400 Section - Study on the Efficacy and Brain Mechanism of MI-BCI Combined with iTBS in Post-Stroke Upper Limb Motor Function Rehabilitation

The motor imagery brain-computer interface (MI-BCI), based on the "central → peripheral → central" closed-loop theory, is effective for post-stroke motor rehabilitation. However, in some patients, severe brain damage and insufficient activation of the primary motor cortex (M1) result in poor MI-BCI training outcomes. Additionally, decreased sensory functions, reduced sensory input, and diminished activation of the primary somatosensory cortex (S1) in some patients also lead to poor training effects.

Design:

This study applied intermittent theta burst stimulation (iTBS) to enhance the excitability of the sensorimotor cortex, promoting closed-loop pathway remodeling and improving MI-BCI efficacy. Stroke patients with unilateral hand dysfunction (Brunnstrom stages I-III) were divided into three groups: M1, S1, and sham stimulation. All participants underwent MI-BCI training (hand-grip/release paradigms for 30 minutes) daily for 5 days a week over 4 weeks, immediately following iTBS.

Results:

Compared to the sham group, the M1 and S1 groups showed increased upper limb motor function scores post-intervention, with greater improvement in the M1 group. EEG analysis revealed increased beta wave power in the primary sensorimotor cortex of the M1 and S1 groups compared to the sham group, with no significant difference between the M1 and S1 groups.

Conclusion:

This study highlights the importance of boosting motor and sensory cortex excitability for closed-loop pathway remodeling. Enhancing the "central → peripheral" neural pathways with iTBS synergistically improves MI-BCI training outcomes, providing valuable theoretical support for combined MI-BCI and central nervous regulation strategies.