文章摘要
基于运动想象的脑机接口技术改善颈段脊髓损伤手功能障碍患者1例
Brain-computer interface technology based on motor imaging improved hand dysfunction in 1 patient with cervical spinal cord injury
投稿时间:2024-03-16  修订日期:2024-03-16
DOI:
中文关键词: 运动想象  脑机接口  脊髓损伤  神经康复
英文关键词: motor imagery  brain-computer interface  spinal cord injury  neural rehabilitation
基金项目:
作者单位邮编
王彬 南昌大学第二附属医院康复医学科 330000
杨柳 南昌大学第二附属医院康复医学科 
刘小平 南昌大学第二附属医院康复医学科 
胡东霞 南昌大学第二附属医院康复医学科 330000
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中文摘要:
      脊髓损伤(Spinal cord injury,SCI)是一种高发病率、高费用、高致残率、低发病年龄的疾病 [1],可由高强度损伤引起,如交通事故、坠落伤和暴力损伤,也可由感染、肿瘤、脊柱退行性疾病等原因引起,致使中枢和躯体之间的信息传递通路会出现不同程度的受损 [2],损伤平面以下功能暂时或永久性改变,特别是感觉和运动功能 [3, 4]。严重的 SCI 会给患者及其家人带来严重的身体、心理和经济负担。在SCI恢复期间,康复治疗在其中发挥着重要角色,如运动疗法、物理因子、针灸及矫形器等多种治疗方式的介入,但这些治疗效果存在有限、起效慢、疗效长等缺点,因此SCI患者的功能恢复也一直是康复领域研究的难题和挑战 [5]。 近年来,越来越多新兴智能康复技术运用于此领域,神经科学和工程技术结合的快速发展并不断创新,为SCI患者康复提供了更先进、便捷的手段,如非侵入性的脑机接口(Brain-computer interface,BCI)等,由于非侵入性BCI市场接受程度高、操作简单、安全无创、成本较低等,其已逐步投入到临床使用 [6]。虽然BCI技术在神经科学领域的研究与外部设备(神经假体和功能性电刺激等)结合居多 [7],但目前其在临床上的运用还是与运动想象(Motor imagery,MI)结合为主,大多数患者均能在BCI系统中获得更高精准度,对运动功能障碍患者的功能恢复更有益处 [8]。 本研究进行BCI训练是基于MI基础上联合视、听刺激输入与反馈,对一名颈段SCI的手功能障碍患者进行治疗,在治疗过程中患者通过MI以驱动康复机器人带动患手屈和伸,以期达到改善手功能为目的。
英文摘要:
      Spinal cord injury (SCI) is a disease with high morbidity, high cost, high disability rate, and low age of onset [1], which can be caused by high-intensity injuries, such as traffic accidents, fall injuries, and violent injuries, as well as infections, tumors, and degenerative diseases of the spine, resulting in varying degrees of impairment of the information transmission pathways between the center and the body [2], and temporary or permanent changes in function below the level of injury, especially sensory and motor functions [3, 4]. Severe SCI can be a significant physical, psychological, and financial burden for patients and their families. During the recovery period of SCI, rehabilitation therapy plays an important role in it, such as the intervention of various treatment methods such as exercise therapy, physical factors, acupuncture, and orthoses, but these treatment effects have the disadvantages of limited effect, slow onset, and long curative effect, so the functional recovery of SCI patients has always been a difficult problem and challenge in the field of rehabilitation research [5]. In recent years, more and more emerging intelligent rehabilitation technologies have been applied in this field, and the rapid development and continuous innovation of the combination of neuroscience and engineering technology have provided more advanced and convenient means for the rehabilitation of SCI patients, such as non-invasive brain-computer interface (BCI), which has been gradually put into clinical use due to its high market acceptance, simple operation, safety and non-invasiveness, and low cost [6]. Although BCI technology is mostly combined with external devices (neuroprostheses and functional electrical stimulation) in the field of neuroscience [7], its current clinical application is still mainly combined with motor imagery (MI), and most patients can obtain higher accuracy in the BCI system, which is more beneficial for the functional recovery of patients with motor dysfunction [8]. In this study, BCI training was based on MI combined with visual and auditory stimulus input and feedback to treat a patient with hand dysfunction in cervical SCI, and the patient was driven by a rehabilitation robot to bend and extend the affected hand through MI during the treatment, in order to improve hand function.
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