臺灣博碩士論文加值系統

在痛覺研究及神經纖維病變研究中，經皮神經電刺激器扮演給予受測者電刺激的角色，藉由活化神經纖維讓受測者感覺到疼痛並進行研究。而刺激器及人體之間負責傳導電流的媒介，就是電極。根據許多研究指出，不同材質、形狀及大小的電極之刺激效果也不同。本研究使用同心圓矽膠電極進行測試，利用體感覺誘發電位及計算神經傳導速率來觀察該電極所刺激到的神經纖維，再進一步探討電刺激的效果。
能在磁振造影的環境中使用，且不會造成人體危險或影像品質影響的器材稱為磁振相容(MR Compatibility)。一般市面上的磁振相容器材價格非常昂貴，為了降低研究成本，本研究設計了特殊的電極與導線，以達到自製磁振相容器材之目的。我們會對此電刺激系統進行安全性測試及影像品質分析，探討本研究所自行開發之電刺激系統是否為磁振相容。

In pain and neuropathy physiology, Transcutaneous Electrical Nerve Stimulation (TENS) play the role of giving the electrical stimulation to subjects to activate nerve fibers and let subjects feel painful and then we can do research on pain and neuropathy physiology. The electrodes are the media for the electrical stimulation and human bodies. According to a lot of researches, electrodes with different materials, shapes and sizes could cause different effects of stimulation. Our approaches use concentric planar silica gel electrodes to test. We also utilize somatosensory evoked potentials (SSEP) and nerve conduction velocity (NCV) to observe fibers which are stimulated. Then we can investigate the effects of electrical stimulation.
MR compatibility means that a device which is MR safe and its use in the MR environment does not affect imaging quality. MR compatible devices are always very expensive. We design special electrodes and conductors to implement MR compatibility by ourselves. We test our electrical system to know whether it is MR safe and its use in the MR environment does not affect imaging quality. Then we can know whether our electrical system is MR compatibility or not.

目錄
誌謝.......................................................i
摘要......................................................ii
ABSTRACT.................................................iii
目錄......................................................iv
圖目錄.....................................................vi
表目錄...................................................viii
第一章 緒論................................................1
1.1 痛覺定義及簡介..........................................1
1.2 神經傳導及痛覺生理機制....................................2
1.3 小神經纖維病變診斷方法與發展...............................5
1.4 功能性磁振造影..........................................9
1.5 磁振造影相容 (MR compatibility).........................9
1.6 研究動機與目的.........................................10
第二章 電刺激系統設計與架構..................................12
2.1 電極設計..............................................12
2.2 導線設計..............................................15
2.3 電刺激器..............................................18
第三章 腦電波簡介及應用......................................21
3.1 腦電波訊號介紹.........................................21
3.1.1 腦電波相關生理介紹....................................21
3.1.2 腦電波訊號分類.......................................22
3.1.3 體感覺誘發電位(Somatosensory Evoked Potential, SSEP).26
3.2 腦電波紀錄............................................27
第四章 實驗材料與方法.......................................29
4.1 實驗一................................................29
4.1.1 受試者..............................................29
4.1.2 電刺激系統..........................................30
4.1.3 腦電波與體感覺誘發電位分析.............................30
4.1.4 神經傳導速率.........................................31
4.2 實驗二................................................33
4.2.1 電刺激系統..........................................34
4.2.2 磁振造影相容安全性測試.................................38
4.2.3 磁振造影相容影像品質分析...............................39
第五章 結果與討論...........................................41
5.1 刺激小神經纖維之有效性...................................41
5.2 磁振造影相容測試結果....................................52
第六章 結論與未來展望.......................................56
參考文獻...................................................58
圖目錄
圖1-1 痛覺傳導路徑........................................4
圖2-1 鈕釦式電極貼片......................................12
圖2-2 金屬電極貼片片......................................13
圖2-3 導電矽膠電極貼片....................................13
圖2-4 傳統大電極刺激神經纖維示意圖..........................14
圖2-5 同心圓小電極刺激神經纖維示意圖.........................14
圖2-6 同心圓矽膠電極實體圖.................................15
圖2-7 同心圓矽膠電極與硬幣之大小比較.........................15
圖2-8 同軸電纜..........................................16
圖2-9 同軸電纜構造示意圖..................................17
圖2-10 抗電磁干擾之單芯線設計示意圖..........................17
圖2-11 抗電磁干擾之單芯線設計成品............................18
圖2-12 Stimulus Isolator................................19
圖2-13 Stimulus Isolator軟體調整電刺激參數視窗..............19
圖3-1 大腦皮質功能區.....................................22
圖3-2 國際10-20腦電波系統................................23
圖3-3 事件相關電位.......................................24
圖3-4 腦電波基本頻段.....................................25
圖3-5 體感覺誘發電位, SSEP…..............................26
圖3-6 體感覺神經訊號之上行通路傳導示意圖.....................27
圖3-7 Neuroscan SynAmps2...............................28
圖4-1 實驗一之實驗流程....................................29
圖4-2 遠端及近端位置......................................32
圖4-3 實驗一之完整架構圖..................................32
圖4-4 實驗二之實驗流程....................................33
圖4-5 NI USB-6009......................................34
圖4-6 LabVIEW程式範例...................................35
圖4-7 SSR D3P-054 DC solid state relay 4A.............36
圖4-8 SSR電路示意圖.....................................36
圖4-9 電刺激開關控制電路..................................37
圖4-10 LabVIEW軟體設計...................................37
圖4-11 豬皮..............................................38
圖4-12 磁振造影相容安全性測試架構............................38
圖4-13 fMRI影像..........................................39
圖4-14 影像SNR之計算方法...................................40
圖5-1 接受電刺激後Cz腦區之腦電波訊號........................41
圖5-2 小同心圓矽膠電極測試結果.............................47
圖5-3 大圓形矽膠電極測試結果...............................50
圖5-4 磁振造影相容安全性測試結果............................52
圖5-5 磁振造影相容影像品質分析結果..........................53
表目錄
表1-1 周邊神經纖維之種類...................................3
表2-1 Stimulus Isolator之規格...........................20
表3-1 Neuroscan SynAmps2 輸出規格.......................28
表5-1 小同心圓矽膠電極之測試結果............................43
表5-2 大圓形矽膠電極之測試結果.............................49

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