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.
Post-stroke spasticity, a common sequelae of upper motor neuron lesions, results in motor control deficits and pathological hypertonia that not only reduce patients’ activities of daily living but may also cause impairment of adaptive neuroplasticity. Repetitive peripheral magnetic stimulation (rPMS), as a novel non-invasive neuromodulation technique, demonstrates unique clinical potential through targeted modulation of electromagnetic coupling effects in the peripheral neuromuscular system. Although current international studies have validated the therapeutic potential of rPMS for spasticity, significant heterogeneity persists in elucidating its mechanisms of action, optimizing parameter protocols, and standardizing outcome assessment systems. This review innovatively synthesized recent randomized controlled trials (RCTs) and mechanistic evidence, systematically summarizing rPMS-mediated multidimensional intervention paradigms for upper- and lower-limb spasticity. It rigorously examined the correlations between stimulation frequency parameters (low-frequency vs. high-frequency), anatomical targeting (nerve trunk vs. motor point), and clinical outcomes including spasticity severity, motor function, and quality of life. Crucially, the analysis reveals that rPMS may ameliorate spasticity through dual mechanisms involving local neuroelectrophysiological modulation and central sensorimotor network reorganization, thereby providing a theoretical foundation for developing individualized rPMS clinical protocols and establishing precision treatment strategies.
Objective To explore the effect of " closed-loop rehabilitation”-based digital mirror therapy (MT) on the recovery of upper limb function after stroke. Methods Between December 2017 and April 2018, 90 stroke patients were recruited and randomly assigned to digital MT group (MG) or conventional group (CG), with 45 in each group. Patients in MG received digital MT for 60 minutes and subsequent hand function rehabilitation for 30 minutes, which was a " closed-loop rehabilitation”; moreover, patients in CG received therapeutic exercises, occupational therapy, and hand function rehabilitation for 30 minutes separately (totally 90 minutes). Both interventions were daily provided, 5 days per week and lasting for 4 weeks. Clinical assessments were provided before and after the interventions, including the Fugl-Meyer Assessment Upper Limb (FAM_UL) for motor function evaluation, the Modified Barthel Index (MBI) for the activities of daily life (ADL) evaluation, and the Modified Ashworth Scale (MAS) for the spasticity of wrist extensor/flexor. Results Five patients did not complete the study (3 in MG and 2 in CG), so there were totally 85 subjects analysed in the end. After 4-week interventions, significant improvements of FMA_UL scores (Pre: MG, 25.86±17.41; CG, 21.71±15.60. Post: MG, 33.43±17.08; CG, 26.48±16.47) and MBI scores (Pre: MG, 66.62±21.73; CG, 59.14±21.58. Post: MG, 84.62±15.06; CG, 71.10±19.95) were found in both groups; moreover, higher scores of FMA_UL and MBI were investigated in MG comparing with CG after interventions. However, there were no significantly differences in MAS. Conclusions The " closed-loop rehabilitation”-based digital MT can improve the motor function of upper limb and the ability of ADL in patients with stroke. Moreover, it is more effective than conventional treatments.