卒中后运动神经反馈康复训练研究进展与前景

脑卒中(stroke)是脑区突发血管病变引起局部功能障碍的综合病症,亦是全世界第一致残类恶性神经系统疾病。运动康复训练对卒中后的功能恢复起十分重要作用,其关键在于通过肢体运动,诱发促进脑区受害神经组织产生可塑性改变,以实现运动功能的改善和恢复。但传统的被动重复训练无法调动患者的参与度和积极性,严重影响康复效果。近年来兴起基于运动想象脑-机接口(MI-BCI)的运动神经反馈康复训练模式,可由患者的主观运动意图内源性地驱动相应脑区神经来产生可塑性变化,通过大脑神经功能重组来促进肢体运动康复。评述本体感觉、视觉反馈等不同运动神经反馈模式在卒中康复训练中的应用研究进展,讨论目前MI-BCI神经反馈康复训练系统存在问题及解决对策,并预期未来的发展前景。

Research Progress and Prospects of Motor Neurofeedback Rehabilitation Training after Stroke

Stroke is a comprehensive disease of local dysfunction caused by sudden vascular disease in brain area, which is the first malignant neurological disease in the world. Exercise rehabilitation training plays an important role in the recovery of function after stroke. The key lies in the improvement of the plasticity of the injured nerve tissue in brain area through limb movement induction to achieve the improvement and recovery of motor function. However, traditional passive repeated training approaches cannot arouse patients’ participation and enthusiasm, which seriously affects the rehabilitation effect. In recent years, the model of motor neurofeedback rehabilitation training based on the motor imagery brain-machine interface (MI-BCI) can be driven by the endogenicity of patients′ subjective motor intention to produce plastic changes in the corresponding brain regions, and it can promote limb motor rehabilitation through brain functional recombination. This paper reviewed the application of different motor neurofeedback modes including proprioception and visual feedback in stroke rehabilitation training, discussed the existing challenges and solutions of the current MI-BCI neurofeedback rehabilitation training system, and provided opinions for the future development.