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Leap Motion-based virtual reality training for improving motor functional recovery of upper limbs and neural reorganization in subacute stroke patients

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neural Regeneration Research 2017年第11期12卷 1823-1831页

作者： Zun-rong Wang Ping Wang Liang Xing Li-ping Mei Jun Zhao Tong Zhang Capital Medical University School of Rehabilitation Medicine China Rehabilitation Research Center Beijing Boai Hospital Beijing Rehabilitation Hospital Capital Medical University

Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patients. Most virtual reality systems are only applicable to the proximal upper limbs （arms） because of the limitations of their capture systems. Nevertheless, the functional recovery of an affected hand is most difficult in the case of hemiparesis rehabilitation after a stroke. The recently developed Leap Motion controller can track the fine movements of both hands and fingers. Therefore, the present study explored the effects of a Leap Motion-based virtual reality system on subacute stroke. Twenty-six subacute stroke patients were assigned to an experimental group that received virtual reality training along with conventional occupational rehabilitation, and a control group that only received conventional rehabilitation. The Wolf motor func- tion test （WMFT） was used to assess the motor function of the affected upper limb; functional magnetic resonance imaging was used to measure the cortical activation. After four weeks of treatment, the motor functions of the affected upper limbs were significantly improved in all the patients, with the improvement in the experimental group being significantly better than in the control group. The action perfor- mance time in the WMFT significantly decreased in the experimental group. Furthermore, the activation intensity and the laterality index of the contralateral primary sensorimotor cortex increased in both the experimental and control groups. These results confirmed that Leap Motion-based virtual reality training was a promising and feasible supplementary rehabilitation intervention, could facilitate the recovery of motor functions in subacute stroke patients. The study has been registered in the Chinese Clinical Trial Registry （registration number： ChiCTR-OCH- 12002238）.

关键词： nerve regeneration virtual reality Wolf motor function test functional magnetic resonance imaging stroke Leap Motion rehabilitation upper limb neural reorganization neural regeneration

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FUNCTIONAL MAGNETIC RESONANCE IMAGING STUDY OF THE BRAIN IN PATIENTS WITH AMYOTROPHIC LATERAL SCLEROSIS

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Chinese Medical Sciences Journal 2006年第4期21卷 228-233页

作者： Jing Han Lin Ma Department of Neuroradiology Huanhu Hospital Tianjin 300060 Department of Radiology General Hospital of People＇s Liberation Army Beijing 100853

Objective To study the activation changes of the brain in patients with amyotrophic lateral sclerosis （ALS） while executing sequential finger tapping movement using the method of blood oxygenation level dependent （BOLD） functional magnetic resonance imaging （tMRI）. Methods Fifteen patients with definite or probable ALS and fifteen age and gender matched normal controls were enrolled. MRI was performed on a 3.0 Tesla scanner with standard headcoiL The functional images were acquired using a gradient echo single shot echo planar imaging （EPI） sequence. All patients and normal subjects executed sequential finger tapping movement at the frequency of 1-2 Hz during a block-design motor task. Structural MRI was acquired using a three-dimensional fast spoiled gradient echo （3D-FSPGR） sequence. The tMRI data were analyzed by statistical parametric mapping （SPM）. Results Bilateral primary sensorimotor cortex （ PSM）, bilateral premotor area （ PA）, bilateral supplementary motor area （SMA）, bilateral parietal region （ PAR）, contralateral inferior lateral premotor area （ ILPA）, and ipsilateral cerebellum showed activation in both ALS patients and normal controls when executing the same motor task. The activation areas in bilateral PSM, bilateral PA, bilateral SMA, and ipsilateral cerebellum were significantly larger in ALS patients than those in normal controls （ P 〈 0.05 ）. Extra activation areas including ipsilateral ILPA, bilateral posterior limb of internal capsule, and contralateral cerebellum were only detected in ALS patients. Conclusions Similar activation areas are activated in ALS patients and normal subjects while executing the same motor task. The increased activation areas in ALS patients may represent neural reorganization, while the extra activation areas in ALS patients may indicate functional compensation.

关键词： amyotrophic lateral sclerosis blood oxygenation level dependent functional compensation neural reorganization

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Effects of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper limb motor dysfunction in patients with subacute cerebral infarction

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neural Regeneration Research 2016年第10期11卷 1584-1590页

作者： Jiang Li Xiang-min Meng Ru-yi Li Ru Zhang Zheng Zhang Yi-feng Du Shandong Provincial Hospital of Shandong University Jinan Shandong Province China Affiliated Hospital of Qingdao University Qingdao Shandong Province China

Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons. However, there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction. We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function. This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction. These patients were randomly assigned to three groups. The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex （M1）. The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1. Finally, the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1. A total of 135 seconds of stimulation was applied in the sham group and high-frequency group. At 2 weeks after treatment, cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment. Moreover, motor function scores were significantly improved. The above indices for the low- and high-frequency groups were significantly different compared with the sham group. However, there was no significant difference between the low- and high-frequency groups. The results show that low- and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.

关键词： nerve regeneration brain injury repetitive transcranial magnetic stimulation cerebral infarction low-frequency stimulation high-frequency stimulation upper-limb motor function cerebral cortex stroke rehabilitation motor-evoked potential central motor conductiontime primary motor cortex neuroplasticity neural reorganization neural regeneration

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