作者：袁艳秋，张秀芳，陈杰，张莉，张明

单位：

221003江苏省徐州市，徐州医科大学附属徐州康复医院康复治疗部

Units：

Rehabilitation Department, Xuzhou Rehabilitation Hospital Affiliated to Xuzhou Medical University, Xuzhou 221003, China

关键词：

卒中；经颅电刺激技术；脑机接口技术；认知

Keywords：

Stroke; Transcranial electrical stimulation; Brain-computer interface technology; Cognition

CLC：

R 743

DOI：

10.12114/j.issn.1008-5971.2024.00.005

Funds：

江苏省高层次卫生人才“六个一工程”拔尖人才项目（LGY2020030）

摘要：

目的　探讨经颅电刺激技术联合脑机接口技术对脑卒中患者认知功能及上肢功能的影响。方法　选 取2021年11月—2023年5月徐州医科大学附属徐州康复医院收治的94例脑卒中患者为研究对象，采用随机数字表法将 患者分为脑机接口组及联合组，每组47例。脑机接口组患者接受脑机接口技术治疗，联合组在脑机接口组的基础上 接受经颅电刺激技术治疗，均连续治疗4周。比较两组治疗前后认知功能〔简易精神状态检查量表（MMSE）评分、 蒙特利尔认知评估量表（MoCA）评分、连线测验（TMT）完成时间、数字广度测验（DST）结果及Stroop色词干扰 测验（SCWT）完成时间、正确数〕、脑电波指标（α、β、δ、θ波波幅）、上肢功能〔Fugl-Meyer运动功能评估 量表上肢部分（FMA-UE）、上肢动作研究量表（ARAT）评分〕及治疗期间不良反应发生率。结果　治疗后，两组 MMSE、MoCA评分分别高于同组治疗前，且联合组高于脑机接口组（P＜0.05）；治疗后，联合组TMT-A、TMT-B、 SCWT完成时间短于治疗前，DST结果、SCWT正确数多于治疗前，且联合组TMT-A、TMT-B、SCWT完成时间短于脑 机接口组，DST结果、SCWT正确数多于脑机接口组（P＜0.05）；治疗后，脑机接口组α波波幅高于治疗前，联合组 α波波幅高于治疗前，δ、θ波波幅低于治疗前，且联合组α波波幅高于脑机接口组，δ、θ波波幅低于脑机接口组 （P＜0.05）；治疗后，两组FMA-UE、ARAT评分分别高于同组治疗前，且联合组高于脑机接口组（P＜0.05）。两组 治疗期间头痛、恶心呕吐、过敏、疲乏发生率比较，差异无统计学意义（P＞0.05）。结论　经颅电刺激技术联合脑机 接口技术可改善脑卒中患者的认知功能，调节脑电波，促进上肢功能的恢复。

Abstract：

Objective To investigate the effects of transcranial electrical stimulation combined with brain-computer interface technology on cognitive function and upper limb function in patients with stroke. Methods A total of 94 stroke patients admitted to Xuzhou Rehabilitation Hospital Affiliated to Xuzhou Medical University from November 2021 to May 2023 were selected as the research objects. The patients were divided into brain-computer interface group (n=47) and combined group (n=47) using random number table method. Brain-computer interface group was treated with brain-computer interface technology treatment, combined group was treated with transcranial electrical stimulation on the basis of the brain-computer interface group, all patients were treated continuously for 4 weeks. The cognitive function [Mini-Mental State Examination (MMSE) score, Montreal Cognitive Assessment (MoCA) score, Trail Making Test (TMT) execution time, Digit Span Test (DST) results, Stroop Color and Word Test (SCWT) execution time and accurate number] , electroencephalographic indicators (α, β, δ, θ wave amplitude) and upper limb function [Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT) scores] before and after treatment, and the incidence of adverse reactions were compared between the two groups. Results After treatment, the scores of MMSE and MoCA in the two groups were higher than those before treatment respctively, and those of combined group were higher than those of brain-computer interface group (P < 0.05) . After treatment, the execution time of TMT-A, TMT-B, and SCWT in combined group was shorter than that before treatment, the DST results and correct number of SCWT in combined group were higher than those before treatment, the execution time of TMT-A, TMT-B, and SCWT of combined group was shorter than that of brain-computer interface group, the DST results and correct number of SCWT of combined group were higher than those of brain-computer interface group (P < 0.05) . After treatment, the α wave amplitude in brain-computer interface group was higher than that before treatment, the α wave amplitude in combined group was higher than that before treatment, the δ and θ wave amplitude in combined group was lower than that before treatment, the α wave amplitude of combined group was higher than that of brain-computer interface group, the δ and θ wave amplitude of combined group was lower than that of brain-computer interface group (P < 0.05) . After treatment, the scores of FMA-UE and ARAT in the two groups were higher than those before treatment respectively, and those of combined group were higher than those of brain-computer interface group (P < 0.05) . There was no statistically significant difference in the incidences of headache, nausea and vomiting, allergies, and fatigue between the two groups (P > 0.05) . Conclusion Transcranial electrical stimulation combined with brain-computer interface technology can improve cognitive function in patients with stroke, regulate brain waves, and promote the recovery of upper limb function.

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