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研究生:陳韋哲
研究生(外文):Wei-Che Chen
論文名稱:接觸熱誘發電位的腦區定位分析
論文名稱(外文):Topographic Analysis of Contact Heat Evoked Potentials
指導教授:謝松蒼謝松蒼引用關係
口試委員:江伯倫趙啟超江明彰
口試日期:2016-07-04
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:臨床醫學研究所
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
論文出版年:2016
畢業學年度:104
語文別:中文
論文頁數:45
中文關鍵詞:熱接觸誘發電位腦區定位多通道腦波低解析度電磁斷層獨立成分分析
外文關鍵詞:contact heat evoked potential (CHEP)brain localizationmulti-channel electroencephalographlow-resolution electromagnetic tomography (LORETA)independent component analysis (ICA)
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背景:
由於接觸熱不會對於局部的組織造成傷害,受試者的皮膚可以連續接受刺激,因此接觸熱誘發電位適合用來研究熱疼痛的腦部活化。單一頭頂Cz腦波通道的研究已經證實接觸熱誘發電位是一個客觀的疼痛以及周邊神經損傷的指標。接觸熱也已經用於健康受試者的腦波與功能性磁振造影的腦區活化研究。本研究將進行多通道的腦波紀錄,研究健康受試者與周邊神經病變患者接觸熱刺激後活化的腦區。

方法:
健康受試者與周邊神經病變患者的右側小腿接受51°C的接觸熱脈衝刺激,同時頭戴NeuroScan Quik-Cap紀錄64通道的腦波。使用MATLAB與EEGLAB軟體進行腦波訊號前處理之後,再利用標準化低解析度電磁斷層(standardized low-resolution electromagnetic tomography, sLORETA)分析事件相關電位的活化腦區。也利用群體獨立成分分析法獲得獨立成分,再進行各個有顯著變化的獨立成分的sLORETA定位。最後依上述分析結果與文獻中研究的發現定義感興趣腦區,進行該腦區的sLORETA電流密度與口頭疼痛分數的迴歸分析。

結果:
本研究共收集了17個健康受試者與17個周邊神經病變患者的接觸熱誘發電位紀錄。事件相關電位的sLORETA腦區定位發現健康受試者在兩側前扣帶迴、周邊神經病變患者在左側顳葉-枕葉交界處皮質有最大的活化。同時獨立成分的腦區定位除了顯示上述腦區的活化之外,也發現兩組皆有左側後頂葉皮質的活化之外,也顯示接觸熱刺激後有眾多腦區活化反應。感興趣腦區的sLORETA估計電流密度分析發現在正常受試者除了在兩側前扣帶迴與左側腦蓋-腦島皮質之外,背外側前額葉皮質的活化程度亦與口頭疼痛分數呈現正相關。

結論:
本研究提出前扣帶迴、背外側前額葉皮質、對側中央後迴與對側後頂葉皮質在健康受試者與周邊神經病變患者是共同活化的區域。而對側顳葉-枕葉交界處皮質這個腦區在周邊神經患者的特異性活化,則待進一步的研究。

Background:
Contact heat evoked potentials (CHEPs) can be used to study pain phenomenon because contact heat does not cause local tissue damage and therefore the skin can be repeatedly stimulated. EEG recording using single vertex channel at Cz has demonstrated that it is an objective marker to document pain and peripheral nerve injury. Previous studies using EEG or functional MRI have shown activation of various brain areas. This study is designed to further study brain activation when healthy subjects or patients of peripheral neuropathy are stimulated with contact heat.

Methods:
Healthy subjects and patients of peripheral neuropathy are stimulated in the right leg with contact heat pulses of 51°C and multiple channel EEG signals are recorded by using the Neuroscan Quik-Cap System. After the signals are preprocessed by MATLAB and EEGLAB, standardized low-resolution electromagnetic tomography(sLORETA) is used to localize areas of activation in each subject group. Group independent component analysis (ICA) is also performed in each group to find independent components with significant activation after heat stimuli. sLORETA analyses are then applied to those significant independent component for localization of brain activation. After reviewing the above results and references, several regions of interests (ROIs) are chosen and correlation of sLORETA current density in each ROI with pain score are performed.
Results:
Seventeen healthy subjects and 17 patients of various peripheral neuropathies are recruited to the current study. Brain localization using event-related potential and sLORETA reveals the activation of the anterior cingulate gyri in the healthy subjects and of the left temporooccipital junction in the patients. Brain activation after group ICA analysis also concurs with the previous findings and common activation in the left (contralateral) posterior parietal cortex is found. Participation and/or responses of multiple brain areas after contact heat stimuli are found. Regions of interest analyses not only reveal correlation of the activation in the bilateral cingulate gyri and left operculoinsular cortex with numerical rating scales of pain, but also activation in the dorsolateral prefrontal cortices is also positively correlated with scales of pain.
Conclusion:
In this study, common activation in the anterior cingulate gyri, dorsolateral prefrontal cortices, contralateral postcentral gyrus and contralateral posterior parietal cortex is found in both healthy subjects and patients of peripheral neuropathy. Specific activation of the left temporooccipital junction in patients is also found and needs further study.

口試委員會審定書…………………………………………………….…………… i
誌謝…………………………………………………………….……….……………. ii
中文摘要…………………………………………………….………….…………… iii
英文摘要………………………………………………….…………….……………. v
碩士論文內容
第一章 緒論.………………………………………………………………….. 1
第二章 研究方法….……………………………………………………………….. 5
2.1 接觸熱誘發電位紀錄
2.2 訊號前處理
2.3 事件相關電位與sLORETA定位
2.4 群體獨立成分分析
2.5 挑選刺激下有顯著激發的獨立成分
2.6 進行有顯著激發的獨立成分的sLORETA定位
2.7 進行有顯著激發的獨立成分的時頻分析
2.8 腦區中sLORETA電流密度及曲線下面積
第三章 結果………………………………………………………………….. 10
3.1 本研究受試者基本資料
3.2 事件相關電位與sLORETA定位
3.3 群體獨立成分分析
3.4 有顯著激發的獨立成分進行sLORETA定位
3.5 有顯著激發的獨立成分進行時頻分析
3.6 腦區中sLORETA電流密度曲線下面積
第四章 討論………………………………………………………………….. 14
第五章 展望………………………………………………………………….. 18
第六章 論文英文簡述………………………………………………………… 19
參考文獻………………………………………………………………….…..…….. 25
附錄
圖1-8…………………………………………………………………..……………. 29
表1-9…………………………………………………………………..….………… 38

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