Motor Imagery Brain-Computer Interface in Rehabilitation of Upper Limb Motor Dysfunction After Stroke

Yongchun Jiang; Junxiao Yin; Biyi Zhao; Yajie Zhang; Tingting Peng; Wanqi Zhuang; Siqing Wang; Siqi Huang; Meilian Zhong; Yanni Zhang; Guibing Tang; Bingchi Shen; Haining Ou; Yuxin Zheng; Qiang Lin

doi:10.3791/65405

Interface cérebro-computador de imagens motoras na reabilitação da disfunção motora do membro sup...

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JoVE Journal Neuroscience

Motor Imagery Brain-Computer Interface in Rehabilitation of Upper Limb Motor Dysfunction After Stroke

Interface cérebro-computador de imagens motoras na reabilitação da disfunção motora do membro superior após acidente vascular cerebral

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09:42 min

September 1, 2023

DOI: 10.3791/65405-v

Yongchun Jiang*^1,2,3, Junxiao Yin*⁴, Biyi Zhao^1,3,5, Yajie Zhang^1,3, Tingting Peng^1,3, Wanqi Zhuang^1,3, Siqing Wang^1,3, Siqi Huang^1,3, Meilian Zhong^1,3, Yanni Zhang^1,3, Guibing Tang^1,3, Bingchi Shen⁶, Haining Ou^1,3, Yuxin Zheng*^2,3, Qiang Lin*^2,3

¹Guangzhou Medical University, ²Department of Rehabilitation Medicine,The Seventh Affiliated Hospital of Sun Yat-sen University, ³Department of Rehabilitation Medicine,The Fifth Affiliated Hospital of Guangzhou Medical University, ⁴Clinical Medical College of Acupuncture and Rehabilitation,Guangzhou University of Traditional Chinese Medicine, ⁵School of Traditional Chinese Medicine,Jinan University, ⁶Department of Stomatology, Second Clinical Medical College,Dongguan Campus of Guangdong Medical University

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Overview

This study explores the clinical application of motor imagery brain-computer interface (MI-BCI) for enhancing upper limb motor function in stroke patients. By utilizing functional near-infrared spectroscopy (fNIRS), it aims to provide insights into the mechanism and operationalization of MI-BCI interventions. The findings indicate positive effects on motor dysfunction which could guide future rehabilitation protocols.

Key Study Components

Area of Science

Neuroscience
Rehabilitation
Clinical Neuroscience

Background

Motor imagery brain-computer interfaces (MI-BCI) are emerging rehabilitation technologies for stroke patients.
Upper limb motor dysfunction is a common aftermath of stroke.
Standardizing clinical operations for MI-BCI can enhance therapeutic outcomes.

Purpose of Study

To establish a reference for the clinical operation of MI-BCI.
To evaluate the efficacy of MI-BCI in improving motor dysfunction in stroke patients.
To demonstrate the operational process and intervention effects of MI-BCI.

Methods Used

Utilized functional near-infrared spectroscopy (fNIRS) for real-time monitoring of hemoglobin concentration changes in the cerebral cortex.
Conducted assessments using Fugl-Meyer and Wolf Motor Function Tests pre- and post-MI-BCI intervention.
Followed a structured training protocol involving EEG cap placement and task settings based on patient performance.

Main Results

MI-BCI training resulted in significant improvements in both motor and cognitive functioning post-treatment.
Increased activation of key cortical areas was observed during functional assessments.
Demonstrated the adaptability of task difficulty in MI-BCI based on patient feedback and performance.

Conclusions

The study establishes MI-BCI as a viable intervention for improving motor function in stroke rehabilitation.
Findings advocate the need for additional research to refine treatment protocols and enhance efficacy.
The operational framework provided can support further studies into the neuroplastic effects of MI-BCI in stroke care.

Frequently Asked Questions

What advantages does MI-BCI offer for stroke rehabilitation?

MI-BCI provides an innovative approach to engage patients in motor rehabilitation through mental imagery, potentially enhancing recovery outcomes.

How is the MI-BCI training protocol structured?

The training involves patient education, EEG cap placement, and gradual adjustments to task difficulty based on the patient's real-time performance.

What types of data are obtained from fNIRS during the study?

fNIRS measures changes in hemoglobin concentrations, which reflect the activation of cerebral areas related to motor tasks during MI-BCI sessions.

How can MI-BCI methods be adapted for various levels of stroke severity?

The training difficulty in MI-BCI can be modulated based on individual patient assessments, ensuring personalized rehabilitation protocols.

What are some limitations of the current MI-BCI study?

Future studies are necessary to confirm the long-term efficacy of MI-BCI and to develop standardized protocols that accommodate different patient needs.

O objetivo deste estudo é fornecer uma referência importante para a operação clínica padrão da interface cérebro-computador de imagens motoras (MI-BCI) para disfunção motora do membro superior após acidente vascular cerebral.

Este estudo enfoca a aplicação clínica do IM-BCI em pacientes com AVC com disfunção motora moderada a grave do membro superior. E fornece ideias e referências para a operação clínica padronizada e pesquisa de mecanismos, demonstrando o processo de operação e o efeito de intervenção do MI-BCI. O MI-BCI apresentou um efeito positivo na melhora da disfunção motora em pacientes com AVC.

No entanto, mais pesquisas clínicas neste campo serão feitas no futuro para protocolos de tratamento mais adequados para este nível diferente de função em pacientes com AVC. Neste estudo, a espectroscopia funcional de infravermelho próximo, fNIRS, foi usada para monitorar as mudanças de concentração de hemoglobina e hemoglobina oxigenante no córtex cerebral em tempo real sob diferentes tarefas de estimulação. Fornecendo assim evidências de imagem para o efeito clínico do MI-BCI.

Apresentamos um protocolo para usar o treinamento MI-BCI em pacientes com AVC para reabilitação motora de membros superiores. Os escores da avaliação de Fugi-Meyer da extremidade superior e do Teste de Função Motora de Wolf melhoraram após o tratamento com MI-BCI. Enquanto isso, a avaliação do fNIRS também mostrou mais ativação do córtex pré-frontal dorsolateral, córtex motor primário e córtex sensorial primário.

Os achados sugerem melhora potencial na função motora e cognitiva em pacientes com AVC após a intervenção do MI-BCI. Métodos originais de intervenção de reabilitação de membros superiores, intervenção periférica ou intervenção central. Considerando que o MI-BCI é baseado no princípio de circuito fechado de centro, periférico e centro, ou modelo central combinado com feedback motor periférico.

O princípio de circuito fechado é mais adequado para a característica da doença do sistema nervoso central.

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Palavras-chave: Imagens Motoras Interface Cérebro-Computador Acidente Vascular Cerebral Disfunção Motora do Membro Superior Reabilitação Não Invasivo Aplicação Clínica Avaliação da Função Cerebral