Interactive metronome applied in the rehabilitative treatment of the central nervous system

doi:10.3969/j.issn.2095-4344.2017.16.027

Abstract

Abstract:

BACKGROUND: Interactive metronome (IM), also known as millisecond rhythm feedback, is a rehabilitative treatment technology supported by neural plasticity theory. Cerebral immediate feedback measured in milliseconds is helpful for understanding neurocognitive mechanisms.
OBJECTIVE: To overview the progress of IM applied in the rehabilitation of central nervous system.
METHODS: The first author retrieved CNKI (2001-2016), Medline (1989-2016) and Imedpub (2015-2017) databases using the keywords of “millisecond rhythm feedback, cognition, motor behavior” in English and Chinese, respectively. Data such as theoretical researches on cerebral timing function, the mechanism underlying IM affecting cerebral timing function, and IM operation skills and application were evaluated.
RESULTS AND CONCLUSION: A total of 26 eligible articles were enrolled. IM is an objective assessment and training tool that improves neural synchronization and function. IM can accelerate the speed and the efficiency of processing information of white matter tracts, and enhance the function of attention control system in order to improve the disorder of the cerebral timing. IM achieves satisfactory outcomes in the treatment of learning disabilities in children, cognitive impairment after brain injury and cerebral stroke with hemiplegia in adults. Based on the traditional rehabilitative training in the central nervous system, IM addresses critical brain timing skills, which is a promising technology in the future rehabilitation of the central nervous system.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Tissue Engineering, Cognition, Attention

CLC Number:

R318

Liu Shi-wen, Duan Chang-qiu. Interactive metronome applied in the rehabilitative treatment of the central nervous system[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(16): 2619-2624.

Figures/Tables 2

2.3 纳入资料的研究结果特征 ①纳入资料的理论研究较深入、系统化：如大脑3个等级的定时系统、互动节拍器作用认知和运动的机制研究逐年进展，具有连续性；②互动节拍器训练方案设计较细化且规范，注重适用性，强调个性化；③临床应用目的明确，主要表现在毫秒级节律相关的中枢神经系统疾病康复方面。 2.3.1 毫秒级节律运动技术与脑定时功能互动节拍器的理论基础：众所周知，大脑能持续的测量时间，这种能力对人类很多关键性的行为极其重要(例如节奏感、运动协调、认知、言语及日常生活行为等)。神经心理学的研究高度肯定了大脑定时能力的重要性，它是学习和环境适应能力的关键因素之一。有研究已经证实，时间感觉从婴儿时期就伴随着中枢神经系统的成熟，并不断提高其精密度。以往研究已经证实，所谓的大脑定时，已经形成共识的3个等级的定时系统包括[1]：①生理定时：指食欲，睡眠-觉醒的循环等行为的管控，一般在24 h范围；参与结构在视交叉上核等大脑的位置；机制有转录/翻译周期环路等；②间隔定时：行为有觅食，行为决定的作出，时间估计从秒到小时的范围；大脑结构有皮质纹状体环路，多巴胺神经；机制有确认的监测，纹状体LTP(长时程增强效应)和LTD(长时程抑制)；③毫秒级定时：其行为关系到演讲，谈话、音乐、注意力和运动控制能力，时间精确在毫秒范围内；主要涉及到的脑结构，包括：小脑、基底神经节、右顶叶和背外侧前额叶皮质；机制有小脑的LTP/LTD等。目前国内外的互动节拍器反馈仪器的开发，认为是基于大脑定时机制，以矫正毫秒级定时系统机能障碍为原理，来改善认知或运动行为的，所以互动节拍技术也称为毫秒级节律反馈技术(millisecond rhythm feedback technique，MRF)。 McGrew等[2]在综合以往毫秒级节律性互动(互动节拍器)康复训练研究的有效性时，提出互动节拍器作用机制的大脑3级水平模型的解释，包括：第Ⅰ级：大脑时钟(或时间加工)的激活；第Ⅱ级：大脑网络交流与同步化的促进；第Ⅲ级：注意力控制系统(ACS)的提升。节拍器模型的理论基础：大脑时钟是由一个持续产生神经脉冲的起搏器-累加器(PAM)构成[3]。有研究提出大脑时间记录有3种平行时间的可行性系统模式来感知时间(图1)[4]。另外，科学家们探讨了时间测量性表现的神经基础，发现大脑的时间间隔(节律)并不是由大脑某个单一的解剖结构或位置控制，而是涉及数个大脑结构的同步化(通常在网络通路，循环或环路上出现)，尤其与小脑，前扣带回，基底神经节，背外侧前额叶皮质，右顶叶皮质，运动皮质以及前纹状体循环有关。"

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