脑机接口步行模拟器在脊髓损伤患者中的应用
Operation of a Brain-Computer Interface Walking Simulator by Users with Spinal Cord Injury
摘要：
背景：脊髓损伤（SCI）可使受影响的个体无法行走。由于SCI没有恢复性治疗，因此一直在寻求新的方法，如脑控假体。我们最近的研究表明，一个脑机接口（BCI）可以用来控制截肢在虚拟现实环境（VRE），这表明BCI控制截肢下肢假肢是可行的。然而，我们的BCI的可操作性尚未在SCI人群中进行测试。研究方法：五名受试者截瘫或四肢瘫痪，由于SCI进行了10分钟的训练课程，他们之间交替的运动觉运动想象（KMI）的空转和步行，同时记录他们的脑电图（EEG）。然后，受试者进行了一个目标导向的在线任务，在那里他们利用KMI来控制化身的线性振幅，并在VRE内的指定点连续停止10次。在5个实验日内进行了多次在线试验。结果如下：离线估计空转和行走的分类准确性，受试者和天数的范围为60.5%（p=0.0176）至92.3%（p=1.36*10^-20）。在在线任务中，所有受试者都实现了有目的的控制，平均表现为在273 +/- 51秒内成功停止7.4 +/- 2.3次（p<0.01）。在整个研究过程中，所有受试者都保持了有目的的控制，他们的在线表现随着时间的推移而改善。结论：结果表明，SCI受试者可以有目的地操作一个自步速的BCI步行模拟器，以完成一个目标导向的american任务。该BCI系统的操作需要短期培训，是直观的，并且对受试者之间和日常神经生理变化具有鲁棒性。这些研究结果表明，BCI控制的下肢假肢的步态康复或恢复后SCI可能是可行的，在未来。
英文摘要：
Background: Spinal cord injury (SCI) can leave the affected individuals unable to ambulate. Since there are no restorative treatments for SCI, novel approaches such as brain-controlled prostheses have been sought. Our recent studies show that a brain-computer interface (BCI) can be used to control ambulation within a virtual reality environment (VRE), suggesting that a BCI-controlled lower extremity prosthesis for ambulation may be feasible. However, the operability of our BCI has not been tested in a SCI population. Methods: Five subjects with paraplegia or tetraplegia due to SCI underwent a 10-min training session in which they alternated between kinesthetic motor imagery (KMI) of idling and walking while their electroencephalogram (EEG) were recorded. Subjects then performed a goal-oriented online task, where they utilized KMI to control the linear ambulation of an avatar and make 10 sequential stops at designated points within the VRE. Multiple online trials were performed over 5 experimental days. Results: Classification accuracy of idling and walking was estimated offline and ranged from 60.5% (p=0.0176) to 92.3% (p=1.36*10^-20) across subjects and days. In the online task, all subjects achieved purposeful control with an average performance of 7.4 +/- 2.3 successful stops in 273 +/- 51 sec (p<0.01). All subjects maintained purposeful control throughout the study, and their online performances improved over time. Conclusions: The results demonstrate that SCI subjects can purposefully operate a self-paced BCI walking simulator to complete a goal-oriented ambulation task. The operation of this BCI system requires short training, is intuitive, and robust against subject-to-subject and day-to-day neurophysiological variations. These findings indicate that BCI-controlled lower extremity prostheses for gait rehabilitation or restoration after SCI may be feasible in the future.
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