| Objective:To investigate the clinical efficacy of brain-computer interface（BCI）rehabilitation technology combined with conventional rehabilitation in treating upper limb dysfunction in patients with ischemic stroke,and to explore the objective evaluation indexes of upper limb function from brain bioelectrical signals.Methods:A total of 60 patients with upper limb dysfunction after ischemic stroke were recruited and randomly divided into experimental group（30 cases）and control group（30 cases）.By the end of the experiment,1 case had fallen off in the experimental group and 2 cases in the control group.Finally,57 patients were included,including28 males and 29 females;aged 61-78 years old with mean age of 68.30 years old;body mass index（BMI）was 20.06～28.96 Kg/m~2with mean BMI of 23.54 Kg/m~2;disease course was 0.2～3.0 months with mean of 1.48 months;34 cases with hemiplegia on the left side and 23 on the right side.Treatment methods:The patients in both groups were given routine rehabilitation treatment such as exercise therapy and occupational therapy.In addition,the patients in the experimental group were given brain-computer interface treatment（20min/time）.Patients in the control group were treated with neuromuscular electrical stimulation（20min/time）.Patients in both groups were treated 5 days per week with 2 days off for 4 weeks.Efficacy evaluation indexes:Before treatment（0 weeks）,during treatment（2 weeks）,and after treatment（4 weeks）,Fugl-Meyer assessment-upper extremity（FMA-UE）,Wolf motor function test（WMFT）,Action Research Arm Test（ARAT）and modified Barthel index（MBI）were used to evaluate motor function and activity of daily living of the affected upper extremities.At the same time node,the resting-state EEG was collected,and the absolute power value of theαwave based on the fast Fourier transform and the node degree of the brain network based on the Pearson correlation coefficient were calculated to evaluate the electroencephalogram changes in the motor function area of the patient’s brain.Statistical analysis methods:Statistical analysis was performed using SPSS version 23.0 statistical software.Count data were expressed using theχ~2test,and measurement data were expressed as（x±s）.The comparison between the number of brain-computer interface motor imagery in the experimental group and the number of neuromuscular electrical stimulation in the control group was performed using One-sample t-test.The comparison between different time point groups was analyzed by two-way repeated-measures ANOVA.The relationship between EEG parameters and FMA-UE,WMFT and ARAT scale scores was analysed using Pearson correlation analysis.Results:1 General information analysisThere was no significant difference in the gender,age,duration,body mass index and hemiplegia general data between the 2 groups before treatment（P>0.05）.There was no significant difference in the number of brain-computer interface motor imagery in the experimental group and the number of neuromuscular electrical stimulation in the control group,and the data of the two groups were comparable.2 Analysis of scale score resultsBefore treatment,there was no significant difference in the comparison of FMA-UE,WMFT,ARAT and MBI scores between the two groups（P>0.05）;After treatment,the scores of FMA-UE,WMFT and ARAT in the experimental group were significantly higher than those in the control group scores（P<0.05）;During the treatment,WMFT and ARAT scores in the experimental group were significantly higher than those in the control group（P<0.05）;There was no significant difference in the MBI score between the two groups（P>0.05）.In-group comparison,the scores of FMA-UE,WMFT,ARAT and MBI in the two groups after treatment were significantly higher than those before or during treatment（P<0.05）.3 Analysis of EEG parametersBefore treatment,there was no significant difference in the comparison of the alpha wave absolute power values of C3,C4,FC3,FC1,FCZ,FC2,FC4 leads in both groups（P>0.05）;During the treatment,the alpha wave absolute power values of C4,FC1,FC2,FC4 leads in the experimental group were significantly higher than those in the control group（P<0.05）;After treatment,the alpha wave absolute power values of C3,C4,FC3,FC1,FCZ,FC2,FC4 leads in the experimental group were significantly higher than those in the control group（P<0.05）.In-group comparison,in the experimental group,the absolute power values of alpha waves in leads C3,C4,FC3,FC1,FCZ,FC2,and FC4 during treatment were significantly higher than those before treatment（P<0.05）.After treatment,the absolute power values of alpha waves in leads FCZ,FC2 and FC4 were significantly higher than those before treatment or during treatment（P<0.05）;There was no significant difference in the absolute power values of alpha waves in each lead before,during and after treatment in the control group（P<0.05）.Before treatment,there was no significant difference in the nodal degree of brain function network between the two groups（P>0.05）;After treatment,the nodal degree of global brain function network in the experimental group was significantly higher than that in the control group（P<0.01）.In-group comparison,the nodal degree of global brain function network was significantly higher in the experimental group after treatment than before or during treatment（P<0.01）;There was no significant difference in the nodal degree of global brain function network in the control group at the three time points before,during and after treatment（P>0.05）.4 Correlation analysis between scales and EEG parametersPearson correlation analysis results showed that:Absolute power of C3αwave（r~2=0.210,0.222,0.176,P<0.05）,C4αwave（r~2=0.167,0.153,0.138,P<0.05）,FC3alpha wave（r~2=0.309,0.259,0.296,P<0.05）,FC1αwave absolute power values（r~2=0.308,0.327,0.360,P<0.05）,FCZαwave absolute power values（r~2=0.197,0.180,0.195,P<0.05）,absolute power values ofαwave of FC2 lead（r~2=0.273,0.280,0.324,P<0.05）,absolute power values ofαwave of FC4 lead（r~2=0.291,0.254,0.286,P<0.05）was positively correlated with FMA-UE,WFMT and ARAT scores.Conclusion:On the basis of routine rehabilitation therapy,BCI therapy or neuromuscular electrical stimulation therapy can improve the motor function of the upper limbs and improve the daily living ability of patients with ischemic stroke;The effect of BCI training combined with conventional rehabilitation was better than that of neuromuscular electrical stimulation combined with conventional rehabilitation.Changes in the absolute power value of alpha wave and the node degree value of brain functional network can reflect changes in the functional state of the brain in stroke patients.The alpha wave can reflect the improvement of upper limb function and is expected to be an objective evaluation index for the clinical efficacy of upper limb function in stroke patients. |
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