TMS与超越：与Colin Simon共探多模态脑机接口之旅

准备好进入脑机接口的奇妙世界吧。

Get ready to blast off into the incredible world of brain computer interfaces.

《挑战不可能的神经载体》将带您踏上旅程，结识那些突破可能边界的无畏先驱者。

Neurocarriers Doing the Impossible is taking you on a journey to meet the fearless pioneers pushing the boundaries of what's possible.

在本特别系列中，我们将聚焦国际BCI奖的提名者和获奖者，这是脑机接口领域最盛大且最具声望的奖项之一。

In this special series, we'll be shining a spotlight on the nominees and winners of the International BCI award, one of the biggest and most prestigious awards in the BCI world.

您将听到BCI专业人士分享他们的革命性工作，并一窥获奖背后的故事。

You'll hear from BCI professionals as they share their revolutionary work and get a behind the scenes sneak peek at what it takes to be a winner.

所以系好安全带，拿些零食，准备好见证BCI世界中不可能变为现实的奇迹。

So buckle up, grab a snack, and get ready to be amazed as we explore the impossible becoming a reality in the world of BCIs.

但在启程前，我要特别感谢本期BCI奖项播客的联合主持人——博士。

But before we blast off, I want to give a big thanks to the co host of this BCI award edition on our podcast, Doctor.

克里斯托夫·格鲁格和GTEC医疗工程公司。

Christoph Gruger and GTEC Medical Engineering.

当我在辛辛那提大学和辛辛那提儿童医院医疗中心担任教职时，我的团队为需要癫痫手术的患者完成了一些非常了不起的工作。

When I was a faculty member at the University of Cincinnati and Cincinnati Children's Hospital Medical Center, my team and I did some pretty amazing stuff for patients needing epilepsy surgery.

我们会在患者大脑上直接放置特殊传感器（也称为网格），为手术做准备，并以比常规方法更快更安全的方式绘制大脑图谱。

We would put special sensors, also called grids, directly on their brain to prepare for surgery and create maps of their brain in a much faster and safer way than is usually done.

这项技术称为高伽马映射，能在短短几分钟内帮助我们确定手术中需要保留的大脑关键区域。

It's called high gamma mapping and it lets us figure out in just a few minutes the essential parts of the brain that need to be spared during surgery.

你能想象吗？

Can you imagine?

你可以立即绘制出语言、运动甚至大规模处理的脑区图谱。

You can create a map of language, motor and even mass processing in no time.

这是辛辛那提儿童医院医疗中心首次使用这项创新技术。

It was the first time this innovative technology was used at Cincinnati Children's Hospital Medical Center.

当我搬到佛罗里达后，在佛罗里达医院建立了首个功能性脑图谱和脑机接口项目。

When I moved to Florida, I established the first functional brain mapping and BCI program at Florida Hospital.

我继续使用高伽马映射技术，帮助癫痫患者在术后保留语言和运动能力。

I continued to use high gamma mapping to help epilepsy patients avoid losing their ability to speak or move after surgery.

但更酷的是，我开展了脑机接口研究，让患者能够实时用大脑控制外部设备。

But even cooler than that, I created brain computer interface studies that let patients control things with their brain in real time.

我们的患者仅凭大脑就能以惊人的速度拼写单词。

Our patients could even spell words with incredible speed by just using their brains.

完全不需要用手。

No hands involved.

我还发现，脑机接口可以帮助中风多年后手部或腿部长期功能障碍的患者活动肢体，这是其他方法难以实现的。

I also discovered that brain computer interfaces could help patients move their chronically impaired hands or legs years after a stroke when not much else could help them.

于是我开始与Advent Health大学的教职人员合作，帮助这些患者恢复手部功能。

So I started working with the faculty from Advent Health University to help these patients restore their ability to use their hands.

我为此接受了专业培训，这项技术至今仍让我感到震撼不已。

I received special training for it and it's still mind blowing how cool it is.

我最喜欢的工作部分是教学。

My favorite part of what I do is teaching.

在我创立的神经方法研究所里，我将所有经验和知识整合成一门独特的脑机接口课程。

At my established Institute of Neuro approaches, I've integrated all my experience and knowledge into a unique course on brain computer interfaces.

我和神经生物学研究生们从理论开始，然后为他们提供BCI设备，让他们获得实际操作经验。

With graduate neurobiology students, we started with theory and then I gave them the BCI equipment so they could have hands on experience working with BCIs.

这显著改善了学生的学习方式，他们非常喜欢这种学习如何使用神经技术的实践环节。

It significantly improved the way students learn, and they absolutely love this practical part of learning how to use neurotechnology.

而这一切的实现都要归功于GTEx卓越的脑机接口技术。

And all of this was made possible thanks to GTEx awesome brain computer interface technology.

他们拥有从高科技的10-24通道EEG系统到可穿戴设备、神经康复工具（如医疗级系统Recoverix）以及配备Unicorn混合模块的教育套件等全套设备，用于学习BCI技术。

They have everything from high-tech up to ten twenty four channel EEG systems to wearables, tools for neurorehabilitation such as the medical grade system recoveries and educational kits with Unicorn hybrid block for learning how to work with BCI technology.

但最重要的部分是他们的支持与关怀。

But the most important part is their support and care.

我很享受与博士的合作。

I have enjoyed working and collaborating with Doctor.

Christoph Gruger和GTEC员工共事超过15年，我期待未来更多成功的合作 岁月。

Christoph Gruger and GTEC employees for over fifteen years, and I hope for many more successful years ahead.

所以如果你对GTEx脑机接口和神经技术感兴趣，请访问他们的官网gtech.net。

So if you are interested in GTEx brain computer interfaces and neurotechnologies, check out their website at gtech.net.

绝对物超所值。

It's worth it.

请记住，我并未接受GTEC的任何经济支持，我所分享的是基于多年使用他们设备的真实体验。

And keep in mind, I do not receive any financial support from GTEC and share my honest opinion supported by many years of experience working with their equipment.

亲爱的NeuroCareers播客听众，欢迎收听BCI奖NeuroCareers播客系列特别节目，在这里我们赞颂神经科技领域的杰出人才与突破性项目。

Dear NeuroCareers podcast listeners, welcome to a special episode of the BCI award NeuroCareers podcast series, where we celebrate the brilliant minds and groundbreaking projects in the field of neurotechnology.

本期节目，我们很荣幸邀请到BCI奖得主科林·西蒙，他凭借利用经颅磁刺激肌肉反应开发多模态脑机接口的创新项目获此殊荣。

In this episode, we have the privilege of featuring Colin Simon, the recipient of the BCI award for his remarkable remarkable project, a multimodal brain computer interface approach using muscle responses to transcranial magnetic stimulation of the brain.

请随我们一同探索科林研究的奇妙世界，看他如何创新性地运用肌肉反应和经颅磁刺激技术开发多模态脑机接口。

Join us as we dive into the fascinating world of Collins research, where he explores the innovative use of muscle responses and transcranial magnetic stimulation in developing a multimodal brain computer interface.

探索这种创新方法如何有望彻底改变神经技术领域并增强人机交互。

Discover how this novel approach holds the potential to revolutionize the field of neurotechnology and enhance human computer interaction.

科林将分享这个项目背后的灵感、开发过程中面临的挑战，以及它为神经康复和辅助技术带来的激动人心的可能性。

Colin will share the inspiration behind this project, the challenges he faced during his development and the exciting possibilities it presents for neurorehabilitation and assistive technology.

我们将深入探讨他工作的技术细节，研究TMS与肌肉反应在创建强大高效BCI系统时的整合。

We will delve into the technical aspects of his work exploring the integration of TMS and muscle responses in creating a robust and efficient BCI system.

准备好被科林在神经技术领域突破界限的经验、热情和奉献精神所激励和吸引吧。

Get ready to be inspired and captivated by Colin's experience, passion, and dedication to pushing the boundaries of neurotechnology.

科林，今天能邀请你来到我们的播客节目真是莫大的荣幸。

Colin, it's a great pleasure to have you here today on our podcast.

能否请你简单介绍一下自己，并告诉我们的听众你目前身处世界的哪个角落与我们连线？

Can you please briefly introduce yourself and also let our listeners know where you are joining us from, from what part of the world?

好的。

Yes.

大家好。

Hello.

非常感谢你精彩的介绍，米莱娜。

Thank you for that great introduction, Milena.

此刻能受邀来到这里让我感到无比荣幸，我几乎要在屏幕后脸红了。

I feel absolutely honored to be here now, and, I'm almost blushing here behind my screen.

我今天是从瑞士与你们连线的。

So I am joining you today from Switzerland.

那里就是我的故乡。

That's where I am originally from.

但目前，我实际上是在都柏林圣三一学院攻读博士学位。

But, currently, I'm doing my PhD actually at the Trinity College Dublin.

也许你可以分享一些关于都柏林圣三一学院的有趣事实，比如它因何闻名，以及你参与的项目内容。

Maybe you can share some interesting facts about Trinity College in Dublin, what it is known for, what the program that you are involved in is about.

所以在我博士期间...

So in my PhD D.

在都柏林，我认为圣三一学院最著名且做得非常出色的一点就是它的国际性。

In Dublin, I think one of the great things that Trinity College is known for, but also what it does really well is the internationality of it.

比如我知道，在我所在的楼层——我在三楼——

So I know, for example, that on on my level, I'm I'm on the 3rd Floor.

有来自不同背景和国籍的人。

There's so many people from different backgrounds and different nationalities as well.

而且学科交叉性非常强。

And it's really incredibly interdisciplinary.

我认为特别是对神经科学而言，这种跨学科特性是巨大的优势，因为神经科学的许多不同方面都需要依赖不同的方法或背景知识。

And I think that especially for neuroscience, this interdisciplinarity is a great boon and it just helps because there's so many different aspects of neuroscience that are reliant on different methods or different backgrounds.

有细胞神经科学，也有计算神经科学。

There's cellular neuroscience, there's computational neuroscience.

是的，在我所在的三一学院大楼里，我们有来自各种背景的人——计算机科学、细胞神经科学、像我这样的心理学背景。

And, yeah, in in my floor, in my building in Trinity, we have people from all the backgrounds from computer science, from cellular neuroscience, from psychology like myself.

所以我认为这种国际性正是使三一学院成为绝佳学习场所的原因。

And so really the internationality of it is what I think makes Trinity a great place to study.

太棒了。

Wonderful.

你已经提到过你的心理学背景，这很有趣——你是如何从心理学背景转向神经技术领域的。

And you already mentioned your background your background in psychology, which is very interesting how with psychology background, you transitioned into neurotechnology.

请详细讲讲这个经历。

So tell us everything about that.

这一切是怎么发生的？

How did it all happen?

好的。

Yes.

实际上我经常被问到这个问题，每次我都有些惊讶，因为对我来说，神经科学有一半其实就是心理学，只是思维方式略有不同。

I get asked this question a lot, actually, and I'm always a little bit surprised because for me, half of neuroscience is actually just psychology with a slightly different frame of mind.

所以对我来说这是个非常自然的转变。

So for me it was an absolutely natural transition.

我刚开始学心理学时，对神经语言学很感兴趣。

When I started psychology, I was interested in neuro linguistics.

当时我可以选择主修心理学，辅修语言或神经语言学。

And at the time I had the choice to choose a major in or psychology was my major, but I could choose a minor in languages or in neuro linguistics.

那时我想，或许先学习一门不同的语言能让我获得更直接的体验。

And at the time I thought, well, it might make more sense to learn a different language so I get the firsthand experience of that.

所以我最终选择了日语，而不是直接攻读语言学。

So I did choose Japanese instead of going straight into linguistics.

现在回想起来，这个选择更好，因为我在过程中明白了很多事，包括发现神经语言学并非我的兴趣所在。

And in the end, I think that was the better choice because I learned so many things among them that neurolinguistics was not what I was interested in.

我感兴趣的仍然是神经科学，但不是神经语言学。

It was still neuroscience, but not neurolinguistics.

随着不断深入，我对认知领域越来越感兴趣，这驱使我进入了神经科学中认知研究的核心领域。

And as as I moved on, I just got more and more interested in cognition really, and that's what drove me to the very neuroscience heavy area of cognition.

从那时起，只需一个小小的跨越，就进入了我职业生涯中第一个具有定义性意义的项目——我的硕士研究，当时我从事的是身体所有权方面的研究。

And from there, was really just a little jump to go into what I would say that the first defining project of my career was my my master's, where I worked on body ownership.

这项研究探讨的是为什么人类会认为自己的身体属于自己。

So that is the study of why do humans feel that their body belongs to them.

因为存在一些非常有趣的案例，患者会突然感觉自己的身体不再属于自己。

Because there are some very interesting cases where people stop feeling like their body belongs to them.

从心理学角度来看，这种现象绝对令人着迷。

And that was absolutely fascinating from a psychological perspective.

这也是研究变得更具技术性的转折点，因为我们大量使用了脑电图和体温测量技术。

And that's also where everything got a lot more technical because we were working with EEG heavily and with body temperature.

突然间，研究不再仅仅关乎大脑、思维和我们如何感知世界，而是变成了如何精确测量人们的感知过程。

So suddenly it wasn't really just about brains and thoughts and thinking about how we perceive the world, but it was suddenly very technical in measuring how people perceive things.

我在都柏林圣三一学院获得了博士学位。

From there, I got my PhD at the Trinity College Dublin.

那时才真正进入了全面的神经科学研究阶段，主要涉及脑机接口、人机交互以及如何辅助中风康复治疗。

And that was really when it was full blown neuroscience, where it was all about brain computer interfaces and how to interact with computers and how to help with, stroke rehabilitation.

这就是一切的开始。

So that's how it got started.

嗯。

Yeah.

真是段了不起的历程。

It's an amazing journey.

关于身体所有权的研究，这是你博士课题的一部分吗？

And this work on body ownership, was this a part of your PhD that you were doing?

对吗？

Is that correct?

这取决于你如何界定。

Well, that kind of depends on how you frame it.

从欧洲大陆的学术体系来看，那属于我的硕士研究阶段，所以严格来说不算。

So from a continental European perspective, that was my masters, so no.

但在英语国家，硕士学位通常是博士学位的一部分，或者并不一定独立存在。

But in the Anglophone sphere, the masters is usually part of the PhD or is not necessarily separate.

所以我确实在都柏林开始了独立的博士研究。

So I did start separate PhD in in Dublin.

人体所有权项目是在瑞士苏黎世进行的。

The human body ownership project was back in Switzerland, in Zurich.

但正是在那里，我对我们如何感知世界、如何与外界及自身身体互动产生了极其浓厚的兴趣。

But that's really where I got extremely interested in how we perceive and how we interact with the world and our body.

而这一切最终将我引向了脑机接口领域。

And and this is what ultimately led me to brain computer interfaces.

确实如此。

Absolutely.

虽然这可能不是我们今天谈话的直接主题，但或许你可以就这个身体所有权话题再多分享些见解。

And maybe it's not a direct topic of our today's conversation, but maybe you you can provide a little bit more insights on this body ownership subject.

你提到在某些情况下，人们会停止承认自己的身体属于自己。

You mentioned that there are conditions when people stop to recognize their body as their own.

你能列举一些这类病症吗？并谈谈背后可能的理论解释是什么？

Can you maybe mention some of those conditions and what are possible theories behind that?

为什么会发生这种情况？

Why does this happen?

是的。

Yes.

通常来说，或者说我认为描述最充分的现象是中风后遗症，这通常会损伤脑岛。

So usually or I I would say the best described phenomenon is after a stroke, which usually damages the insula.

就是说，当脑岛受损时，患者可能发展出一种称为躯体妄想症的状态，他们会认为自己身体的某部分——尽管旁人看来明显属于他们——不属于自己，而是别人的，有时甚至认为这部分根本不存在。

So it says, yeah, when the insula is damaged, then they can develop a condition called somatoparaphrenia, where they believe that part of their body, which everyone outside of them can obviously see is their body, but they believe it is not theirs, someone else's, and I think sometimes as well just not present at all.

当你观看相关视频时——虽然这种现象相当罕见——你会看到人们坚称他们手中握着的其实是他们侄女的手，尽管侄女根本不在房间里。

So when you see videos of that and there are videos of that, although it is quite a rare phenomenon, you can see people steadfastly saying that the hand that they are holding in their own hands or their hand is, for example, someone's their niece's hand even though the niece is not in the room.

这种身体所有权的问题是个备受争议的话题，因为历史上也有大量文献记载的案例。

So this kinda like this ownership of the body is very hotly debated topic because there's lots of documented cases historically as well.

这也略微涉及到身体完整性认同障碍的讨论，这与性别焦虑话题密切相关。

And also it goes a little bit into this discussion of body integrity dysphoria, which is very closely linked to all the the gender dysphoria topics.

不过我认为科学界的共识是这是一个独立的问题，但它与此密切相关，因为都涉及对身体部位的排斥。

Although I think the scientific consensus is that it is a separate issue, but it is closely linked to that because it is about the rejection of one's body part.

我明白了。

I see.

有些人可能无法认出自己的身体部位属于自己。

And some people may not recognize their body parts as their own.

另一个问题是我们如何能识别某些部位属于自己？

Another question is how can we recognize certain parts as our own?

比如人们使用假手或假腿时，对吧？

For example, if people are using prosthetic hands or prosthetic legs, yes?

对。

Yes.

他们如何开始将其视为身体的一部分。

How they can start recognizing that as the part of their body.

是的。

Yes.

这也是该领域探讨的课题之一吗？

Is this also one of the topics that this field explores?

当然。

Absolutely.

这确实是最值得探讨的问题之一，因为已有许多惊人的发现。

It is it is one of the best questions to ask as well because there are so many cool findings.

所以简单谈谈它的神经生物学基础。

So just maybe a little bit about the neurobiology of it.

我们已知的是，大脑中有神经元负责连接动作——基本上就是我们看到的动作、感受到的动作以及自身的动觉。

So what we do know is there are neurons in the brain that are responsible for connecting movements, basically, movement we see, movement we feel and our own kinesthetic senses.

这意味着，比如当我移动我的手时，我的手有特定感觉，我能看到它在移动，这些信息在大脑中被编码为：这是我的身体部位，因为是我发起了这个动作。

So that means for example that when I move my hand, both my hand has a specific feeling, I can see it move and that together in my brain is coded towards saying, oh, this is my body part because I effectuated this movement.

我能看到它的移动与实际发生的情况协调一致。

I can see it moving coherently with what is happening.

我硕士阶段的部分工作就是开发了一套实验装置。

Part of my master's then was developing a setup.

显然我在这方面得到了一些技术帮助，因为这套系统非常复杂。

And then obviously I had some technical help with that because it was very complex.

但我们确实搭建了一个虚拟现实头显装置，让人们可以看到现实世界。

But we did set up, a virtual reality headset where people could see the real world.

这个VR系统没有改变任何东西，除了轻微的时间延迟。

So the the VR was not changing anything except for a slight time delay.

我们试图让那些神经元产生错误归因，因为人们看到的内容会有几毫秒或半秒的延迟。

So we were trying to get those neurons to kind of misattribute because what people were seeing was delayed by by a few milliseconds or or half a second.

这导致感觉非常怪异，因为你能感觉到小机器人在触碰你，但看到的触碰动作其实已经停止了。

And that led to it feeling very strange because you could feel a little robot was touching you and you could see the robot touching you when the touching had already stopped.

你可以看到机器人停止触碰你，却仍然能感觉到它在触碰你。

And you could see the robot stop touching you, but you could still feel the robot touching you.

这种感觉非常奇怪。

So that felt very strange.

这某种程度上解构了身体所有权领域著名的'橡胶手错觉'实验——在实验中将镜子放在人脸侧边，当触碰被镜子遮挡的那只手时，人们会产生被触碰的是镜中那只手的错觉。

And it's kind of a a deconstruction of what is called in the body ownership field, the rubber hand illusion, which is quite famous where you put a mirror to the side of someone's face and then you touch their one hand while the other is hidden behind the mirror.

你看到的是自己真实的手被触碰，同时另一只手也被触碰。

And what you see is both your actual hand being touched, but also the other hand being touched.

然后他们突然制造了一个不一致的情况。

And then suddenly they introduce a discongruency.

比如我们在实验室里会拿叉子假装刺向那只手，这当然完全安全因为有一面镜子。

So for example, what we do in the lab obviously is we take a fork and pretend to stab the hand, which is completely safe obviously because there's a mirror.

但因为你从镜中看到那只手，你会感觉那是你自己的手，并且你也感受到了那只手的触感。

But still, because you can see the hand in the mirror, you feel that it is it is yours and you have felt the touch of the hand as well.

所以你会认为那是你的手，突然间你感到受到威胁并对此做出反应。

So you feel that it is yours and suddenly you're you're under threat and you react to that.

这种感觉确实非常奇怪。

And it does feel very strange.

这种体验我一直觉得有点诡异。

And it's a feeling that I always thought it was a bit strange.

你知道，人们都说感觉很奇怪，但除非亲身体验过，否则你不会相信。

You know, people report feeling strange, but until you have done it to yourself, you don't believe it.

是的。

Yes.

这真是个令人惊叹的领域。

That is an amazing, amazing field.

我现在非常好奇，你是如何从这个研究进展到经颅磁刺激项目的？

And I'm very curious now how did you progress from this to your, project, with transcranial magnetic stimulation?

我相信两者之间肯定存在某些关联。

I'm sure there is some overlap between them.

完全正确。

Absolutely.

确实有很多方法上的重叠，因为我们大量使用脑电图技术，而且我们在身体所有权领域的研究常与中风患者合作，因为他们会表现出最显著也最可预测的躯体失认症状。

So there's a lot of, methods overlap because we did use a lot of EEG, And we also were working with our body ownership is in the field often worked with stroke patients because they exhibit the most pronounced but also the most predictable symptoms of somatoparaphrenia, for example.

因此我对中风及其症状、以及这种疾病的整体表现有一定了解。

So I had some knowledge of stroke and what it meant to have a stroke and some symptoms of the stroke and the disease overall.

同时我在脑电图检测方法方面也积累了丰富经验。

And also I had lots of experience with the method of EEG.

我认为这正是吸引我现在的导师——Ruddy博士的关键原因。

And I think that's what definitely got my now supervisor, Doctor.

Kathy Ruddy对我产生兴趣，是因为我能独立操作EEG设备，并且具备MATLAB的使用经验。

Kathy Ruddy, interested in me because I could also work on my own with EEG and I had some experience with MATLAB.

所以这确实是我进入这个领域的起点。

So that was really I think what got me started in this field.

而我对经颅磁刺激技术部分特别感兴趣。

And I was really interested in the transcranial magnetic stimulation bits.

经颅磁刺激是一种无创脑刺激技术，通过短暂激活强大的电磁铁来改变神经元中的铁离子浓度，从而激活神经元。

So transcranial magnetic stimulation is a noninvasive brain stimulation method where you switch on very powerful electromagnetic magnets for a very short duration of time, which changes iron concentrations in your neurons and gets them to be activated.

这是一种无需开颅或直接接触大脑就能激活神经元的方法。

So it's a way to activate neurons in the brain without actually touching or opening the brain up.

这非常有趣。

So that's very interesting.

这项技术尤其适用于各种与大脑功能相关的疾病研究。

And that is a method that is especially interesting for all sorts of illnesses and diseases where obviously the brain is affected in some way.

因此对于脑部受损的中风患者来说，经颅磁刺激是一种特别有效的治疗工具。

So in stroke where you have damage in the brain happening, TMS is an especially powerful tool to try and help those people.

是的。

Yes.

非常感谢你的详细解释。

Thank you so much for explaining this.

我现在很好奇，那具体是哪种类型的经颅磁刺激？

And now I'm curious what type of TMS was that?

是导航经颅磁刺激吗？就是能根据患者核磁共振定位到特定脑区的那种？还是你们刺激的区域更广泛普遍？

Was it navigated TMS so that you can navigate to the specific region of the brain based on the patient's MRI or it's more broad and general area that you were affecting?

整个治疗过程是如何运作的？

How did it all work?

就我所使用的经颅磁刺激而言，单脉冲经颅磁刺激在多数情况下都相当精准。

So TMS, as I use it, so that is single pulse TMS, is most of the time quite precise.

它并不会刺激整个目标区域。

So it is not a whole target area that is stimulated.

刺激的是非常精确的位置。

It is a very precise location that is stimulated.

TMS有多种应用方式，并不排斥从事不同研究的人。

There's different things you can do with TMS, so it's not excluding anyone who does different work on that.

但理论上，至少我所使用的技术是相当精确的。

But in theory, or at least what I'm using is quite precise.

精确到可以定位患者手部的特定肌肉。

So precise in fact that we target a specific muscle in someone's hand.

另外需要说明的是，我原本计划在医院开展工作，但由于新冠疫情，这项工作被推迟了。

So and also as a caveat, I was supposed to do work in the hospital, but because of COVID-nineteen that work has has been pushed back.

不过我的团队正在全力推进医院项目，应该很快就能启动。

However, my team is now very much working on getting into the hospital and the work should start soon.

这是个非常好的消息。

So that's very good news.

当我们用这种TMS技术定位特定肌肉时，可以精准刺激FDI肌——这是控制食指侧向运动的手部肌肉，我们能在脑部精确定位这块肌肉。

When we target a specific muscle with this type of TMS we can get the FDI so that it is the muscle in the hand that is responsible for the lateral movement of a finger of the index finger in this case And we can target this muscle specifically in the brain.

我们不需要使用神经导航工具，因为可以通过运动诱发电位来实现定位。

We don't use neuro navigation tools because we can do that using motor evoked potentials.

运动诱发电位是指我们记录手指肌电活动时的电位变化。

So a motor evoked potential is when we record the electromyographic activity in the fingers.

这就是肌电图（EMG）活动。

So that's EMG activity.

当我们通过TMS发送脉冲时，目标肌肉会抽搐，我们可以在患者头部移动刺激线圈，从而找出哪个位置能产生最大振幅的CMG活动。

Whenever we send a pulse through the TMS, the targeted muscle twitches and we can move around on the patient's head with the stimulation coil and then figure out which spot produces the most, the highest amplitude in the CMG activity.

因此这种刺激非常精确，我们甚至可以精准定位到某块特定肌肉。

So it is quite precise stimulation and we even target one specific muscle.

是的，我能理解。

Yes, I can see.

既然我们已经熟悉了TMS和单脉冲TMS及其精确性，能否描述下你为BCI奖项提交的项目？

As we already became familiar with the TMS and single pulse TMS and how precise it can be, can you describe the project that you submitted for the BCI award?

所以现在是EG和TMS的结合应用，没错。

So now it's a combination, yes, of EG, TMS.

那么请告诉我们所有细节。

So tell us tell us everything.

是的。

Yes.

这是多种不同技术的组合。

It's a it's a combination of of a lot of different things.

整个项目旨在利用我们实验室所称的经颅磁神经反馈或经颅磁刺激神经反馈的能力。

The project overall is trying to harness the ability of what we call in the lab transcranial magnetic neurofeedback or transcranial magnetic stimulation neurofeedback.

我将解释项目的各个小部分。

I'm going to explain the individual little bits of the project.

TMS神经反馈的核心是让患者（或我们研究中的健康受试者）能够调控他们对TMS刺激的反应。

So TMS NF is all about trying to make patients or in our case also healthy people be able to manipulate their response to the TMS stimulation.

想象你坐在我们的椅子上，我们已精准定位到食指肌肉。

So imagine that we got you in our chair and we have targeted the very specific muscle, this index finger muscle.

当我们通过TMS线圈发送刺激时，就能使这块肌肉产生运动。

And whenever we send a stimulation for the TMS coil, we can make this muscle move.

现在我们会要求你，比如增强或减弱对这种刺激的反应。

Now we would ask you, for example, to increase your response to this stimulation or to decrease it.

本质上是对整个皮层运动通路的抑制或兴奋。

So inhibition or excitation of basically the whole cortical motor pathway.

我们刺激大脑，但最终希望能在手指运动层面获得增强的效果。

So we stimulate brain, but in the end we would like to have an increased outcome at the finger movement level.

因此我们这里是从大脑顶部皮层开始，经过整个脊髓和低位脑区，直到引发抽动的胳膊。

So we are traveling here from the top of the brain, the cortex of the brain through the whole spine and the lower brain levels to the arm where the twitch is then effectuated.

我们已经能够证明这是可能的，参与者既能增强也能减弱对刺激的反应。

And we have been able to show that this is possible so that participants are able to increase their response to the stimulation and decrease it as well.

我们相当确信这不是与整个实验环境其他因素交互的结果。

And we're fairly confident that this is not the result from some other interaction with the whole experimental setting.

能够自主增强对刺激的反应本身就很有趣。

So being able to volitionally increase the response to the stimulus is in itself quite interesting.

但当你了解到经颅磁刺激（尤其是单脉冲TMS）可作为中风预测或中风恢复轨迹的标志物时，这就加倍有趣了。

But it's double interesting when you do know that TMS, especially single pulse TMS, can be used as a marker in stroke prediction or the prediction of stroke recovery trajectories.

例如，我们知道，多亏了新西兰Cafestiniere的一些研究，中风幸存者，即那些曾患中风的人，当他们入院时，通常存在某种上肢功能障碍，可能是无力或完全无法移动。

So we know, for example, thanks to some work from Cafestiniere in New Zealand, that stroke survivors, people who have had a stroke, when they come into the hospital, usually they have some kind of upper limb dysfunction, be that weakness or not being able to move at all.

随着时间的推移，这种情况会有所改善。

And this over time gets better.

但我们可以预测，当我们对这些中风幸存者进行某种刺激或TMS（经颅磁刺激）时，我们能以比以往更高的准确度预测他们是否能良好康复。

But we can predict when we do some stimulation or some TMS on these stroke survivors, we can predict whether or not they will recover well with some degree of precision better than what we've had before.

其中一个主要标准是，即使他们没有自主运动能力，但如果对TMS有反应——即在我们进行TMS时目标手臂出现某些反应，那就是一个好迹象。

So one of the main criteria is if they react to the TMS even though they have no volitional movement, but when we do the TMS they have some response in the targeted arm, then that is a good sign.

例如，我们确实知道，中风后不久的反应幅度通常非常低。

And for example, we do know that those amplitudes of the reactions just after the stroke, they tend to be really low.

因此，必须大幅增加刺激强度才能引发微弱的反应。

So you have to increase the stimulation intensity by a lot to get even a small response.

随着这些中风幸存者的康复，我们称之为MEP（运动诱发电位）的振幅会逐渐上升。

And then as these stroke survivors recover, this what we call MEP amplitude goes up over time.

因此，在衰弱的肌肉中诱发反应所需的刺激强度会降低。

So you need less intensity to provoke a response in the weakened muscle.

这就是你看到与中风幸存者关联的地方。

So that's where you see the connection with stroke survivors.

因此TMS神经反馈的一个理念是，或许我们可以通过帮助中风患者改善对TMS的反应来加速他们的康复，因为我们知道这本身就是一个自然过程。

So one idea of of this TMS NF is that maybe we can help those people who have had a stroke recover more quickly by helping them improve their reaction to the TMS because we know this is a natural process that happens anyway.

所以也许我们能够影响这个过程会产生积极效果，至少我们希望能如此。

So maybe us being able to influence it will have positive results or we hope at least.

这就是TMS神经反馈的部分。

So that is the TMS NF part.

现在TMS技术面临的问题是设备搭建相当复杂，需要专业人员操作。

Now the problem with TMS is that it is quite complex to set up because you need someone who knows how the TMS works.

需要懂得如何定位大脑目标区域的操作人员。

You need someone who knows how to target the brain.

这些都是需要支付报酬的专业技能，用以帮助中风康复。

So it's all skilled labor that needs to be paid to help stroke recovery.

而中风患者一个非常突出的问题就是精神疲劳。

And one thing that is very prominent with stroke survivors is mental fatigue.

因此中风幸存者通常难以承受长时间的治疗疗程。

So stroke survivors will usually not necessarily have the endurance to stay in for a very long session.

所以我们提案的一个核心理念就是BCI的多模式特性——既然我们知道患者在刚中风后难以应对高强度疗程，

So one of the idea of our submission was this kind of multimodal aspect of BCI where we say, alright, we know people struggle with really intense sessions just after they had a stroke.

那么如果我们尝试减少这些疗程次数，这对医疗成本控制也极为有利，这显然是医疗体系中的关键因素。

So what if we try and minimize those sessions, which is also very beneficial for for cost and that is a huge factor for for health care, obviously.

我们既要尽量减少高强度疗程，同时也为参与者提供自主训练的选项。

So we try and minimize those intense sessions, but also try and give an option for participants to train on their own.

这就是EGBCI的核心理念：我们明确知道如何指导患者增强或抑制对TMS的反应，

So that's the EGBCI aspect where we say, well, we kind of know what we tell people to do or how we tell them to increase their response to the TMS and how to decrease the response.

那么能否开发一种EGBCI系统，识别患者大脑中的这两种心理意象状态，让他们在家就能进行训练？

So what if we could create an EGBCI that can recognize those two mental imagery states in their brain, those two mental states and and have them train that at home.

基本流程是：先让患者入院接受最低限度的指导培训，然后让他们带着训练设备回家自主练习。

So the basic idea is we get them in, we show them how it works to try and make as little an effort as we can or as much as we can have them do in the hospital and then send them home with kits that they can train with alone at home.

这显然也能提升患者的治疗积极性，并带来诸多其他益处。

And obviously that also increases motivation and lots of other beneficial aspects.

因此其多模态特性体现在我们同时使用TMS和F（这是BCI的一部分）以及EG BCI，试图将训练从对中风幸存者来说既费力又需要高度集中注意力的方式，转变为可以自主设置并随时训练的灵活模式。

So the multimodal nature of it is that we use TMS and F which is one part of the BCI and also the EG BCI where we try and take over the training from this very labor intensive and also concentration intensive for the stroke survivor to something that they can set up and train as long as they want.

谢谢。

Thank you.

那么这种方法与目前对相同中风患者的治疗方式有何不同？

And now how this approach is different from what is currently being done in the same stroke patients?

我们尝试这种方法的主要原因之一是，中风康复治疗——特别是针对运动功能恢复或运动康复的治疗——强度极高，不仅需要患者花费大量时间与专业人员相处，患者自身也需要投入大量时间。

So one of the main reasons that we try this approach is that stroke recovery or stroke therapy for especially for the return of movement or for motor rehabilitation is incredibly intensive, both in terms of how much time they have to spend with with skilled people and also the amount of time that the patient has to invest.

而且效果并不惊人。

And the results are not mind blowing.

举例来说，目前最有效的方法（并非脑机接口）可能是约束诱导运动疗法——将健康手戴上类似烤箱手套的限制性装置，让中风幸存者用患手进行大量重复动作训练。

So for example, the best that we have at the moment, which is not a brain computer interface, would probably be constrained movement therapy where you put the healthy hands in a kind of oven mitten or a mitten that restricts movement and have a stroke survivor do lots of repetitions of movements with their hand.

这种方法存在两个问题。

There's two problems with that.

首先，他们需要训练很长时间才能获得改善，而这些改善有时难以区分是自然恢复还是训练效果。

First of all, they need to train so much for improvements that are sometimes difficult to say if they come about naturally or if they are due to the training.

所以这方面存在不确定性。

So there's ambiguity about that.

但对于完全丧失活动能力的人来说训练也很困难，因为你需要能够反复尝试动作才能进行物理治疗训练。

But also it is quite difficult for people who have no movement left to train because you need to be able to repeatedly attempt movements to be able to train, to be able to do the physiotherapy.

如果你完全不能动，就无法进行物理治疗。

And if you can't move at all, then you can't do physiotherapy.

因此脑机接口在这里填补了一个非常重要的空白——它们能以其他方式无法实现的方法桥接神经通路或脊髓，因为我们可以监测脑部信号并给予参与者他们自身无法获得的反馈。

So brain computer interfaces here fill a gap that is very important in that they can kind of bridge the neural pathways or the spine in a way that can't really be done with anything else than brain computer interfaces, because we can look at brain signal and give you a response or give feedback for the participant that they just don't have themselves.

这个理念还在于它可能帮助患者度过恢复期。

And the idea here is also that it might be able to bridge the time.

正如我所说，中风患者往往会自然恢复部分运动功能。

As I said, stroke survivors tend to increase or tend to recover some movements naturally.

但我们的设想是，如果能帮助他们度过无法自主运动的阶段，并为其患肢提供反馈，可能会加速康复进程。

But our idea is that if we can bridge the gap where they can't really move volitionally and give them feedback of their disaffected limb anyway, it might help them recover even more quickly.

是的，这很有道理。

Yeah, it makes sense.

我知道目前有几种针对中风后运动功能康复的系统。

And I know that there are several systems for motor rehabilitation post stroke.

其中一些系统包括电流刺激和手部的三维可视化。

Some of them include electrical current stimulation and also three d visualization of the hand.

这些系统会提供不同类型的反馈。

Types of feedback are provided.

还有哪些系统也在使用经颅磁刺激技术（TMS）？

What are other systems that are also using TMS?

你了解这些系统吗？你们的TMS方法与这些特定的TMS方案有何不同？

Are you aware of those and how your TMS approach is different from those specific TMS approaches?

如果有的话，也许并没有。

If there are any, maybe there are not.

确实有很多方法尝试使用重复经颅磁刺激（rTMS），这种刺激通常强度较低，但会采用间歇性θ波爆发模式，所以总体刺激量更大，只是阈值较低。

So there are a lot of approaches that are trying to do something with RTMS, which is Repositive Transcranial Magnetic Stimulation, which typically is a lower intensity stimulation, but usually you use intermittent theta bursts, so it's a lot more stimulation overall, but just at a lower threshold.

据我所知，这些系统中有许多都试图针对我们所说的半球间失衡理论，简单来说就是当你中风后，大脑部分区域会受到损伤。

As far as I know, many of those systems have tried to target what we call the interhemispheric imbalance theory, or basically the theory that when you've had a stroke, you've had part of the brain that is damaged.

该理论认为大脑通常会持续抑制其对侧半球。

And the theory goes that the brain is usually always inhibiting its counterpart on the other hemisphere.

当大脑某部分受损时，它无法抑制另一半球，因此自身受到的抑制反而比往常更多。

And when one part of the brain is damaged, it cannot inhibit the other hemisphere and therefore gets inhibited in return a lot more than it is used to.

我们的设想是，如果能阻止这种抑制，或许就能帮助患者获得更好的康复效果。

And the idea was that maybe if we can stop this inhibition, then we can enable a better recovery for patients.

通过RTMS技术，他们尝试抑制健康半球或增强受损半球的兴奋性，从而恢复理论中认为不利于患者康复的半球间抑制平衡。

And then using RTMS, they would try to inhibit the healthy hemisphere or increase the excitation of the damaged or injured hemisphere and therefore kind of restoring the balance that the interhemispheric inhibition theory predicts would be negative for the recovery of the patient.

据我所知，这些研究尚未得出明确结论。

As far as I know, those have been inconclusive.

可能我们仍需解决一些技术难题，而且学界对半球间抑制理论也存在质疑——至少它并不能直接适用于中风病例。

So might be that we still need to work out some kinks, but also there has been a bit of critique about this interhemispheric inhibition theory, at least in a way to predict that it's not directly applicable to stroke.

以上就是关于RTMS的情况。

So that's about RTMS.

据我所知，目前用TMS进行中风康复研究的人并不多。

As far as I know, there's not a lot of people doing stroke rehabilitation research with TMS.

目前有很多关于尝试用TMS预测中风康复轨迹的研究。

There is a lot going on about trying to predict recovery trajectories of stroke with TMS.

正如我所说，标准之一是通过刺激运动皮层并观察反应情况，来预测康复进程。

As I said, one of the criteria is simulating the motor cortex and seeing how the response works out to try and predict how the recovery is going to be.

因为中风的问题还在于，由于脑部受损区域可能呈现多种不同形态，受伤部位不同、症状不同，康复轨迹往往也大相径庭。

Because one of the problems of stroke as well is that since the stroke can take many different forms and shapes in the brain, the target that the injured area can be different and the symptoms can be different and the recovery trajectories tend to be quite different as well.

所以当你看到中风研究时，总是很难判断——尤其是中风研究中的患者样本量通常都很有限。

So whenever you see a stroke study, it's always quite difficult to know, especially because we tend to not have a lot of people who have had a stroke in stroke studies.

很难确定你遇到的只是不幸遭遇严重中风的患者，还是症状较轻的患者，因为他们的康复轨迹实在难以预测。

It can be quite difficult to know whether you were just unlucky with people who had especially bad strokes, or people who had more light strokes, because it is quite difficult to predict their recovery trajectory.

因此有大量研究试图分析如何更好地预测康复情况，并对双侧大脑半球进行大量重复性刺激实验。

So there's a lot of research trying to analyze how to better predict their recovery and there's a lot of repetitive simulation for both hemispheres.

但据我所知，此前从未有人尝试过用单脉冲TMS治疗视觉认知障碍。

But as far as I know, using the single pulse TMS for VCIs has not been attempted before.

另外，这可能与我们构建脑机接口的方式有关——无论是TMS还是F和EGBCI，我们并非断言TMS本身能帮助患者康复。

Also, it might be because the way we construct our brain computer interfaces or the TMS and F and the EGBCI, we are not necessarily saying that it is the TMS that will help people recover.

我们实际上是在说，我们试图针对大脑内源性的愈合过程。

We're actually saying we are trying to target endogenous healing processes within the brain.

我们试图让人们使用心理意象或尝试运动，然后通过TMS为他们提供关于运动质量的反馈。

We're trying to get the people to use mental imagery or to attempt movement and then giving them feedback on the quality of this movement using the TMS.

所以显然TMS可能也有有益的副作用。

So obviously TMS might have beneficial side effects as well.

例如在我的导师在中国进行的一项试点研究中，他们注意到患者在受到刺激时看到中风影响的肢体移动会感到非常高兴和受到激励。

For example in a pilot study that my supervisor did in China, they noted that patients were extremely happy and motivated to see their stroke affected limb move when they received the stimulation.

这本身可能就是极其有益的，因为人们看到他们自己无法移动的肢体再次动了起来。

So that in itself may be just extremely beneficial because people see their limb that they cannot move themselves, move again.

所以他们知道潜力存在，因此在治疗过程中更加努力和专注。

So they know the potential is there and so they work harder and are more concentrated during the therapy sessions.

所以这是一种可能性。

So that is a possibility.

当我们讨论脑机接口在中风康复中的研究时，我们确实看到了很多相关研究。

And then when we talk about research in brain computer interfaces for stroke rehabilitation, we do actually see that there is a lot.

脑机接口在中风康复领域应用广泛，效果确实相当不错。

So brain computer interfaces have been used for stroke rehabilitation a lot and they're actually quite good.

它们似乎效果很好，至少没有负面影响，这一点也非常值得了解。

They seem to be quite good or at least they seem to not have any negative effects, which is also very good to know.

但脑机接口研究真正令人印象深刻（或者说非常有趣）的是，它们在中风康复和运动功能恢复方面表现优异，却尚未在临床环境中广泛应用。

But what is really impressive about BCI research is, or at least very interesting, is that they seem to be performing very well at stroke rehabilitation, motor rehabilitation, but they aren't quite widely used in hospital setting nowadays.

这有其合理原因，因为几乎每个研究团队都有自己独特的脑机接口系统配置。

And there are good reasons for that because pretty much every research group has their own individual BCI set up.

而且我们也不完全清楚如何触发大脑的内源性修复机制。

And also we don't quite exactly know how to trigger those endogenous healing processes of the brain.

因此对医疗机构而言，既不确定该采用哪种系统，也不清楚系统如何具体帮助患者康复。

So for a health care provider there is an insecurity about what kind of system to use and there is an insecurity about how the system is helping the patient.

所以大多数医疗机构选择不使用脑机接口是可以理解的。

So it's understandable why instead of using BCIs, most health care provider just don't.

但相关研究结果相当积极，我认为未来几年内，首批用于中风康复的脑机接口至少会进入大规模临床试验阶段。

But the research is quite positive and I think that within the next few years we will probably have the first brain computer interfaces for stroke rehabilitation reaching at least large clinical trials.

是的。

Yes.

我真的很期待看到那一天。

I really hope to see that.

现在谈谈你们的研究结果吧。

And now about the results of your study.

我们有任何初步数据吗？

Do we have any preliminary data?

有。

Yes.

有的。

Yes.

当然。

Absolutely.

目前这些都还是初步结果。

It's it's all preliminary results so far.

但我们似乎能够证明，人们仍然可以自主地增强或减弱他们的反应。

But what we seem to be able to show is that people can still volitionally increase or decrease their response.

正如我之前所说，由于新冠疫情，我讨论的是健康参与者的结果，而非中风幸存者。

So as I said before, due to the COVID pandemic, I am talking about results with healthy participants, not with stroke survivors.

在健康人群中，我们早已知道TMS神经反馈可以帮助人们增强或减弱对刺激的反应。

So within healthy people, we already knew that the TMS NF could be used to help people increase or decrease their reaction to the stimulation.

这是在仅要求参与者增强或减弱反应的实验设置中得出的结论。

Now this was made in settings where people would just increase or just decrease their response.

因此我们不知道同时训练两种反应会有多高效，也不清楚人们是否能同样快速地掌握——我们只进行了两次TMS和F的疗程。

So we didn't know how efficient it would be to train both at the same time, and we didn't know if people would be able to do it as fast or we did just two sessions of TMS and F.

对于脑机接口训练来说，这是相当短的疗程。

So that's quite a short training sessions for a brain computer interface.

而我们发现人们实际上能相当快速地掌握这项技能。

And what we found is that people were actually able to do this quite fast.

因此即使在两次疗程中的第一次，我们就能观察到MEP振幅的差异，即TMS模拟产生的这些肌肉反应变化。

So even within the first of the two sessions, we can see differences in MEP amplitude or these muscle responses from the TMS simulation.

这非常有趣。

So that is very interesting.

但我们还能证明的是，进行TMSNF训练的组似乎能将这种从TMS和F脑机接口中获得的学习效果迁移到EG BCI上。

But also what we could show is that the group that does TMSNF seems to be able to carry over this learning from this TMS and F brain computer interface into an EG BCI.

这对BCI领域具有更广泛的启示意义，因为我们能够通过不同模态进行训练。

This also has wider implications for the BCI field because we are able to train on a different modality.

这是多模态特性的另一部分，并将一种模式中的增益趋势延伸到另一种模式。

That's another part of the multimodal aspect and trends further those gains in one mode into another mode.

脑机接口在卒中康复中面临的另一个问题是，学习控制脑机接口需要较长时间。

So one of the other problems that the brain computer interface faces for stroke rehabilitation is that it takes a while to learn how to control a brain computer interface.

如果你从事脑机接口研究且只关注控制功能，可以采用特定范式让受试者几乎立即学会控制。

If if you're doing brain computer interface research and you're strictly just interested in control, then you can have very specific paradigms which participants can learn to control pretty much immediately.

或者可以使用类似P300拼写器这类依赖外部事件来解读大脑活动的设备。

Or you can use, for example, like P300 spellers where you have kind of external events that kind of try and read what happens in the brain.

因此如果仅关注控制功能，实现控制是相对容易的。

And so if you're just interested in control, control is achievable easily.

但当我们讨论中风康复时，主要关注的不是脑机接口的控制结果，而是其康复功能。

But when we talk about stroke rehabilitation, the main interest is not the outcome of the BCI control, but it is the rehabilitation aspect of the brain computer interface.

因此，我们通常倾向于研究运动想象或尝试性运动。

And therefore, usually there we tend to look at motor imagery or attempted movement.

我们会指导中风幸存者尝试活动他们的手部。

So we try and tell stroke survivors to try and move their hands.

然后我们利用这个过程中产生的脑信号开展工作。

And then we work with the brain signal that this generates.

首先，中风患者的脑信号存在差异，而且会随时间变化。

And first of all, the brain signal of people who have had a stroke is different, but also it changes over time.

因此多模态脑机接口的理念和本项目目标，就是要证明在患者康复轨迹中切换或伴随治疗方式是有益的。

So the idea of a multimodal BCI and the idea of the project also was to show that there is benefit to switching or accompanying the stroke survivors along his recovery trajectory.

在初期阶段，当患者脑信号受损或大脑受伤难以操作脑机接口时，我们使用经颅磁刺激（TMS）——它能提供更直观的触觉反馈，并且我们不是直接使用脑信号作为输入，而是利用大脑对TMS刺激的反应，即肌肉抽搐。

So at the start, when their brain signal or when their brain is injured and might have trouble to work with a brain computer interface, we use TMS, which gives us a more haptic feedback or and also means that instead of using directly the brain signal as as an input for the brain computer interface, we use the reaction of the brain to the TMS simulation, so the twitch in the muscle.

这样获得的反馈维度对患者而言比脑电图（EEG）等传统方式更易感知。

So that gives us a dimension of feedback that is also a lot more accessible for patients than the EEG, for example.

因此多模态确实能实现许多不同的功能，脑机接口领域有大量引人入胜的研究。

So really the multimodal aspect does a lot of different things and there's lots of different research in brain computer interfaces, which is fascinating.

确实如此。

Absolutely.

我对你提到的让潜在参与患者在家完成的部分非常好奇。

And I'm very curious about that part that you mentioned that you ask patients of potential participants to do at home.

是的。

Yes.

这样可以减少他们在实验室环境中的时间。

So to decrease the time that they spend in the lab settings.

能否举例说明患者可以做些什么来提高这部分皮层的兴奋性？

Can you provide an example what patients can do to make that part of the cortex more more excitable?

可以吗？

Yes?

正是这样。

Exactly.

是的。

Yes.

通常对于健康参与者，我们会让他们进行运动想象训练，因为他们可以实际运动。

Typically, with healthy participants, speak of motor imagery where you ask them to just imagine because they can move.

对于中风幸存者，通常会让他们尝试实际运动，因为他们通常存在运动障碍。

With stroke survivors, usually you would tell them just try and move because normally they have difficulty moving.

这样你就可以直接针对想要改善的运动功能进行训练。

So you're you can work with with direct outcome that you're trying to to improve, so the movement itself.

多模态脑机接口的理念是让受试者接受经颅磁刺激神经反馈训练，以获得我之前提到的所有益处。

And the idea of the multimodal BCI was we have people trained with the TMS NF for all the benefits that I've listed before.

这是一种触觉反馈。

So it's a haptic feedback.

经颅磁刺激可能具有积极作用，而且经颅磁刺激神经反馈系统相对容易掌握。

The TMS might have beneficial aspects, and it's quite easy to learn the TMS NF system.

一旦他们掌握了这个方法，我们就可以让他们带着脑电图脑机接口回家，尝试在没有经颅磁刺激的情况下实现相同的训练效果。

And then once they can do that, we can send them home with an EG BCI to try and do the same thing as the TMS NF, but without the whole TMS part.