AUTHOR=Li Hao , Fu Xuefeng , Lu Lijun , Guo Hua , Yang Wen , Guo Kaifeng , Huang Zhen 

TITLE=Upper limb intelligent feedback robot training significantly activates the cerebral cortex and promotes the functional connectivity of the cerebral cortex in patients with stroke: A functional near-infrared spectroscopy study

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1042254

DOI=10.3389/fneur.2023.1042254

ISSN=1664-2295

ABSTRACT=Background: Upper limb intelligence robots are widely used to improve the upper limb function of stroke patients, but the treatment mechanism is still not clear. In this study, functional near-infrared spectroscopy (fNIRS) was used to evaluate the concentration changes of oxygenated hemoglobin (oxy-Hb) and deoxyhemoglobin (deoxy-Hb) in different brain regions and functional connectivity (FC) of the cerebral cortex in patients with stroke. 

Result: Compared with the other two groups, stronger cerebral cortex activation was observed during ACT. One-way repeated measures ANOVA revealed significant differences in mean oxy-Hb changes among conditions in the four ROIs: contralesional PFC (F (2,48) = 6,798, p < 0.01), ipsilesional M1 (F (2,48) = 6.733, p < 0.01), ipsilesional S1 (F (2,48) = 4,392, p < 0.05), and ipsilesional PM (F (2,48) = 3.658, p < 0.05). Oxy-Hb responses in the contralesional PFC region were stronger during ACT than during SUS (p < 0.01) and PAS (p < 0.05). Cortical activation in the ipsilesional M1 was significantly greater during ACT than during SUS (p < 0.01) and PAS (p < 0.05). Oxy-Hb responses in the ipsilesional S1 (p < 0.05) and ipsilesional PM (p < 0.05) were significantly higher during ACT than during PAS. And there is no significant difference in mean deoxy-Hb changes among conditions. Compared with SUS, the FC increased during ACT, which was characterized by the enhanced function of the ipsilesional cortex (p < 0.05). And there was no significant difference in FC between the ACT and PAS. 

Conclusion: The study found that cortical activation during ACT was higher in the contralesional PFC, and ipsilesional M1 than during SUS, and showed tighter cortical FC between the cortices. The activation of the cerebral cortex of ACT was significantly higher than that of PAS, but there was no significant difference in FC. Our research is helpful in understanding the difference in cerebral cortex activation between upper limb intelligent feedback robot rehabilitation and other rehabilitation training and provides an objective basis for the further application of upper limb intelligent feedback robots in the field of stroke rehabilitation.