镜像视觉反馈训练中大脑运动皮质激活的脑电特征研究

doi:10.3969/j.issn.1006-9771.2023.08.015

摘要/Abstract

摘要：

目的观察优势手和非优势手进行镜像视觉反馈训练(MVF)过程中大脑运动皮质激活及大脑偏侧化情况。
方法 2021年3月至9月于沈阳体育学院招募右利手男性受试者17例。应用eego^TMmylab脑电系统实时采集其在MVF过程中的脑电(EEG)和指伸肌的表面肌电(sEMG)信号。被试完成单侧手指的伸展运动，包含左/右手MVF和左/右手直视(VF)训练4个实验范式，每种范式重复80个试次，4种范式分两次进行，每次实验间隔1周。分析sEMG信号的时域特征以及与运动密切相关的α频段(8~13 Hz)、β频段(13~20 Hz) EEG信号的时频特征，采用事件相关去同步化/同步化(ERD/ERS)、非对称指数(AI)评价优势和非优势手MVF时运动皮质激活及偏侧化现象。
结果放松手为右手时，MVF和VF指伸肌的sEMG振幅大于静息状态(P < 0.05)。在α频段，训练状态在ERD/ERS上主效应非常显著(F = 14.125, η_p² = 0.469, P = 0.002)，MVF高于VF;在β频段，训练状态在ERD/ERS上主效应非常显著(F = 9.704, η_p² = 0.378, P = 0.007)，运动手与训练状态在ERD/ERS上交互作用显著(F = 8.014, η_p² = 0.334, P = 0.012)，其中VF时，右手运动ERD/ERS高于左手运动(F = 7.267, η_p²= 0.312, P = 0.016)，当右手运动时，MVF时ERD/ERS高于VF时(F = 17.530, η_p²= 0.523, P = 0.001)。在C4电极位置，VF时，右手运动ERD/ERS高于左手运动(t = -3.201, P = 0.006, Cohen's d = 0.776);当右手运动时，MVFERD/ERS高于VF(t = -4.060, P = 0.001, Cohen's d = 0.985)。AI仅在β频段训练状态主效应显著(F = 5.796, η_p²= 0.266, P = 0.028)，MVF高于VF。
结论 MVF可能通过募集额-顶区镜像神经元以及减少半球间与皮质内抑制活动来提高运动手同侧初级运动皮质区神经元的活动，并且这种效应对于优势手训练的效果更佳。

关键词: 镜像视觉反馈, 单侧运动, 脑电, 事件相关去同步化/同步化

Abstract:

Objective To explore the activation of motor cortex and brain lateralization of healthy male subjects during mirror visual feedback (MVF) of dominant and non-dominant hands.
Methods From March to September, 2021, 17 right-handed male subjects were recruited in Shenyang Sport University. The eego^TMmylab electroencephalography (EEG) system was applied to acquire the EEG and surface electromyography (sEMG) signals of digital extensor muscle during MVF. The subjects were completed unilateral finger stretching exercise, including left/right hand MVF and left/right hand visual feedback (VF). Each paradigm was repeated 80 trials, and the four paradigms were divided into two experiments, with one week between each experiment. The time-domain characteristics of sEMG signals and the time-frequency characteristics of α-band (8 to 13 Hz) and β-band (13 to 20 Hz) EEG signals which were closely related to motion were analyzed. Activation and asymmetry of motor cortex during MVF in dominant and nondominant hands were measured with event-related desynchronization/synchronization (ERD/ERS) and asymmetric index (AI).
Results When the relaxed hand was right hand, the sEMG amplitude of digital extensor muscle were more in MVF and VF than in resting state (P < 0.05). In α bands, the main effect of training state on ERD/ERS was significant (F = 14.125, η_p² = 0.469, P = 0.002), and it was higher in MVF than in VF. In β band, the main effect of training state on ERD/ERS was significant (F = 9.704, η_p² = 0.378, P = 0.007), the interaction effect of moving hand and training state was significant on ERD/ERS (F = 8.014, η_p² = 0.334, P = 0.012); for VF, ERD/ERS was higher in right hand movement than in left hand movement (F = 7.267, η_p²= 0.312, P = 0.016); for right hand movement, ERD/ERS was higher in MVF than in VF (F = 17.530, η_p²= 0.523, P = 0.001). At the position of C4 electrode, ERD/ERS was higher in right hand movement than in left hand movement under VF (t = -3.201, P = 0.006, Cohen's d = 0.776), and ERD/ERS was higher in MVF than in VF under right hand movement (t = -4.060, P = 0.001, Cohen's d = 0.985). Main effect of training state was significant on AI at β band (F = 5.796, η_p²= 0.266, P = 0.028), and it was higher in MVF than in VF.
Conclusion MVF may improve the activity of motor cortex neurons on the ipsilateral side of the motor hand through recruitment of frontal and parietal mirror neurons and reduction of interhemispheric and intracortical inhibitory activities, and it is more effective for the dominant hand training.

Key words: mirror visual feedback, unilateral movement, electroencephalography, event-related de-synchronization/synchronization

中图分类号:

R493

陈渔, 郭峰, 郭建瑞, 董彤彤, 夏雪莲. 镜像视觉反馈训练中大脑运动皮质激活的脑电特征研究[J]. 《中国康复理论与实践》, 2023, 29(8): 967-976.

CHEN Yu, GUO Feng, GUO Jianrui, DONG Tongtong, XIA Xuelian. Activation characteristics of motor cortex during mirror visual feedback based on electroencephalography[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 967-976.

图/表 11

图1

图2

图3

表1

图4

表2

图5

图6

图7

表3

表4

参考文献 34

[1]	ALTSCHULER E L, WISDOM S B, STONE L, et al. Rehabilitation of hemiparesis after stroke with a mirror[J]. Lancet, 1999, 353: 2035-2036. doi: 10.1016/s0140-6736(99)00920-4 pmid: 10376620
[2]	PEREZ-CRUZADO D, MERCHAN-BAEZA J A, GONZALEZ-SANCHEZ M, et al. Systematic review of mirror therapy compared with conventional rehabilitation in upper extremity function in stroke survivors[J]. Aust Occup Ther J, 2017, 64(2): 91-112.
[3]	王莉. 应用脑功能成像技术研究脑卒中运动想象疗法神经康复机制[D]. 重庆: 重庆大学, 2015.
[4]	HOWATSON G, ZULT T, FARTHING J P, et al. Mirror training to augment cross-education during resistance training: a hypothesis[J]. Front Hum Neurosci, 2013, 7: 396. doi: 10.3389/fnhum.2013.00396 pmid: 23898251
[5]	FARTHING J P. Crosseducation of strength depends on limb dominance: implications for theory and application[J]. Exerc Sport Sci Rev, 2009, 37: 179-187. doi: 10.1097/JES.0b013e3181b7e882
[6]	NOJIMA I, OGA T, FUKUYAMA H, et al. Mirror visual feedback can induce motor learning in patients with callosal disconnection[J]. Exp Brain Res, 2013, 227: 79-83. doi: 10.1007/s00221-013-3486-4 pmid: 23543104
[7]	FUKUMURA K, SUGAWARA K, TANABE S, et al. Influence of mirror therapy on human motor cortex[J]. Int J Neurosci, 2007, 117: 1039-1048. pmid: 17613113
[8]	ZULT T, HOWATSON G, KÁDÁR E E, et al. Role of the mirrorneuron system in cross-education[J]. Sports Med, 2014, 44: 159-178. doi: 10.1007/s40279-013-0105-2
[9]	ROSENKRANZ K, WILLIAMON A, ROTHWELL J C. Motorcortical excitability and synaptic plasticity is enhanced in professional musicians[J]. J Neurosci 2007, 27: 5200-5206. doi: 10.1523/JNEUROSCI.0836-07.2007 pmid: 17494706
[10]	RIDDING M C, BROUWER B, NORDSTROM M A. Reduced interhemispheric inhibition in musicians[J]. Exp Brain Res, 2000, 133: 249-253. doi: 10.1007/s002210000428 pmid: 10968226
[11]	MÜLLER S, VALLENCE A M, WINSTEIN C. Investigation of perceptual: motor behavior across the expert athlete to disabled patient skill continuum can advance theory and practical application[J]. J Mot Behav, 2018, 50(6): 697-707. doi: 10.1080/00222895.2017.1408557
[12]	PETRO B, EHMANN B, BÁRDOS G, et al. Perceived usefulness of mirrored video self-modeling in the development of bilateral competence in elite team-sports[J]. J Health Sport Exerc, 2018, 13: 621-630.
[13]	CATTANEO L, RIZZOLATTI G. The mirror neuron system[J]. Arch Neurol 2009, 65: 557-560. doi: 10.1001/archneurpsyc.1951.02320050014002
[14]	HAMZEI F, LÄPPCHEN C H, GLAUCHE V, et al. Functional plasticity induced by mirror training: the mirror as the element connecting both hands to one hemisphere[J]. Neurorehabil Neural Repair, 2012, 26: 484-496. doi: 10.1177/1545968311427917 pmid: 22247501
[15]	LÄPPCHEN C H, RINGER T, BLESSIN J, et al. Optical illusion alters M1 excitability after mirror therapy: a TMS study[J]. 2012, 108(10): 2857-2861.
[16]	MATTHYS K, SMITS M, VAN DER GEEST J N, et al. Mirrorinduced visual illusion of hand movements: a functional magnetic resonance imaging study[J]. Arch Phys Med Rehabil 2009, 90: 675-681. doi: 10.1016/j.apmr.2008.09.571
[17]	ZIJDEWIND I, BUTLER J E, GANDEVIA S C, et al. The origin of activity in the biceps brachii muscle during voluntary contractions of the contralateral elbow flexor muscles[J]. Exp Brain Res, 2006, 175(3): 526-535. doi: 10.1007/s00221-006-0570-z pmid: 16924489
[18]	RJOSK V, KAMINSKI E, HOFF M, et al. Mirror visual feedback-induced performance improvement and the influence of hand dominance[J]. Front Hum Neurosci, 2015, 9: 702. doi: 10.3389/fnhum.2015.00702 pmid: 26834605
[19]	HORTOBÁGYI T, RICHARDSON S P, LOMAREV M, et al. Interhemispheric plasticity in humans[J]. Med Sci Sports Exerc, 2011, 43: 1188-1199. doi: 10.1249/MSS.0b013e31820a94b8
[20]	PEREZ M A, TANAKA S, WISE S P, et al. Neural substrates of intermanual transfer of a newly acquired motor skill[J]. Curr Biol, 2007, 17: 1896-1902. pmid: 17964167
[21]	IMAI I, TAKEDA K, SHIOMI T, et al. Sensorimotor cortex activation during mirror therapy in healthy righthanded subjects: a study with near-infrared spectroscopy[J]. J Phys Ther Sci, 2008, 20: 141-145. doi: 10.1589/jpts.20.141
[22]	COHEN M X. A better way to define and describe Morlet wavelets for time-frequency analysis[J]. Neuroimage, 2019, 199: 81-86. doi: S1053-8119(19)30440-9 pmid: 31145982
[23]	牛小辰. 康复运动中的脑肌电特征分析[D]. 秦皇岛: 燕山大学, 2015.
[24]	FONG K, TING K H, CHAN C, et al. Mirror therapy with bilateral arm training for hemiplegic upper extremity motor functions in patients with chronic stroke[J]. Hong Kong Med J, 2019, 25 (Suppl 3): 30-34.
[25]	HEINRICHS-GRAHAM E, WIESMAN A I, EMBURY C M, et al. Differential impact of movement on the alpha and gamma dynamics serving visual processing[J]. J Neurophysiol, 2022, 127(4): 928-937. doi: 10.1152/jn.00380.2021
[26]	LEE H M, LI P C, FAN S C. Delayed mirror visual feedback presented using a novel mirror therapy system enhances cortical activation in healthy adults[J]. J Neuroeng Rehabil, 2015, 12: 56. doi: 10.1186/s12984-015-0053-1
[27]	ZHANG J, FONG K, WELAGE N, et al. The Activation of the mirror neuron system during action observation and action execution with mirror visual feedback in stroke: a systematic review[J]. Neural Plast, 2018, 2018: 2321045.
[28]	PINEDA J A. The functional significance of mu rhythms: translating "seeing" and "hearing" into "doing"[J]. Brain Res Brain Res Rev, 2005, 50(1): 57-68. doi: 10.1016/j.brainresrev.2005.04.005
[29]	余倩如, 张建, 肖桦. 镜像视觉反馈疗法在Ⅱ型复杂区域性疼痛综合征中的应用进展[J]. 中国康复理论与实践, 2019, 25(12): 1439-1443. doi: 10.3969/j.issn.1006-9771.2019.12.012
	YU Q R, ZHANG J, XIAO H. Application of mirror visual feedback in complex regional pain syndrome type II (review)[J]. Chin J Rehabil Theroy Pract, 2019, 25(12): 1439-1443.
[30]	BAHR F, RITTER A, SEIDEL G, et al. Boosting the motor outcome of the untrained hand by action observation: mirror visual feedback, video therapy, or both combined: What is more effective?[J]. Neural Plast, 2018, 2018: 8369262.
[31]	GÜNTÜRKÜN O, STRÖCKENS F, OCKLENBURG S. Brain lateralization: a comparative perspective[J]. Physiol Rev, 2020, 100(3): 1019-1063. doi: 10.1152/physrev.00006.2019 pmid: 32233912
[32]	ZOH Y, CHANG S, CROCKETT M J. The prefrontal cortex and (uniquely) human cooperation: a comparative perspective[J]. Neuropsychopharmacology, 2022, 47(1): 119-133. doi: 10.1038/s41386-021-01092-5
[33]	BARTOLOMEO P, SEIDEL MALKINSON T. Hemispheric lateralization of attention processes in the human brain[J]. Curr Opin Psychol, 2019, 29: 90-96. doi: S2352-250X(18)30239-2 pmid: 30711910
[34]	KANG Y J, KU J, KIM H J, et al. Facilitation of corticospinal excitability according to motor imagery and mirror therapy in healthy subjects and stroke patients[J]. Ann Rehabil Med, 2011, 35(6): 747-758. doi: 10.5535/arm.2011.35.6.747 pmid: 22506202

训练状态	运动手	放松手
M+	136.221±10.976	1.829±0.207
M-	132.723±10.458	1.705±0.200
t值	0.379	0.647
P值	0.707	0.522
Cohen's d	0.065	0.111

训练状态	左手	右手
RE	2.207±0.239	1.281±0.118
M+	1.669±0.213	1.990±0.193^a
M-	1.647±0.217	1.763±0.181^b
F值	1.921	7.387
P值	0.158	0.006
η_p²值	0.074	0.496

效应	F值	η_p²	P值
α频段 (8~13 Hz)
运动手	0.001	0.000	0.970
训练状态	14.125	0.469	0.002
大脑半球	1.029	0.060	0.325
运动手×训练状态	0.308	0.019	0.586
运动手×大脑半球	0.256	0.016	0.620
训练状态×大脑半球	0.042	0.003	0.841
运动手×训练状态×大脑半球	4.207	0.208	0.057
β频段 (13~20 Hz)
运动手	0.852	0.051	0.370
训练状态	9.704	0.378	0.007
大脑半球	0.080	0.005	0.780
运动手×训练状态	8.014	0.334	0.012
运动手×大脑半球	1.895	0.106	0.188
训练状态×大脑半球	0.132	0.008	0.721
运动手×训练状态×大脑半球	3.922	0.197	0.065

效应	F值	η_p²	P值
α频段(8~13 Hz)
运动手	1.392	0.080	0.255
训练方式	4.207	0.208	0.057
运动手×训练方式	0.005	< 0.001	0.944
β频段 (13~20 Hz)
运动手	0.080	0.005	0.780
训练状态	5.796	0.266	0.028
运动手×训练状态	0.001	< 0.001	0.982