基于功能性近红外光谱技术, 观察脑机接口训练系统对亚急性期脑卒中后上肢功能障碍患者功能连接网络的影响

doi:10.3969/j.issn.1004-583X.2025.05.008

摘要/Abstract

摘要：

目的应用功能性近红外光谱技术(functional near-infrared spectroscopy, fNIRS)观察基于运动想象的脑机接口(motor imagery-brain-computer interface, MI-BCI)训练系统对亚急性期脑卒中偏瘫患者脑功能连接(functional connection,FC)的影响。方法按照入院顺序选取2023年1月-2024年1月在常州市德安医院康复医学中心就诊的脑卒中上肢偏瘫患者24例,应用fNIRS采集患者休息以及MI-BCI训练20 min后即刻的静息态数据,以FC为观察指标,选择患者双侧前额叶皮层、初级运动皮层和初级感觉皮层的氧合血红蛋白为感兴趣区域,分析总体FC强度和基于感兴趣区水平的FC强度的差异。结果训练后的总体功能连接强度显著高于休息状态(P<0.05),感兴趣区分析结果发现训练后患侧前额叶皮层(ipsilateral prefrontal cortical,iPFC)与健侧前额叶皮层、iPFC与患侧初级运动皮层(ipsilateral primary motor cortex,iM1)、iPFC与健侧初级运动皮层(contralesional primary motor cortex,cM1)、iM1与cM1、cM1与健侧初级感觉皮层间的FC显著高于休息状态(P<0.05)。结论 MI-BCI训练系统有助于调节双侧大脑平衡并诱导患者皮质重建,可能是其临床有效性的中枢机制。

关键词: 卒中, 上肢功能, 运动想象, 脑机接口, 皮质功能

Abstract:

Objective To observe the effect of motor imagery-brain-computer interface (MI-BCI) training system on brain functional connectivity (FC) in patients with subacute stroke and hemiplegia by functional near infrared spectroscopy (fNIRS). Methods According to the order of admission, 24 stroke patients with upper limb hemiplegia who were treated in the Rehabilitation Medical Center of Changzhou De'an Hospital from January 2023 to January 2024 were recruited. The resting data of patients immediately after resting and MI-BCI training for 20 minutes were collected by fNIRS. Taking FC as the observation index and the oxygenated hemoglobin (HbO2) of bilateral prefrontal cortex (PFC), primary motor cortex (M1) and primary sensory cortex (S1) were selected as the regions of interest, and the differences in the overall FC strength and the FC strength in the region of interest were analyzed. Results After training, the overall FC strength was significantly higher than that of the rest state (P<0.05). The results of region-of-interest (ROI) analysis showed that the FC strength, between affected ipsilateral prefrontal cortex (iPFC) and health contralateral prefrontal cortex (cPFC), between iPFC and affected ipsilateral primary motor cortex (iM1), between iPFC and health contralateral primary motor cortex (cM1), between iM1 and cM1, between cM1 and health contralateral primary somatosensory cortex (cS1) were significantly higher than those of the resting state (P<0.05). Conclusion MI-BCI training system is helpful to regulate bilateral brain balance and induce cortical reconstruction in patients, which may be the central mechanism of its clinical effectiveness.

Key words: stroke, upper limb function, sports imagination, brain-computer interface, cortical function

中图分类号:

R743

徐胜, 杨青青, 张敏. 基于功能性近红外光谱技术, 观察脑机接口训练系统对亚急性期脑卒中后上肢功能障碍患者功能连接网络的影响[J]. 临床荟萃, 2025, 40(5): 428-433.

Xu Sheng, Yang Qingqing, Zhang Min. Effect of motor imagery-brain-computer interface training system on brain functional connectivity in subacute stroke patients with upper limb dysfunction by functional near infrared spectroscopy[J]. Clinical Focus, 2025, 40(5): 428-433.

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链接本文: https://lchc.magtechjournal.com/CN/10.3969/j.issn.1004-583X.2025.05.008

https://lchc.magtechjournal.com/CN/Y2025/V40/I5/428

图/表 6

参考文献 28

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组别	例数	总体FC
训练前	24	0.573±0.394
训练后	24	0.772±0.273
t值		-2.091
P值		0.042

组别	例数	总体FC
训练前	24	0.573±0.394
训练后	24	0.772±0.273
t值		-2.091
P值		0.042

组别	例数		RPFC-										RM1-
组别	例数		LPFC		RM1		LM1		RS1		LS1		LM1	RS1	LS1
训练前	24		0.391(0.148,0.620)		0.429(0.221,0.780)		0.492±0.198		0.443(0.151,0.947)		0.321(0.131,0.739)		0.671±0.439	0.711±0.490	0.518(0.271,1.040)
训练后	24		0.524(0.442,0.809)		0.662(0.462,0.987)		0.683±0.301		0.708(0.501,0.962)		0.652(0.381,0.826)		0.932±0.328	0.981±0.359	0.982(0.603,1.108)
t/Z值			-2.261		-1.939		-1.872		-1.868		-1.891		-2.301	-2.120	-1.921
P值			0.021		0.052		0.071		0.059		0.062		0.029	0.038	0.061
组别		LPFC-								LM1-					RS1-LS1
组别		RM1		LM1		RS1		LS1		RS1		LS1			RS1-LS1
训练前		0.429±0.361		0.418±0.411		0.453±0.381		0.452±0.392		0.523(0.322,1.217)		0.771±0.547			0.780±0.431
训练后		0.646±0.312		0.659±0.303		0.638±0.251		0.641±0.309		0.990(0.702,1.101)		1.009±0.452			0.949±0.311
t/Z值		-2.182		-2.337		-2.019		-1.792		-1.848		-1.531			-1.557
P值		0.032		0.023		0.051		0.079		0.058		0.131			0.130

组别	例数		RPFC-										RM1-
组别	例数		LPFC		RM1		LM1		RS1		LS1		LM1	RS1	LS1
训练前	24		0.391(0.148,0.620)		0.429(0.221,0.780)		0.492±0.198		0.443(0.151,0.947)		0.321(0.131,0.739)		0.671±0.439	0.711±0.490	0.518(0.271,1.040)
训练后	24		0.524(0.442,0.809)		0.662(0.462,0.987)		0.683±0.301		0.708(0.501,0.962)		0.652(0.381,0.826)		0.932±0.328	0.981±0.359	0.982(0.603,1.108)
t/Z值			-2.261		-1.939		-1.872		-1.868		-1.891		-2.301	-2.120	-1.921
P值			0.021		0.052		0.071		0.059		0.062		0.029	0.038	0.061
组别		LPFC-								LM1-					RS1-LS1
组别		RM1		LM1		RS1		LS1		RS1		LS1			RS1-LS1
训练前		0.429±0.361		0.418±0.411		0.453±0.381		0.452±0.392		0.523(0.322,1.217)		0.771±0.547			0.780±0.431
训练后		0.646±0.312		0.659±0.303		0.638±0.251		0.641±0.309		0.990(0.702,1.101)		1.009±0.452			0.949±0.311
t/Z值		-2.182		-2.337		-2.019		-1.792		-1.848		-1.531			-1.557
P值		0.032		0.023		0.051		0.079		0.058		0.131			0.130