基于闭环理论的卒中后上肢感觉障碍康复研究进展 Progress on Upper Limb Sensory Impairment Rehabilitation after Stroke Based on Closed-Loop Theory

卒中后患者常存在上肢躯体感觉障碍，包括浅感觉障碍、深感觉障碍和复合感觉障碍。“中枢-外周-中枢”闭环理论作为卒中后的康复新理论，目前在卒中后上肢感觉障碍的康复中逐渐得到应用。常见的中枢干预方法有经颅直流电刺激、经颅磁刺激、镜像疗法、脑机接口和头针等，本研究阐述这些中枢干预方法联合不同外周康复训练对卒中后上肢感觉障碍康复的研究进展。目前研究证明，不同模式的“中枢-外周-中枢”闭环治疗方法均对卒中后上肢感觉障碍的康复具有较好的治疗效果。然而，中枢干预和外周干预联合的时间有效性、不同闭环模式的临床机制仍不明确，未来有待进一步研究去探索这些问题。 Abstract: Post-stroke patients have upper extremity somatosensory disorders, including superficial sensory disorders, profound sensory disorders and compound sensory disorders. As a new theory of post-stroke rehabilitation, the "central-peripheral-central" closed-loop theory has been gradually applied in the rehabilitation of upper extremity sensory disorders after stroke. Based on the common central interventions - transcranial direct current stimulation, transcranial magnetic stimulation, mirror therapy, brain-computer interface and head acupuncture, this article introduced the progress of these central interventions combined with different peripheral rehabilitation training for post-stroke upper limb sensory disorders. The current studies have demonstrated that different modalities of "central-peripheral-central" closed-loop therapy are effective in the rehabilitation of upper extremity sensory disorders after stroke. However, the temporal effectiveness of the combination of central and peripheral interventions and the clinical mechanisms of different closed-loop modalities are still unclear, which need to further research to elucidate.