Neurofeedback facilitation enhances post-stroke gait and balance recovery: a randomized trial

Objective: To test the hypothesis that supplementary motor area (SMA) facilitation with functional near-infrared spectroscopy mediated neurofeedback (fNIRS-NFB) augments post-stroke gait and balance recovery using the 3-meter-Timed Up-and-Go (TUG) test, we conducted this two-center, double-blind, randomized controlled trial involving 54 Japanese patients. Methods: Patients with subcortical stroke-induced mild-to-moderate gait disturbance more than 12 weeks from onset, underwent 6 sessions of SMA neurofeedback facilitation during gait- and balance-related motor imagery using fNIRS-NFB. Participants were randomly allocated to intervention (REAL: 28 patients) or placebo (SHAM: 26 patients) group. In the REAL group, the fNIRS signal contained participants’ cortical activation information. Primary outcome was TUG improvement, 4 weeks post intervention. Results: The REAL group showed greater improvement in the TUG test (12.84 ± 15.07 s, 95% CI: 7.00-18.68) than the SHAM group (5.51± 7.6...研究目的：为验证“采用功能近红外光谱介导神经反馈（functional near-infrared spectroscopy mediated neurofeedback, fNIRS-NFB）对辅助运动区（supplementary motor area, SMA）进行调控，可改善脑卒中后步态与平衡功能”这一假说，本研究依托3米计时起身行走（3-meter-Timed Up-and-Go, TUG）测试，开展了一项纳入54名日本患者的双中心双盲随机对照试验。 研究方法：研究对象为发病超过12周、因皮质下脑卒中（subcortical stroke）导致轻中度步态障碍的患者，所有受试者均接受6次基于fNIRS-NFB的辅助运动区神经反馈调控训练，训练过程中同步进行与步态及平衡相关的运动意象任务。受试者被随机分配至干预组（REAL组，28例）与安慰剂组（SHAM组，26例）。其中干预组的fNIRS信号采集受试者的皮层激活信息。本研究的主要结局指标为干预后4周的TUG测试改善情况。 研究结果：干预组TUG测试的改善幅度（12.84±15.07秒，95%置信区间：7.00~18.68）显著优于安慰剂组（5.51±7.6...）