Predicting upper limb motor recovery in subacute stroke patients via fNIRS-measured cerebral functional responses induced by robotic training.

Autor: Zhou Y; Key Laboratory of Biorheological Science and Technology of Ministry of Education, Chongqing University, Chongqing, 400044, P.R. China.; Chongqing Medical Electronics Engineering Technology Research Center, Chongqing University, Chongqing, 400044, P.R. China., Xie H; Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, 100176, P.R. China.; Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China., Li X; Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, P.R. China., Huang W; Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, P.R. China., Wu X; Key Laboratory of Biorheological Science and Technology of Ministry of Education, Chongqing University, Chongqing, 400044, P.R. China.; Chongqing Medical Electronics Engineering Technology Research Center, Chongqing University, Chongqing, 400044, P.R. China., Zhang X; Key Laboratory of Biorheological Science and Technology of Ministry of Education, Chongqing University, Chongqing, 400044, P.R. China.; Chongqing Medical Electronics Engineering Technology Research Center, Chongqing University, Chongqing, 400044, P.R. China., Dou Z; Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, P.R. China., Li Z; Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, 100176, P.R. China., Hou W; Key Laboratory of Biorheological Science and Technology of Ministry of Education, Chongqing University, Chongqing, 400044, P.R. China. w.s.hou@cqu.edu.cn.; Chongqing Medical Electronics Engineering Technology Research Center, Chongqing University, Chongqing, 400044, P.R. China. w.s.hou@cqu.edu.cn., Chen L; Key Laboratory of Biorheological Science and Technology of Ministry of Education, Chongqing University, Chongqing, 400044, P.R. China.; Chongqing Medical Electronics Engineering Technology Research Center, Chongqing University, Chongqing, 400044, P.R. China.
Jazyk: angličtina
Zdroj: Journal of neuroengineering and rehabilitation [J Neuroeng Rehabil] 2024 Dec 23; Vol. 21 (1), pp. 226. Date of Electronic Publication: 2024 Dec 23.
DOI: 10.1186/s12984-024-01523-6
Abstrakt: Background: Neural activation induced by upper extremity robot-assisted training (UE-RAT) helps characterize adaptive changes in the brains of poststroke patients, revealing differences in recovery potential among patients. However, it remains unclear whether these task-related neural activities can effectively predict rehabilitation outcomes. In this study, we utilized functional near-infrared spectroscopy (fNIRS) to measure participants' neural activity profiles during resting and UE-RAT tasks and developed models via machine learning to verify whether task-related functional brain responses can predict the recovery of upper limb motor function.
Methods: Cortical activation and brain network functional connectivity (FC) in brain regions such as the superior frontal cortex, premotor cortex, and primary motor cortex were measured using fNIRS in 82 subacute stroke patients in the resting state and during UE-RAT. The Fugl-Meyer Upper Extremity Assessment Scale (FMA-UE) was chosen as the index for assessing upper extremity motor function, and clinical information such as demographic and neurophysiological data was also collected. Robust features were screened in 100 randomly divided training sets using the least absolute shrinkage and selection operator (LASSO) method. Based on the selected robust features, machine learning algorithms were used to develop clinical models, fNIRS models, and combined models that integrated both clinical and fNIRS features. Finally, Shapley Additive Explanations (SHAP) was applied to interpret the prediction process and analyze key predictive factors.
Results: Compared to the resting state, task-related FC is a more robust feature for modeling, with screening frequencies above 90%. The combined models built using artificial neural networks (ANNs) and support vector machines (SVMs) significantly outperformed the other algorithms, with an average AUC of 0.861 (± 0.087) for the ANN and an average correlation coefficient (r) of 0.860 (± 0.069) for the SVM. Furthermore, predictive factor analysis of the models revealed that FC measured during tasks is the most important factor for predicting upper limb motor function.
Conclusion: This study confirmed that UE-RAT-induced FC can serve as an important predictor of rehabilitation, especially when combined with clinical information, further enhancing the accuracy of model predictions. These findings provide new insights for the early prediction of patients' recovery potential, which may contribute to personalized rehabilitation decisions.
Competing Interests: Declarations. Ethics approval and consent to participate: All participants gave their informed consent before their participation. The study was approved by the Institutional Review Board and Ethics Committee of the Third Affiliated Hospital of Sun Yat-sen University. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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