signal abnormality has the potential to be more beneficial for a greater number of stroke survivors and has the potential to more completely restore normal function, than is otherwise possible without direct brain training.

描述（由申请人提供）：问题。常规治疗不会恢复许多中风幸存者的正常运动功能。大多数可用的干预措施直接在周围神经系统（臂/腿）上进行治疗。由于中风发生在大脑中，并导致大脑神经元损伤和功能障碍，因此更直接的方法是通过直接处理控制运动的大脑信号的激活来重新训练大脑。 目的：我们的目的是确定是否可以重新训练表面获得表面的脑信号（脑电图（EEG）），以驱动中风幸存者中更正常的功能触及范围/抓握。我们将使用两个不同和免费的大脑信号，训练组件。对于第一个组件，我们将以四个脑信号特征训练越来越正常的大脑信号（在上肢到达组件中）：信号的位置，信号的幅度，信号的波形形式以及信号的频率含量。在第二个组件中，我们将将大脑信号与所需的运动配对，并尽可能接近正常。方法：假设I：大脑信号训练将在功能触及/掌握任务期间导致更正常的大脑信号。 （主要度量：电极位置的EEG信号振幅，C3/4和C5/6，在Alpha频带（8-12Hz）中。次级措施将包括：大脑信号，在每个电极位置和每个电极位置的事件相关的异步（ERD），并在1Hz频率范围内，在1Hz频率跨6-30Hz。将大脑信号训练纳入上肢运动的运动训练将导致更多的运动恢复，而无需EEG的大脑信号训练（主要措施：ARM运动能力测试，上肢功能），我们将招募16个受试者。肢体学习，但对两组的脑部信号训练将是5天/周的5天，基于先前已建立的运动方案，每天的5小时训练组中的16个受试者HR/DAY，运动学习（没有大脑信号训练）。脑信号异常有可能对更多的中风幸存者更有益，并且有可能在没有直接脑训练的情况下进行更完全恢复正常功能。