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非侵入式脑机接口在老年脑卒中患者运动功能康复中的应用与神经机制

Applications and neural mechanisms of non-invasive brain-computer interfaces in motor function rehabilitation for elderly stroke patients

  • 摘要: 脑卒中是老年人群高发的神经系统疾病,常导致严重运动功能障碍。非侵入式脑机接口(brain-computer interface, BCI)通过解码运动意图驱动外部设备,为老年脑卒中康复提供新思路。当前主流范式包括运动想象-BCI、稳态视觉诱发电位-BCI和P300-BCI,各范式在认知负荷与感官依赖方面存在差异。在临床应用中,BCI常与功能性电刺激、外骨骼机器人、虚拟现实等技术联合,形成闭环训练系统。老年患者因神经可塑性减退、脑网络连接减弱及认知功能下降,其BCI干预效果可能受影响。神经机制研究表明,BCI训练可通过激活Hebbian可塑性、促进脑网络重组和恢复半球间平衡来改善运动功能。本文对非侵入式BCI在老年脑卒中患者运动功能康复中的应用现状与神经机制进行综述,并分析老年人群应用的特殊问题。

     

    Abstract: Stroke is a highly prevalent neurological disorder among older adults, frequently resulting in severe motor impairment. Non-invasive brain-computer interface (BCI), which decodes motor intentions to actuate external devices, offers a promising avenue for motor function rehabilitation in elderly stroke patients. Current mainstream paradigms include motor imagery-BCI (MI-BCI), steady-state visual evoked potential-BCI (SSVEP-BCI), and P300-BCI, each exhibiting distinct profiles in terms of cognitive load and sensory dependence. In clinical practice, BCI is frequently integrated with functional electrical stimulation (FES), robotic exoskeletons, and virtual reality (VR) to constitute closed-loop training systems. However, reduced neuroplasticity, compromised brain network connectivity, and cognitive decline in elderly patients may attenuate the therapeutic efficacy of BCI interventions. Neurophysiological evidence indicates that BCI training can ameliorate motor function by activating Hebbian plasticity, facilitating brain network reorganization, and restoring interhemispheric balance. This review summarizes the current clinical applications and underlying neural mechanisms of non-invasive BCI for motor function rehabilitation in elderly stroke patients, with particular attention to the unique challenges encountered in this population.

     

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