Research On Influence And Brain Mechanism Of Brain-computer Interface And Scalp Acupuncture Therapy On Rehabilitation Of Motor Recovery After Stroke

Stroke is currently one of the main diseases that cause disability in patients.Animal experiments and clinical trials have proved that the plasticity of the central nervous system is the main neurophysiological mechanism for the recovery of motor function after stroke over the past decades.The brain-computer interface is to establish a direct communication path between a person and an external device,allowing the computer to analyze the person’s behavior intention from the brain,and then use neural decoding to transform the neural signal to control the external device.Non-invasive BCI technique has received widespread attention because it has been proven to improve motor function and regulate cortical excitatory activities after stroke.Motor imagery is an popular and emerging strategy for motor dyskinesia.The study on brain-computer interface(BCI)technology based on motor imagery(MI)has accumulated plenty of experience.At present,methods for studying brain plasticity continue to emerge,and functional magnetic resonance imaging(fMRI)is an important technology for studying brain nerve function.According to “add-on” design,this article uses clinical scale evaluation and multi-modal fMRI(task state and resting state)to explore the effects of MI-BCI and scalp acupuncture combination therapy on stroke motor function recovery and changes in brain function remodeling related to exercise and motor imagery to explore the impact on brain plasticity in the chronic stroke.An in-depth reseach was conducted on the influence of brain-computer interface(BCI)based on motor imagery(MI)on the imagination ability and its mechanism of motor recovery to uncover new methods so that promoting the effects of motor imagery.Part I.Research on the effect of brain-computer interface intervention on motor function improvement and imagination ability after strokeObjective: To investigate the impact of brain-computer interface on brain plasticity of stroke patients from multiple perspectives from brain regions(task state and resting state),connections between brain regions,and topological networks.Methods: Forty patients with upper limb motor dysfunction after stroke were randomly divided into conventional rehabilitation group and brain-computer interface group,and received conventional rehabilitation treatment,conventional rehabilitation +brain-computer interface treatment,respectively.Multimodal functional magnetic resonance was used to analyze the differences in brain activation areas in task states(including motor execution and motor imaging)before and after MI-BCI treatment,and the changes in brain activity,neural pathways and brain topology networks in the resting state.The resting state fMRI data uses the AAL90 template to segment the brain regions,and calculate the level and changes of the brain’s spontaneous neural activity(low frequency oscillation amplitude ALFF,local consistency ReHo);functional connection establishes a 90×90 brain region connection matrix for the whole brain Information activities in the brain area are analyzed;topological network analysis first identifies the resting functional network through ICA(Independent Component Analysis),and then evaluates the efficiency of information interaction within the network.Results:(1)Compared with the conventional rehabilitation group,the braincomputer interface group was significantly activated in the posterior central gyrus and middle frontal gyrus of the healthy side compared with the control group(P<0.01)in the state of motor performance tasks;in the state of motor imaging tasks,In the braincomputer interface group,the activation of the middle frontal gyrus and the medial superior frontal gyrus of the healthy side was more significant(P<0.01);(2)Based on the measurement results of brain regions,the spontaneous activities of the anterior central gyrus of the affected side,the cortex around the talar fissure,the contralateral cuneiform lobe,and the middle occipital gyrus of the brain-computer interface group were significantly higher than those of the conventional rehabilitation group(P<0.01),and The activity of the anterior central gyrus of the affected side was positively correlated with the improvement of the patient’s motor function(r = 0.425,P<0.05);the neuronal activity of the cortex around the talus cleft of the affected side and the cuneiform lobe on the unaffected side were more consistent with the motor-related brain regions.The rehabilitation group was significantly enhanced(P<0.01),and the consistent activity of the cuneiform lobe was positively correlated with the improvement of the patient’s motor function(r = 0.399,P<0.05);(3)Based on the functional connection analysis at the level of neural pathways,the conventional rehabilitation group had higher functional connections between the healthy basal ganglia and the cortex,and the frontal and parietal lobe than the brain-computer interface group(P<0.01),while the brain-computer interface group had a higher functional connection between the basal ganglia and the cortex,the frontal lobe and the parietal lobe.The main performance of the machine interface group is the enhancement of functional connectivity in the affected hemisphere(P<0.01);(4)Seven sub-networks are identified through ICA,namely Auditory Network(AUN),Default Mode Network(DMN),Dorsal Attention Network(DAN),Ventral Attention Network(VAN),Frontal Control Network(FPN),Sensory motor network(SMN),visual network(VN).The results of the topological attributes inside the resting state network based on the voxel level show that the small-world attributes(γ,σ)of the visual network of the brain-computer interface group are lower than those of the conventional rehabilitation group,while the homology index of the dorsal attention network is more conventional The rehabilitation group improved(P<0.01),and this increase was positively correlated with the recovery of motor function(r = 0.498,P<0.05).Conclusion:(1)Compared with the conventional rehabilitation group,the MI-BCI group has obvious motor brain activation in the motor performance task;in the motor imaging task,the MI-BCI group is compared with the conventional rehabilitation group,except for the movement-related brain area(In addition to the activation of the middle frontal gyrus,the medial superior frontal gyrus related to motor memory also has increased excitability.After treatment,the motor function of the brain-computer interface group,the functions of brain areas related to exercise preparation,planning,and exercise intention were significantly improved;(2)Patients in the brain-computer interface group can improve motor function by increasing the activity of the primary motor cortex on the affected side;the cortex around the talar fissure,cuneiform lobe,and middle occipital gyrus are all involved in the regulation of visual function.The motor-related areas of the affected brain area and the visual space sensory brain area are obviously activated,and are positively correlated with the improvement of motor function.Therefore,MI-BCI can significantly improve functional recovery,and the multi-sensory stimulation of the brain-computer interface activates the movement and motor imagination related Brain activity,so enriching the form and content of stimulation is beneficial to the patient;(3)After treatment,the functional connection of the brain of the two groups of patients was significantly enhanced;compared with before treatment,the brain-computer interface group showed more obvious enhancement of the connection in the affected hemisphere;the connection in the healthy side of the control group was enhanced Therefore,the brain-computer interface group treatment may reverse this abnormal generalized connection mode of the contralateral hemisphere;(4)Based on the results of the topological attributes inside the resting state network,the patient’s motor function recovery is positively correlated with the strength of the connection between the core brain area activities of the visual space information processing network.MI-BCI modulates the brain areas related to visual spatial information integration through multi-sensory visual stimulation,and affects brain function remodeling after stroke through the dorsal attention network and visual network.Part Ⅱ.Research on the Multimodal Central Mechanism of Brain-Computer Interface Promoting the Recovery of Motor Function after StrokeObjective: To study the influence of brain-computer interface based on motor imagery on brain plasticity.Methods: Forty patients with upper limb motor dysfunction after stroke were randomly divided into conventional rehabilitation group and brain-computer interface group,and received conventional rehabilitation treatment,conventional rehabilitation +brain-computer interface treatment,respectively.Multimodal functional magnetic resonance was used to analyze the differences in brain activation areas in task states(including motor execution and motor imaging)before and after MI-BCI treatment,and the changes in brain activity,neural pathways and brain topology networks in the resting state.Results:(1)Based on the measurement results of the brain area,it is suggested that the motor-related areas of the affected brain area and the visual space sensory brain area are significantly activated,and are positively correlated with the improvement of motor function.MI-BCI can significantly improve the functional recovery;(2)Based on the measurement results of the connection,both groups showed a tendency to change to the normal brain pattern;and MI-BCI can inhibit the undesirable remodeling of the contralateral hemisphere;(3)Based on the results of the topological properties inside the resting state network,the recovery of the patient’s motor function is positively correlated with the recovery of the visual space network.MI-BCI uses multi-sensory visual stimuli to modulate the brain areas related to the integration of visual spatial information,and jointly affects brain function remodeling after stroke through the visual network and the dorsal attention network.Conclusion:MI-BCI can significantly activate brain areas related to motor circuits and brain networks related to visual space processing to promote the rehabilitation of upper limbs after stroke.Part Ⅲ.Based on resting state functional magnetic resonance,we devote to exploring the mechanism of electroacupuncture regulation combined with braincomputer interface to promote the improvement of motor function after strokeObjective: To explore the effect of scalp acupuncture control combined with MIBCI to reshape the neural circuit of integrated traditional Chinese and Western medicine rehabilitation therapy on the motor performance,imagination and neuroplasticity of stroke patients.Methods: Forty patients with upper limb motor dysfunction after stroke were randomly divided into brain-computer interface group and brain-computer interface +scalp acupuncture group,and received conventional rehabilitation treatment + braincomputer interface,conventional rehabilitation + brain-computer interface + scalp acupuncture treatment.Before and after treatment,the patients were evaluated for motor function,imagination,cognition and activities of daily living;and the mixed linear model was used to study the effect of different treatment methods and different imagination on the recovery of motor function;and the use of multiple Modal functional magnetic resonance analyzes the changes related to the brain neural pathways and the brain topology network in the patient’s resting state(the method of constructing the matrix and the network is the same as that of the second part)Results: There was no significant difference between the baseline general data and clinical data of patients in the brain-computer interface + scalp acupuncture group and the brain-computer interface group alone(P>0.05).Repeated measures analysis of variance compared Fugl-Meyer upper limb motor function and arm movement test scores between the two groups at different time points.There was a statistical difference in the time item(P<0.001).With the changes before and after treatment,both groups had upper limbs Improvement of motor function.The results of multivariate analysis of variance indicated that there was no significant difference between the two groups after treatment(P>0.05).In the interactive study of imagination ability and motor function score,the motor function of the brain-computer interface + scalp acupuncture group can significantly regulate the effect of imagination on motor function than the brain-computer interface group alone(P<0.05).In the study of the mechanism of neuroplasticity,in terms Conclusion:of the connection of neural pathways,the functional connection between the affected occipital lobe and the temporal lobe of the combined group was stronger than that of the brain-computer interface group alone(P<0.01).Extensive functional connectivity enhancement appeared in the affected hemisphere(P<0.01);the results of the network topology attribute research showed that the coordinative index of the joint group in the visual network,the default mode network,and the frontal control network decreased(P<0.01);In the analysis of functional connection between networks,the functional connection between these three networks was stronger than that of the simple braincomputer interface group(P<0.01).Conclusion:(1)Combination therapy can adjust the relationship between motor imagination ability and motor function,and combination therapy can enhance the effect by adjusting the effect level between motor imagination ability and motor function recovery;(2)After the combination therapy strengthens the connection between the affected hemispheres,it improves the connection between the visual space processing function network,and induces the enhancement of the function of the visual network-the default mode network-the frontal control network to promote the recovery of patient function.