{"title":"脑机接口控制功能性电刺激训练对中风后上肢康复的影响：系统综述和荟萃分析。","authors":"Chunlin Ren, Xinmin Li, Qian Gao, Mengyang Pan, Jing Wang, Fangjie Yang, Zhenfei Duan, Pengxue Guo, Yasu Zhang","doi":"10.3389/fnhum.2024.1438095","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Several clinical studies have demonstrated that brain-computer interfaces (BCIs) controlled functional electrical stimulation (FES) facilitate neurological recovery in patients with stroke. This review aims to evaluate the effectiveness of BCI-FES training on upper limb functional recovery in stroke patients.</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane Library, Science Direct and Web of Science were systematically searched from inception to October 2023. Randomized controlled trials (RCTs) employing BCI-FES training were included. The methodological quality of the RCTs was assessed using the PEDro scale. Meta-analysis was conducted using RevMan 5.4.1 and STATA 18.</p><p><strong>Results: </strong>The meta-analysis comprised 290 patients from 10 RCTs. Results showed a moderate effect size in upper limb function recovery through BCI-FES training (SMD = 0.50, 95% CI: 0.26-0.73, I<sup>2</sup> = 0%, <i>p</i> < 0.0001). Subgroup analysis revealed that BCI-FES training significantly enhanced upper limb motor function in BCI-FES vs. FES group (SMD = 0.37, 95% CI: 0.00-0.74, I<sup>2</sup> = 21%, <i>p</i> = 0.05), and the BCI-FES + CR vs. CR group (SMD = 0.61, 95% CI: 0.28-0.95, I<sup>2</sup> = 0%, <i>p</i> = 0.0003). Moreover, BCI-FES training demonstrated effectiveness in both subacute (SMD = 0.56, 95% CI: 0.25-0.87, I<sup>2</sup> = 0%, <i>p</i> = 0.0004) and chronic groups (SMD = 0.42, 95% CI: 0.05-0.78, I<sup>2</sup> = 45%, <i>p</i> = 0.02). Subgroup analysis showed that both adjusting (SMD = 0.55, 95% CI: 0.24-0.87, I<sup>2</sup> = 0%, <i>p</i> = 0.0006) and fixing (SMD = 0.43, 95% CI: 0.07-0.78, I<sup>2</sup> = 46%, <i>p</i> = 0.02). BCI thresholds before training significantly improved motor function in stroke patients. Both motor imagery (MI) (SMD = 0.41 95% CI: 0.12-0.71, I<sup>2</sup> = 13%, <i>p</i> = 0.006) and action observation (AO) (SMD = 0.73, 95% CI: 0.26-1.20, I<sup>2</sup> = 0%, <i>p</i> = 0.002) as mental tasks significantly improved upper limb function in stroke patients.</p><p><strong>Discussion: </strong>BCI-FES has significant immediate effects on upper limb function in subacute and chronic stroke patients, but evidence for its long-term impact remains limited. Using AO as the mental task may be a more effective BCI-FES training strategy.</p><p><strong>Systematic review registration: </strong>Identifier: CRD42023485744, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023485744.</p>","PeriodicalId":12536,"journal":{"name":"Frontiers in Human Neuroscience","volume":"18 ","pages":"1438095"},"PeriodicalIF":2.4000,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464471/pdf/","citationCount":"0","resultStr":"{\"title\":\"The effect of brain-computer interface controlled functional electrical stimulation training on rehabilitation of upper limb after stroke: a systematic review and meta-analysis.\",\"authors\":\"Chunlin Ren, Xinmin Li, Qian Gao, Mengyang Pan, Jing Wang, Fangjie Yang, Zhenfei Duan, Pengxue Guo, Yasu Zhang\",\"doi\":\"10.3389/fnhum.2024.1438095\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Several clinical studies have demonstrated that brain-computer interfaces (BCIs) controlled functional electrical stimulation (FES) facilitate neurological recovery in patients with stroke. This review aims to evaluate the effectiveness of BCI-FES training on upper limb functional recovery in stroke patients.</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane Library, Science Direct and Web of Science were systematically searched from inception to October 2023. Randomized controlled trials (RCTs) employing BCI-FES training were included. The methodological quality of the RCTs was assessed using the PEDro scale. Meta-analysis was conducted using RevMan 5.4.1 and STATA 18.</p><p><strong>Results: </strong>The meta-analysis comprised 290 patients from 10 RCTs. Results showed a moderate effect size in upper limb function recovery through BCI-FES training (SMD = 0.50, 95% CI: 0.26-0.73, I<sup>2</sup> = 0%, <i>p</i> < 0.0001). Subgroup analysis revealed that BCI-FES training significantly enhanced upper limb motor function in BCI-FES vs. FES group (SMD = 0.37, 95% CI: 0.00-0.74, I<sup>2</sup> = 21%, <i>p</i> = 0.05), and the BCI-FES + CR vs. CR group (SMD = 0.61, 95% CI: 0.28-0.95, I<sup>2</sup> = 0%, <i>p</i> = 0.0003). Moreover, BCI-FES training demonstrated effectiveness in both subacute (SMD = 0.56, 95% CI: 0.25-0.87, I<sup>2</sup> = 0%, <i>p</i> = 0.0004) and chronic groups (SMD = 0.42, 95% CI: 0.05-0.78, I<sup>2</sup> = 45%, <i>p</i> = 0.02). Subgroup analysis showed that both adjusting (SMD = 0.55, 95% CI: 0.24-0.87, I<sup>2</sup> = 0%, <i>p</i> = 0.0006) and fixing (SMD = 0.43, 95% CI: 0.07-0.78, I<sup>2</sup> = 46%, <i>p</i> = 0.02). BCI thresholds before training significantly improved motor function in stroke patients. Both motor imagery (MI) (SMD = 0.41 95% CI: 0.12-0.71, I<sup>2</sup> = 13%, <i>p</i> = 0.006) and action observation (AO) (SMD = 0.73, 95% CI: 0.26-1.20, I<sup>2</sup> = 0%, <i>p</i> = 0.002) as mental tasks significantly improved upper limb function in stroke patients.</p><p><strong>Discussion: </strong>BCI-FES has significant immediate effects on upper limb function in subacute and chronic stroke patients, but evidence for its long-term impact remains limited. Using AO as the mental task may be a more effective BCI-FES training strategy.</p><p><strong>Systematic review registration: </strong>Identifier: CRD42023485744, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023485744.</p>\",\"PeriodicalId\":12536,\"journal\":{\"name\":\"Frontiers in Human Neuroscience\",\"volume\":\"18 \",\"pages\":\"1438095\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-09-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464471/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Human Neuroscience\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fnhum.2024.1438095\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Human Neuroscience","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fnhum.2024.1438095","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
The effect of brain-computer interface controlled functional electrical stimulation training on rehabilitation of upper limb after stroke: a systematic review and meta-analysis.
Introduction: Several clinical studies have demonstrated that brain-computer interfaces (BCIs) controlled functional electrical stimulation (FES) facilitate neurological recovery in patients with stroke. This review aims to evaluate the effectiveness of BCI-FES training on upper limb functional recovery in stroke patients.
Methods: PubMed, Embase, Cochrane Library, Science Direct and Web of Science were systematically searched from inception to October 2023. Randomized controlled trials (RCTs) employing BCI-FES training were included. The methodological quality of the RCTs was assessed using the PEDro scale. Meta-analysis was conducted using RevMan 5.4.1 and STATA 18.
Results: The meta-analysis comprised 290 patients from 10 RCTs. Results showed a moderate effect size in upper limb function recovery through BCI-FES training (SMD = 0.50, 95% CI: 0.26-0.73, I2 = 0%, p < 0.0001). Subgroup analysis revealed that BCI-FES training significantly enhanced upper limb motor function in BCI-FES vs. FES group (SMD = 0.37, 95% CI: 0.00-0.74, I2 = 21%, p = 0.05), and the BCI-FES + CR vs. CR group (SMD = 0.61, 95% CI: 0.28-0.95, I2 = 0%, p = 0.0003). Moreover, BCI-FES training demonstrated effectiveness in both subacute (SMD = 0.56, 95% CI: 0.25-0.87, I2 = 0%, p = 0.0004) and chronic groups (SMD = 0.42, 95% CI: 0.05-0.78, I2 = 45%, p = 0.02). Subgroup analysis showed that both adjusting (SMD = 0.55, 95% CI: 0.24-0.87, I2 = 0%, p = 0.0006) and fixing (SMD = 0.43, 95% CI: 0.07-0.78, I2 = 46%, p = 0.02). BCI thresholds before training significantly improved motor function in stroke patients. Both motor imagery (MI) (SMD = 0.41 95% CI: 0.12-0.71, I2 = 13%, p = 0.006) and action observation (AO) (SMD = 0.73, 95% CI: 0.26-1.20, I2 = 0%, p = 0.002) as mental tasks significantly improved upper limb function in stroke patients.
Discussion: BCI-FES has significant immediate effects on upper limb function in subacute and chronic stroke patients, but evidence for its long-term impact remains limited. Using AO as the mental task may be a more effective BCI-FES training strategy.
期刊介绍：
Frontiers in Human Neuroscience is a first-tier electronic journal devoted to understanding the brain mechanisms supporting cognitive and social behavior in humans, and how these mechanisms might be altered in disease states. The last 25 years have seen an explosive growth in both the methods and the theoretical constructs available to study the human brain. Advances in electrophysiological, neuroimaging, neuropsychological, psychophysical, neuropharmacological and computational approaches have provided key insights into the mechanisms of a broad range of human behaviors in both health and disease. Work in human neuroscience ranges from the cognitive domain, including areas such as memory, attention, language and perception to the social domain, with this last subject addressing topics, such as interpersonal interactions, social discourse and emotional regulation. How these processes unfold during development, mature in adulthood and often decline in aging, and how they are altered in a host of developmental, neurological and psychiatric disorders, has become increasingly amenable to human neuroscience research approaches. Work in human neuroscience has influenced many areas of inquiry ranging from social and cognitive psychology to economics, law and public policy. Accordingly, our journal will provide a forum for human research spanning all areas of human cognitive, social, developmental and translational neuroscience using any research approach.
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