慢性中风后患者上肢功能运动时的脑动关系

IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Journal of NeuroEngineering and Rehabilitation Pub Date : 2024-10-22 DOI:10.1186/s12984-024-01461-3
C O Muller, G Faity, M Muthalib, S Perrey, G Dray, B Xu, J Froger, D Mottet, I Laffont, M Delorme, K Bakhti
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引用次数: 0

摘要

背景:中风后,大脑激活重组、运动补偿策略、运动表现及其在康复过程中的演变对临床医生来说非常重要。有两种非侵入性神经成像方法可以记录与任务相关的大脑激活:功能性近红外光谱(fNIRS)和脑电图(fEEG),它们分别基于血液动力学反应和神经元电活动。在运动过程中同时测量这两项技术可以更好地绘制大脑激活的时空图谱,并与运动参数相关联,从而揭示上肢功能恢复的内在机制。本研究旨在利用 fNIRS-fEEG 组合描绘运动皮层活动模式及其与慢性中风后患者在 UL 功能任务中的运动表现和策略之间的关系:研究招募了 21 名健康的老年人和 21 名慢性中风后遗症患者,让他们完成两项标准化的 UL 功能任务:一项是有节奏的前伸任务,要求他们够到前方的目标;另一项是环形转向任务,要求他们用手持式触控笔以最快的速度在投影在电脑屏幕上的环形轨道内移动目标。利用 fNIRS-fEEG 和运动学平台同时记录了双侧运动皮层的活动和运动表现:运动学分析表明,脑卒中后患者在环形转向任务中表现较差,在这两项任务中都使用了更多的躯干补偿。对双侧运动皮层的大脑分析显示,中风患者在瘫痪UL伸手任务中过度激活,这与更多的躯干使用和更高的损伤程度(临床评分)有关。这项研究为使用这种综合方法更好地跟踪和了解中风康复过程中大脑运动的演变开辟了道路。
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Brain-movement relationship during upper-limb functional movements in chronic post-stroke patients.

Background: Following a stroke, brain activation reorganisation, movement compensatory strategies, motor performance and their evolution through rehabilitation are matters of importance for clinicians. Two non-invasive neuroimaging methods allow for recording task-related brain activation: functional near-infrared spectroscopy (fNIRS) and electroencephalography (fEEG), respectively based on hemodynamic response and neuronal electrical activity. Their simultaneous measurement during movements could allow a better spatiotemporal mapping of brain activation, and when associated to kinematic parameters could unveil underlying mechanisms of functional upper limb (UL) recovery. This study aims to depict the motor cortical activity patterns using combined fNIRS-fEEG and their relationship to motor performance and strategies during UL functional tasks in chronic post-stroke patients.

Methods: Twenty-one healthy old adults and 21 chronic post-stroke patients were recruited and completed two standardised functional tasks of the UL: a paced-reaching task where they had to reach a target in front of them and a circular steering task where they had to displace a target using a hand-held stylus, as fast as possible inside a circular track projected on a computer screen. The activity of the bilateral motor cortices and motor performance were recorded simultaneously utilizing a fNIRS-fEEG and kinematics platform.

Results and conclusions: Kinematic analysis revealed that post-stroke patients performed worse in the circular steering task and used more trunk compensation in both tasks. Brain analysis of bilateral motor cortices revealed that stroke individuals over-activated during the paretic UL reaching task, which was associated with more trunk usage and a higher level of impairment (clinical scores). This work opens up avenues for using such combined methods to better track and understand brain-movement evolution through stroke rehabilitation.

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来源期刊
Journal of NeuroEngineering and Rehabilitation
Journal of NeuroEngineering and Rehabilitation 工程技术-工程:生物医学
CiteScore
9.60
自引率
3.90%
发文量
122
审稿时长
24 months
期刊介绍: Journal of NeuroEngineering and Rehabilitation considers manuscripts on all aspects of research that result from cross-fertilization of the fields of neuroscience, biomedical engineering, and physical medicine & rehabilitation.
期刊最新文献
Comparison of synergy extrapolation and static optimization for estimating multiple unmeasured muscle activations during walking. Immersive virtual reality for learning exoskeleton-like virtual walking: a feasibility study. Instrumented assessment of lower and upper motor neuron signs in amyotrophic lateral sclerosis using robotic manipulation: an explorative study. Rest the brain to learn new gait patterns after stroke. Effects of virtual reality rehabilitation after spinal cord injury: a systematic review and meta-analysis.
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