脑机接口在卒中运动康复中的研究进展与临床转化

Research Progress and Clinical Translation of Brain-Computer Interface in Stroke Motor Rehabilitation

摘要: 脑机接口(brain-computer interface, BCI)技术在卒中患者运动康复中的应用展现出良好的发展前景，并被认为是一种有潜力改善功能结局的创新性干预手段。现有临床研究表明，BCI训练能够显著改善卒中后患者的运动功能表现，尤其在上肢运动控制和功能恢复方面显示出积极效果。与此同时，BCI训练在临床应用中具有良好的安全性和耐受性。来自单组研究及部分对照研究的证据整体一致，支持BCI在提升卒中患者运动表现和促进功能恢复方面的有效性。这些研究结果为BCI在康复领域的应用提供了重要的初步依据。尽管短期疗效较为明确，关于BCI干预长期效果的证据仍然相对有限。在评估BCI训练效果时，还必须充分考虑不同BCI训练范式之间的差异，因为不同的信号来源、解码策略和反馈形式可能对功能恢复产生不同影响。本综述重点讨论了多种常见的BCI训练模式，包括基于运动想象的脑机接口、基于运动尝试的脑机接口以及基于感觉运动节律的脑机接口。这些范式在神经激活机制、训练方式和适用人群方面各具特点，及其潜在临床获益及当前面临的主要挑战。将脑机接口(BCI)与其他康复设备或技术相结合，有望进一步增强康复效果。通过构建闭环反馈系统，这类联合干预策略能够更有效地促进神经可塑性变化，并将神经活动的调控转化为有意义的功能改善，从而提升康复训练的针对性和效率。

Abstract: The application of brain-computer interface (BCI) technology in motor rehabilitation of stroke patients shows good development prospects and is considered an innovative intervention method with the potential to improve functional outcomes. Existing clinical research shows that BCI training can significantly improve the motor function performance of post-stroke patients, especially showing positive effects in upper limb motor control and functional recovery. At the same time, BCI training has good safety and tolerability in clinical applications. The evidence from single-group studies and some controlled studies is generally consistent, supporting the effectiveness of BCI in improving exercise performance and promoting functional recovery in stroke patients. These research results provide important preliminary basis for the application of BCI in the field of rehabilitation. Although short-term efficacy is clear, evidence on the long-term effects of BCI intervention is still relatively limited. When evaluating the effects of BCI training, the differences between different BCI training paradigms must also be fully considered, because different signal sources, decoding strategies, and feedback forms may have different effects on functional recovery. This review focuses on a variety of common BCI training modalities, including motor imagery-based BCI, motor attempt-based BCI, and sensorimotor rhythm-based BCI. These paradigms have their own characteristics in terms of neural activation mechanisms, training methods and applicable populations, as well as their potential clinical benefits and major current challenges. Combining brain-computer interfaces (BCI) with other rehabilitation equipment or technologies is expected to further enhance rehabilitation effects. By building a closed-loop feedback system, this type of joint intervention strategy can more effectively promote neuroplastic changes and transform the regulation of neural activity into meaningful functional improvements, thereby improving the pertinence and efficiency of rehabilitation training.