脑机接口训练用于脊髓损伤患者下肢运动功能改善的效果

Effect of brain⁃computer interface training on improvement of lower limb motor function in patients with spinal cord injury

目的探讨脑机接口训练用于脊髓损伤患者下肢运动功能改善的效果。方法选取安徽医科大学第二附属医院康复医学科进行治疗的脊髓损伤患者60例,分为对照组30例和研究组30例。采用改良Barthel指数(MBI)评估两组患者的日常生活活动能力(ADL),采用功能性步行量表(FAC)评估步行功能,并行静息态功能磁共振成像(rs⁃fMRI),相关性分析采用Pearson检验。结果干预2、4周后两组BBS评分、ASIA运动和感觉评分、MBI评分均优于干预前,其中干预4周后变化更明显(P<0.05);干预2、4周后两组股四头肌和腘绳肌MMT、FAC 3级及以上患者均增加,其中干预4周后增加更多(P<0.05);干预2、4周后研究组各指标变化更明显(P<0.05)。干预4周后研究组患者左侧中央前回背侧(BA4L)/右侧前颞横回(BA41R)、左侧顶叶前梨状皮质(BA5L)/右侧额叶下脚后区(BA48R)间的FC值均明显高于干预前(P<0.05),且与BBS评分、ASIA运动和感觉评分、MBI评分均呈正相关(P<0.05)。结论在常规康复训练基础上给予脑机接口训练有助于改善脊髓损伤患者的下肢运动、感觉功能和生存质量,对提高平衡和步行功能有一定促进作用。

Objective To investigate the effect of brain⁃computer interface(BCI)training on the improve⁃ment of lower limb motor function in patients with spinal cord injury.Methods Sixty patients with spinal cord injury who were treated in the Department of Rehabilitation Medicine of our hospital were selected and divided into control group and study group,with 30 cases in each group.The modified Barthel index(MBI)was used to evaluate the activities of daily living(ADL),and functional ambulation category scale(FAC)to evaluate walking function of the two groups.The resting⁃state functional magnetic resonance imaging(rs⁃fMRI)was performed,and Pearson test was used for correlation analysis.Results The BBS score,ASIA motor and sensory score and MBI score of the two groups after 2 and 4 weeks of intervention were higher than those before,and the changes were more obvious after 4 weeks of intervention(P<0.05);after 2 and 4 weeks of intervention,the numbers of patients with quadriceps muscle and hamstring muscle MMT and FAC of grade 3 or above,and the number of patients with FAC of grade 3 or above increased in both groups,especially after 4 weeks of intervention(P<0.05);after 2 and 4 weeks of intervention,the above indexes of the study group changed significantly(P<0.05).After 4 weeks of intervention,the FC values between BA4L/BA41R and BA5L/BA48R in the study group were significantly higher than those before(P<0.05),and were positively correlated with BBS score,ASIA motor and sensory score and MBI score(P<0.05).Conclusion BCI training on the basis of routine rehabilitation is helpful to improve motor function,sensory function and the quality of life of patients with spinal cord injury,and has a certain role in pro⁃moting the improvement of balance and walking function.