Application of multimodal neuromodulation guided by multidisciplinary team-based management in dynamic assessment and precision rehabilitation for a case of large-area cerebral infarction
10.3969/j.issn.1006-9771.2026.10.005
- VernacularTitle:多学科团队管理下多模态调控对1例大面积脑梗死患者动态评估与精准康复
- Author:
Xiaoli WU
1
;
Xiaoqian XIA
2
;
Changqing YE
1
;
Yunlei WANG
1
;
Xingzhu LI
1
;
LiXu LIU
1
;
Fubiao HUANG
3
;
Jingsong LIU
4
;
Yichuan SONG
5
;
Yue ZHANG
6
;
Xiaoxia DU
1
Author Information
1. Department of Neurology Rehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
2. School of Rehabilitation, Capital Medical University, Beijing 100068, China
3. Department of Occupational Therapy, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
4. Institute of Rehabilitation Engineering, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
5. Music Therapy Center, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
6. Department of Rehabilitation Assessment, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
- Publication Type:Journal Article
- Keywords:
stroke;
functional assessment;
neuromodulation;
rehabilitation;
recovery of function
- From:
Chinese Journal of Rehabilitation Theory and Practice
2026;32(10):1165-1176
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore the efficacy and potential neural mechanisms of individualized precision rehabilitation combining multimodal neuromodulation technologies under the guidance of multidisciplinary team (MDT)-based whole process dynamic assessment in a patient with large-area cerebral infarction who responded poorly to conventional rehabilitation. MethodsA 38-year-old male patient presented with hemiplegia and complete aphasia following large-area cerebral infarction in the left fronto-temporo-parietal lobe and basal ganglia due to arterial dissection. Under the MDT framework, the patient underwent six months of inpatient rehabilitation and one month of outpatient follow-up. Multimodal assessments were performed at multiple time points using diffusion tensor imaging (DTI), functional magnetic resonance imaging (fMRI), three-dimensional gait analysis and 128-channel electroencephalogram (EEG) monitoring, combined with standardized scales, such as Chinese Rehabilitation Research Center Standard Aphasia Examination (CRRCAE), Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), simplified Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI). The rehabilitation protocol integrated conventional therapies with multimodal interventions, including multi-target transcranial magnetic stimulation, brain-computer interface (BCI)-driven robotic hand training and task-oriented virtual reality upper limb training. ResultsAfter intervention, the patient showed significant improvements: LOTCA score increased by 16 points, CRRCAE subscale scores improved by 60% to 90%, total FMA score increased from 20 to 54, FMA-Balance reached 12, and MBI improved from 40 to 91. DTI revealed an increase in global fiber tract count, elevated fractional anisotropy in the corpus callosum and right corticospinal tract, and significantly increased amplitude of low-frequency fluctuations and regional homogeneity in specific brain regions on fMRI. Event-related desynchronization dynamically decreased during BCI training, and three-dimensional gait parameters showed overall improvement. ConclusionFor patients with large-area stroke who respond inadequately to conventional rehabilitation, an individualized precision rehabilitation system based on MDT whole-process dynamic assessment and integrating multimodal neuromodulation with conventional therapy can effectively enhance cognitive, language, motor functions and activities of daily living. Neuroimaging and electrophysiological findings suggest that the mechanism may involve promoting neural fiber remodeling and modulating regional brain activity.
