Stroke causes abnormality of brain physiological function and limb motor function. Brain-computer interface (BCI) connects the patient's active consciousness to an external device, so as to enhance limb motor function. Previous studies have preliminarily confirmed the efficacy of BCI rehabilitation training in improving upper limb motor function after stroke, but the brain mechanism behind it is still unclear. This paper aims to review on the brain mechanism of upper limb motor dysfunction in stroke patients and the improvement of brain function in those receiving BCI training, aiming to further explore the brain mechanism of BCI in promoting the rehabilitation of upper limb motor function after stroke. The results of this study show that in the fields of imaging and electrophysiology, abnormal activity and connectivity have been found in stroke patients. And BCI training for stroke patients can improve their upper limb motor function by increasing the activity and connectivity of one hemisphere of the brain and restoring the balance between the bilateral hemispheres of the brain. This article summarizes the brain mechanism of BCI in promoting the rehabilitation of upper limb motor function in stroke in both imaging and electrophysiology, and provides a reference for the clinical application and scientific research of BCI in stroke rehabilitation in the future.
Objective To investigate factors associated with achieving minimal clinically important difference (MCID) in upper limb motor function after rehabilitation in patients with acquired brain injury (ABI). Methods Patients receiving rehabilitation therapy in the Third Affiliated Hospital of Sun Yat-sen University Hospital between April 2015 and October 2022 were retrospective selected. Upper limb motor function was assessed using the Fugl-Meyer Assessment- Upper Extremity (FMA-UE) at baseline and discharge. An increase of ≥5 points in the FMA-UE score was defined as achieving MCID. Logistic regression analyses were used to identify factors associated with achieving the MCID. Stratified analyses were conducted based on baseline FMA-UE scores (≤21 vs. >21). Results A total of 236 patients were included. Among them, there were 156 males and 80 females; 138 cases met the MCID, and 98 cases did not; 115 cases had FMA-UE scores ≤21, and 121 cases had FMA-UE scores >21. FMA-UE scores significantly improved after rehabilitation therapy compared with admission scores [21 (12, 36) vs. 29 (18, 47) scores, P<0.001]. The results of the multi-factor logistic analysis showed that in the severe impairment group, length of stay was associated with achieving MCID [odds ratio=1.028, 95% confidence interval (1.004, 1.052), P=0.019]. In the mild-to-moderate impairment group, female sex was negatively associated with achieving MCID [odds ratio=0.306, 95% confidence interval (0.107, 0.872), P=0.027]. Conclusions Different lengths of stay and genders may affect the achievement of MCID in ABI patients. Further prospective studies are needed to validate these findings.