Rehabilitation nach Schlaganfall: Durch Gehirn-Computer-Schnittstelle vermittelte funktionelle Elektrostimulation

Zusammenfassung

Eine Gehirn-Computer-Schnittstelle (BCI) in der Rehabilitation von Schlaganfallpatienten ermöglicht die Steuerung einer funktionellen Elektrostimulation (FES), um eine Muskelkontraktion in der gelähmten Extremität zum Zeitpunkt der Bewegungsintention durch Erkennung entsprechender Hirnsignale auszulösen. Es wird angenommen, dass eine genaue zeitliche Kohärenz zwischen Bewegungsintention und visuellem sowie propriozeptivem Feedback, ausgelöst durch eine reale Bewegung, neuroplastische Prozesse begünstigen und eine funktionelle Verbesserung der Parese bewirken kann. In dieser systematischen Übersichtsarbeit zu randomisierten kontrollierten Studien wurden die Datenbanken Pubmed, Scopus und Web of Science durchsucht und von 516 berücksichtigten Publikationen 13 ausgewählt, die auf 7 Studienpopulationen basierten. Ein direkter Vergleich der Studien ist durch Unterschiede im Studiendesign erschwert. Fünf Studien berichten von einer verbesserten motorischen Funktion in der BCI-FES-Gruppe, davon zeigen 3 signifikante Unterschiede zwischen der BCI-FES- und der Kontrollgruppe.

Abstract

A brain-computer interface (BCI) enables delivery of functional electrical stimulation (FES), at the time point of movement intention, to induce muscle contraction in a paretic limb, using brain activity recording. It has been hypothesized that tight temporal coupling between movement intention and visual or proprioceptive feedback obtained from an actual movement can enhance neuroplasticity and thus improve limb function. We provide an overview of this approach to post-stroke rehabilitation based on a systematic review of randomised controlled trials. The PubMed, Scopus, and Web of Science databases were searched and 516 titles identified, out of which 13 papers, originating from 7 study populations that met all inclusion criteria were selected. These studies differed in the frequency, duration, and outcome measures of the therapy used. Five studies reported greater functional improvement in the BCI–FES group, with 3 studies showing a difference between the BCI-FES and control groups.

Schlüsselwörter

Brain-Computer-Interface - EEG - Schlaganfall - motorische Rehabilitation - funktionelle Elektrostimulation

Key words

Brain–computer interface - EEG - stroke - motor rehabilitation - functional electrical stimulation

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