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研究生:何庭萱
研究生(外文):Ting-ChuanHo
論文名稱:利用近紅外光譜系統評估混合式肌肉刺激對大腦皮質活性與肌肉血氧調控之反應
論文名稱(外文):Assessments of Cortical Activity and Muscle Oxygenation During Hybrid Stimulation Using Functional Near Infrared Spectroscopy
指導教授:陳家進陳家進引用關係
指導教授(外文):Jia-Jing Chen
學位類別:碩士
校院名稱:國立成功大學
系所名稱:生物醫學工程學系
學門:生命科學學門
學類:生物化學學類
論文種類:學術論文
論文出版年:2012
畢業學年度:100
語文別:英文
論文頁數:42
中文關鍵詞:電刺激近紅外光譜儀腦部重塑膝關節伸展肌肉代謝復健
外文關鍵詞:electrical stimulationnear-infrared spectroscopybrain reorganizationknee extensionmuscle metabolismrehabilitation
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電刺激已被廣泛應用於肌肉訓練以及復健策略上,同時相關研究也證實經由電刺激可促進腦部皮質重塑活化。近年來更有研究指出混合式肌肉活化之新興復健方式,能藉由同步結合電刺激與自主訓練而達到複合式的刺激效果。然而,目前仍無相關研究探討混合式肌肉活化對於腦部皮質重塑性與肌肉刺激之影響。過去由於神經影像工具的限制,我們無法窺探在動態訓練中電刺激或混合式肌肉活化對大腦可塑性與復原程度的影響。因此本研究應用具高時間解析度且能在動態活動下應用之近紅外光譜系統,評估不同模式等長肌肉訓練下,大腦皮質功能性活化程度與肌肉氧合情形。未來更期望能為腦損傷導致肢體動作失能之患者提供更多相關復健資訊。本研究受試者分別於自主收縮、電刺激及三種混合式電刺激下完成30% MVC膝關節伸展等長收縮運動,同時以近紅外光譜系統量測大腦的主要感覺運動區(primary sensorimotor cortex)、輔助運動區(supplementary motor area)、運動前區(premotor cortex)皮質活化量及大腿股外側肌的血氧變化。結果顯示,單純給予電刺激相對於自主運動所能誘發的大腦活性程度較小,而混合式肌肉刺激則更能促進大腦皮質的活化程度。而在此單側運動之下,前運動皮質區有明顯的側化情形。另外我們也發現混合式肌肉刺激可有效刺激肌肉代謝,並明顯高於單純自主收縮。我們期盼在未來能利用此一評估方式,提供臨床醫療人員快速制定以病人導向且有最大效益的復健方式。
In addition to limb function restoration and neuromodulation, electrical stimulation (ES) has been shown effective in altering cortical plasticity. Recently, increasing interest has been focused on the effect of hybrid stimulation (HS) which incorporates voluntary contraction and ES on brain activity and muscle metabolism. The purpose of present study was to characterize the cortical contribution to the neural control and muscle oxygenation during isometric knee extension task in volitional contraction (VOL), ES, HS schemes. Nighteen male subjects performed one set of isometric knee extension at 30% MVC in five randomized trials of volitional contraction (VOL), electrical stimulation (ES) only, and three hybrid stimulations with 10 mA, 30 mA, and 50 mA intensities, respectively. A frequency-domain near infrared spectroscopy (FD-NIRS) system was employed to assess the cortical activity from the bilateral sensorimotor cortices (SMCs), supplementary motor areas (SMAs), and premotor cortices (PMCs) as well as the muscle oxygenation in the vastus laterali (VL). Our results showed that ES had a similar cortical activation pattern to that during VOL but with smaller intensity. Augmented sensorimotor network was observed during VOL in parallel with ES. In addition, prominent lateralizations of PMC were found in all conditions. Oxygen consumption of muscle was significantly higher in HS-III, HS-II and ES when compared to VOL, implying that the intervention of ES accelerates the oxygen saturation depletion during muscle contraction. These results suggest that HS not only can enhance the activation of cortical regions but also facilitate muscle metabolism.
中文摘要 I
Abstract II
致謝 III
Contents V
List of Figures and Tables VII
Chapter 1 Introduction 1
1-1 Brain control of movement 1
1-2 Electrical stimulation 2
1-3 Neural adaptation to ES 2
1-3-1 Brain adaptations 3
1-3-2 Muscle adaptations 4
1-4 Approaches of decrypting “exercising brain” 5
1-4-1 Principles of near infrared spectroscopy 6
1-4-2 NIRS in detecting cerebral activities 7
1-4-3 NIRS in detecting muscle activities 8
1-5 Motivation and the aims of the study 10
Chapter 2 Materials and Methods 11
2-1 Subjects 11
2-2 NIRS recording 12
2-2-1 NIRS system 12
2-2-2 NIRS measurements of cortical activity 12
2-2-3 NIRS measurements of muscle oxygenation 13
2-3 Experimental paradigms of knee extension task 14
2-4 Data analysis 17
2-4-1 Cortical activity measurement by NIRS 17
2-4-2 Quantifying muscle oxygenationt by NIRS 17
2-5 Statistics 19
Chapter 3 Results 20
3-1 Cortical activation patterns during knee extension 20
3-2 Muscle oxygenation during knee extension 27
Chapter 4 Discussion 30
Chapter 5 Conclusion 34
References 35

List of Figures and Tables
Figure 1-1. Schematic diagram of cerebral system (Leff et al. 2011) 1
Figure 1-2. Primary sensorimotor homunculus in cerebral cortex (Penfield 1950) 1
Figure 1-3. Conceptual model comparing sources of neural adaptations during ES (EST) and volitional contraction (VST) (Hortobágyi & Maffiuletti 2011) 2
Figure 1-4. Muscle recruitment property during muscle contraction (Henneman et al. 1965) …………………………………………………………………………………..4
Figure 1-6. Functional connectivity between neurons and vessels (Gugleta et al. 2007) …………………………………………………………………………………..7
Figure 1-7. Muscular hemodynamic changes during 30% MVC during ES (EMS) and volitional (VOL) sessions (Muthalib et al. 2009) 9
Figure 2-1. Optode locations of the NIRS muscle sensor 14
Figure 2-2. (a) The arrangement of the optode locations and (b) experimental setup. The subject was sitting in custom-made isometric strength device with a PC monitor ahead for display of reference torque level. The electrodes were positioned with cathode over the motor point of quadriceps and to induce muscle contraction by electrical stimulator. During five isometrics contraction trials, torque data will be collected by a data acquisition device from torque sensor (SWS-600, Transducer Techniques Temecula, CA) for real-time visual feedback. The cerebral and muscle NIRS signals were measured by Imagent through parietal and parietal-frontal lobes and the optode channels covered the SMC, SMA, and PMC. 16
Figure 2-3. Flowchart of signal processing for deriving HbO from the recorded NIRS data …………………………………………………………………………………..17
Figure 2-4. Time course of oxygen saturation % during isometrics knee extension exercise for 20s. Dot line represents the raw oxygen saturation data and the solid line is the fitting data.Δ oxygen saturation and depletion rate were computed by hyperbolic tangent equation. 18
Figure 3-1. Representative data for time-coursed cortical regional changes of hemoglobin concentrations including [HbO] (red line), [Hb] (blue line) and [HbT] (green line) covering bilateral SMC, SMA, PMC during knee extension tasks of VOL conditions. …………………………………………………………………………...20
Figure 3-2. Representative data for cortical regional changes of hemoglobin concentrations including [HbO] (red line), [Hb] (blue line) and [HbT] (green line) during knee extension period (yellow bar) covering bilateral SMC, SMA, PMC during knee extension tasks of (a) VOL, (b) ES, (c) HS-I, (d) HS-II and (e) HS-III conditions. …………………………………………………………………………...23
Figure 3-3. Mean cortical regional changes of HbO concentration on the contralateral SMC, SMA, PMC (during right knee movement) correspond to right knee extension movements across subjects. ANOVA test showed a significant interaction effect between regions × conditions. Error bars represent one standard error. *: P 〈 0.05, **: P 〈 0.01, ***: P 〈 0.001 for significant difference between knee extension conditions. SMC: the sensorimotor cortex, SMA: the supplementary motor area, PMC: the premotor cortex. 24
Figure 3-4. Mean cortical regional changes of HbO concentration on the contralateral (black) and ipsilateral (gray) SMC, SMA, PMC correspond to right knee extension movements in five conditions. Error bars represent I standard error. *: P 〈 0.05, ***: P 〈 0.001 for significant difference between knee extension conditions. SMC: the sensorimotor cortex, SMA: the supplementary motor area, PMC: the premotor cortex. ………………………………………………………………………………..25
Figure 3-5. Representative block-averaged cortical mappings during knee extension from a 22-year-old subject. These images are based on the changes in HbO levels during (a) VOL, (b) ES, (c) HS-I, (d) HS-II, (e) HS-III. The scale indicates the color coordinates for concentration changes. 26
Figure 3-6. Representative data of muscle oxygenation and torque data in 8 epochs knee extension exercise. 27
Figure 3-7. The change of muscle oxygen saturation during various isometrics contraction for a representative case. Oxygen saturation decreased in exercise phase that was indicated the oxygen demand. The muscle oxygen saturation of different conditions was indicated by various lines. Voluntary contraction (thick solid line), functional electrical stimulation (dash dot-dot line), hybrid I contraction (thin solid line), hybrid II contraction (dot line) and hybrid III contraction (long dash line). 28
Figure 3-8. Δ oxygen saturation of five conditions in exercise phase. * indicates significant difference between conditions (p〈0.05). 29
Figure 3-9. Time constant of five conditions in exercise phase. * indicates significant difference between conditions (p〈0.05). 29
Table 1. Individual physcial data 11

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