虚拟现实上肢康复机器人对脑卒中偏瘫患者脑网络的影响

关键词：脑卒中  上肢康复机器人  虚拟现实  功能性近红外光谱技术

Keywords:stroke  upper limb rehabilitation robot  virtual reality  functional near-infrared spectroscopy

摘要：

      摘要 目的：通过功能性近红外光谱技术（functional near-infrared spectroscopy，fNIRS）来研究分析脑卒中偏瘫患者静息态下和虚拟现实（virtual reality， VR）上肢康复机器人训练时的脑网络。 方法：本研究纳入14例脑卒中偏瘫患者作为试验组，同时招募14例健康受试者作为对照组。分别采集两组受试者在静息状态和VR上肢康复机器人训练时的fNIRS数据，并计算脑网络功能连接（functional connectivity， FC）指标。 结果：①试验组与对照组在静息状态下FC未发现显著性差异（P＞0.05）；②对照组在VR任务下与静息状态相比总体FC并无显著性增加（P＞0.05），但LSMA-RPFC的FC显著性增加（P＜0.05）；③试验组在VR任务下与静息状态相比总体FC下降（P＜0.05），其中LSMA-RS1以及LSMA-RSMA的FC显著性下降（P＜0.05）；④试验组与对照组在进行VR上肢康复机器人训练任务时，试验组总体FC低于对照组（P＜0.05），其中LSMA-RSMA、LSMA-LM1、LSMA-RM1、LSMA-RS1、LM1-RS1间FC存在显著性差异（P＜0.05）。 结论：VR上肢康复机器人训练能够引起脑卒中偏瘫患者广泛的感觉运动网络的可塑性重组，其改善上肢功能的机制可能与双侧SMA间以及SMA与其他脑区间的FC改变有关。

Abstract:

      Abstract Objective： To study and analyze the brain networks of hemiplegic stroke patients in a resting state or during virtual reality （VR） upper limb rehabilitation robot training by functional near-infrared spectroscopy（fNIRS）. Method： Fourteen hemiplegic stroke patients were included in this study as the test group， while 14 healthy subjects were recruited as the control group. The fNIRS data of the two groups were collected during the resting state or the VR upper limb rehabilitation robot training. The functional connectivity（FC） index of the brain network was calculated. Result： ①No significant difference was found between the test group and the control group in FC in the resting state （P>0.05）. ②The overall FC of the control group did not increase significantly in the VR task compared with the resting state （P>0.05）. But the FC of the LSMA-RPFC increased significantly （P<0.05）. ③The overall FC of the test group decreased in the VR task compared with the resting state （P<0.05）， of which the LSMA-RPFC decreased （P<0.05）. ④The overall FC of the test group was lower than that of the control group （P<0.05）， in which there was a significant difference in FC between LSMA-RSMA， LSMA-LM1， LSMA-RM1， LSMA-RS1， and LM1-RS1 （P<0.05） when the test group and the control group performed the VR upper limb rehabilitation robot training task. Conclusion： VR upper limb rehabilitation robot training can induce plastic reorganization of the extensive sensorimotor network in hemiplegic patients with stroke. And the mechanism of improving upper limb function may be related to the FC changes between bilateral SMA and SMA and other brain regions.