Objective. We describe the case of a 66-year-old Japanese male patient who developed medial medullary infarction along with severe motor paralysis and intense numbness of the left arm, pain catastrophizing, and abnormal physical sensation. We further describe his recovery using a new imagery neurofeedback-based multisensory systems (iNems) training method. Clinical Course and Intervention. The patient underwent physical therapy for the rehabilitation of motor paralysis and numbness of the paralyzed upper limbs; in addition, we implemented iNems training using EEG activity, which aims to synchronize movement intent (motor imagery) with sensory information (feedback visual information). Results. Considerable improvement in motor function, pain catastrophizing, representation of the body in the brain, and abnormal physical sensations was accomplished with iNems training. Furthermore, iNems training improved the neural activity of the default mode network at rest and the sensorimotor region when the movement was intended. Conclusions. The newly developed iNems could prove a novel, useful tool for neurorehabilitation considering that both behavioral and neurophysiological changes were observed in our case.

中文翻译：

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使用新型 iNems 训练治疗内侧延髓梗死：病例报告和文献综述

客观的。我们描述了一名 66 岁的日本男性患者的病例，他出现了内侧延髓梗死，伴有严重的运动麻痹和左臂强烈麻木、灾难性的疼痛和身体感觉异常。我们使用一种新的基于图像神经反馈的多感官系统 (iNems) 训练方法进一步描述了他的康复情况。临床课程和干预。患者接受物理治疗以康复运动麻痹和瘫痪上肢麻木；此外，我们使用 EEG 活动实施了 iNems 训练，旨在将运动意图（运动意象）与感官信息（反馈视觉信息）同步。结果。运动功能的显着改善、灾难性的疼痛、身体在大脑中的表现，异常的身体感觉是通过 iNems 训练完成的。此外，iNems 训练改善了默认模式网络在静止时的神经活动和预期运动时的感觉运动区域。结论。考虑到在我们的案例中观察到行为和神经生理学变化，新开发的 iNems 可以证明是一种新颖的、有用的神经康复工具。