感觉-运动整合的卒中上肢康复脑机接口可行性分析OA

Objective This study aimed to investigate the effects of neuromuscular electrical stimulation(NMES)sensory input during the motor preparation phase on cortical excitability,corticomuscular coherence(CMC),and motor performance in stroke patients performing distal upper limb fine movements,thereby providing evidence for the design of sensorimotor integration-based rehabilitation brain-computer interfaces. Methods This study enrolled stroke patients with hand dysfunction who were hospitalized or treated in the outpatient clinic of the Department of Rehabilitation Medicine,Ninghai NO.2 Hospital in July 2024.A 32-channel high-precision bioelectrical acquisition system was employed to simultaneously record electroencephalography and electromyography(EMG)signals from the affected extensor digitorum,flexor digitorum,biceps brachii,and triceps brachii muscles.Under conditions with and without NMES sensory input,patients randomly performed fine finger extension tasks of the affected side at 20％of maximal voluntary contraction.Task-related CMC,event-related desynchronization(ERD)/event-related synchronization(ERS),and EMG parameters(activation level,fluctuation,and rise time)were analyzed to identify differences between the two conditions. Results Six subacute stroke patients were included,consisting of four males with a mean age of(67.8±4.1)years.Sensory input induced frequency band and muscle-group specific reorganization of CMC:the distal muscles exhibited enhanced CMC in the low-β band(13-20 Hz)(flexor digitorum-Cz at 12-14 Hz,P=0.011)and reduced CMC in the high-β band(＞20-30 Hz)[extensor digitorum-Cz at 20-24 Hz(P=0.012,P=0.043);extensor digitorum-C3 at 18-20 Hz(P=0.006)and 24-26 Hz(P=0.017)],while the proximal muscles showed decreased CMC at 8-10 Hz(P=0.024).The lesioned hemisphere demonstrated enhanced ERD in the high-β band(FC1 at 24-28 Hz,P=0.048,P=0.022),and Cz showed a shift from ERS to ERD in the 4-6 Hz band(P=0.028).Under the sensory input condition,the activation level of the biceps brachii significantly increased(P=0.036),with a slight reduction in EMG rise time of extensor digitorum. Conclusions Sensory input during the motor preparation phase can induce frequency band and spatially specific functional reorganization of the post-stroke sensorimotor network,characterized by reducing pathological synchronization in the lesioned hemisphere,enhancing cortical excitability,and differentially optimizing cortical drive strategies for distal and proximal muscle groups.These findings provide critical evidence for constructing sensorimotor integration-based rehabilitation brain-computer interface systems utilizing CMC and other neurophysiological indices as closed-loop feedback.