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Longitudinal Electroencephalography Analysis in Subacute Stroke Patients During Intervention of Brain–Computer Interface With Exoskeleton Feedback
Frontiers in Neuroscience ( IF 4.3 ) Pub Date : 2020-08-14 , DOI: 10.3389/fnins.2020.00809
Shugeng Chen 1 , Lei Cao 2 , Xiaokang Shu 3 , Hewei Wang 1 , Li Ding 1 , Shui-Hua Wang 4, 5 , Jie Jia 1, 6
Affiliation  

Background Brain–computer interface (BCI) has been regarded as a newly developing intervention in promoting motor recovery in stroke survivors. Several studies have been performed in chronic stroke to explore its clinical and subclinical efficacy. However, evidence in subacute stroke was poor, and the longitudinal sensorimotor rhythm changes in subacute stroke after BCI with exoskeleton feedback were still unclear. Materials and Methods Fourteen stroke patients in subacute stage were recruited and randomly allocated to BCI group (n = 7) and the control group (n = 7). Brain–computer interface training with exoskeleton feedback was applied in the BCI group three times a week for 4 weeks. The Fugl–Meyer Assessment of Upper Extremity (FMA-UE) scale was used to assess motor function improvement. Brain–computer interface performance was calculated across the 12-time interventions. Sensorimotor rhythm changes were explored by event-related desynchronization (ERD) changes and topographies. Results After 1 month BCI intervention, both the BCI group (p = 0.032) and the control group (p = 0.048) improved in FMA-UE scores. The BCI group (12.77%) showed larger percentage of improvement than the control group (7.14%), and more patients obtained good motor recovery in the BCI group (57.1%) than did the control group (28.6%). Patients with good recovery showed relatively higher online BCI performance, which were greater than 70%. And they showed a continuous improvement in offline BCI performance and obtained a highest value in the last six sessions of interventions during BCI training. However, patients with poor recovery reached a platform in the first six sessions of interventions and did not improve any more or even showed a decrease. In sensorimotor rhythm, patients with good recovery showed an enhanced ERD along with time change. Topographies showed that the ipsilesional hemisphere presented stronger activations after BCI intervention. Conclusion Brain–computer interface training with exoskeleton feedback was feasible in subacute stroke patients. Brain–computer interface performance can be an index to evaluate the efficacy of BCI intervention. Patients who presented increasingly stronger or continuously strong activations (ERD) may obtain better motor recovery.

中文翻译:

外骨骼反馈脑机接口干预亚急性脑卒中患者纵向脑电图分析

背景 脑机接口 (BCI) 已被视为促进中风幸存者运动恢复的新开发干预措施。已经在慢性中风中进行了几项研究,以探索其临床和亚临床疗效。然而,亚急性卒中的证据不足,外骨骼反馈的 BCI 后亚急性卒中的纵向感觉运动节律变化仍不清楚。材料与方法 招募亚急性期卒中患者14例,随机分配至脑机接口组(n=7)和对照组(n=7)。BCI 组每周 3 次,连续 4 周应用外骨骼反馈的脑机接口训练。Fugl-Meyer 上肢评估 (FMA-UE) 量表用于评估运动功能的改善。计算了 12 次干预的脑机接口性能。通过事件相关的去同步 (ERD) 变化和拓扑结构探索感觉运动节律的变化。结果 BCI 干预 1 个月后,BCI 组 (p = 0.032) 和对照组 (p = 0.048) 的 FMA-UE 评分均有改善。BCI组(12.77%)的改善百分比高于对照组(7.14%),BCI组(57.1%)获得良好运动恢复的患者多于对照组(28.6%)。恢复良好的患者在线 BCI 性能相对较高,大于 70%。他们在 BCI 培训期间的最后六次干预中显示了离线 BCI 性能的持续改进,并获得了最高值。然而,恢复不佳的患者在前六次干预中达到了一个平台,并且没有任何改善,甚至出现下降。在感觉运动节律中,恢复良好的患者随着时间的变化表现出ERD增强。地形图显示,在 BCI 干预后,同侧半球表现出更强的激活。结论 外骨骼反馈的脑机接口训练在亚急性脑卒中患者中是可行的。脑机接口性能可以作为评价脑机接口干预效果的指标。表现出越来越强或持续强激活 (ERD) 的患者可能会获得更好的运动恢复。恢复良好的患者随着时间的变化表现出ERD增强。地形图显示,在 BCI 干预后,同侧半球表现出更强的激活。结论 外骨骼反馈的脑机接口训练在亚急性脑卒中患者中是可行的。脑机接口性能可以作为评价脑机接口干预效果的指标。表现出越来越强或持续强激活 (ERD) 的患者可能会获得更好的运动恢复。恢复良好的患者随着时间的变化表现出ERD增强。地形图显示,在 BCI 干预后,同侧半球表现出更强的激活。结论 外骨骼反馈的脑机接口训练在亚急性脑卒中患者中是可行的。脑机接口性能可以作为评价脑机接口干预效果的指标。表现出越来越强或持续强激活 (ERD) 的患者可能会获得更好的运动恢复。
更新日期:2020-08-14
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