多模态感知反馈训练对脑卒中后上肢功能恢复的脑可塑性研究

脑卒中是一类常见病和多发病，慢性期患者通常遗留有腕关节和手指运动功能障碍，严重影响其日常生活活动能力恢复，因此这是目前康复治疗亟需解决的重点和难点问题。多模态感知反馈训练是整合了包括视觉和躯体感觉输入在内的感知反馈训练，既往研究证实其在慢性期脑卒中患者中应用的可行性和有效性，但是其背后的作用机制还不甚明了。脑重塑是脑卒中患者慢性期肢体功能恢复的重要机制，大脑皮质通过重塑重新获得对肢体的控制是肢体功能恢复的关键。在本研究中，我们将应用多模态感知反馈训练，在上肢严重运动障碍的慢性期脑卒中患者中，综合应用表面肌电图、运动和感觉诱发电位、脑电图、功能核磁共振和弥散张量成像等构建多模态脑功能网络，全方位的揭示脑卒中损伤大脑的可塑性改变，从而为脑卒中患者的精准康复提供理论依据。

Stroke is a common and frequent disease. Chronic stroke patients lived with motor impairment of wrist and fingers, which seriously affect their recovery of activity of daily life. This is the key and important point faced by the rehabilitation medicine. Multi-modal perception feedback training consists of visual and sensory input. Previous researches have indicated that multi-modal perception feedback training was feasible and effective in chronic stroke patients with wrist and finger impairment. But the mechanism behind their recovery was not fully understood. Brain plasticity is important in the recovery of motor impairment in chronic stroke patients. Key process of recovery is the brain regaining control of the upper and lower limp through plasticity. In this study, we will apply multi-modal perception feedback training in chronic stroke patients with severe upper limb impairment and use surface electromyography, motor and sensory evoked potential, electroencephalogram, functional magnetic resonance images and diffusion tensor imaging to build up multi-function brain network. And by thoroughly revealing the plasticity of brain, we could provide evidences for precision rehabilitation in stroke patients.