臺灣博碩士論文加值系統

自律神經系統的功能會影響生理機制的運作，有許多研究指出自律神經失調是造成心血管疾病的原因之一。評估自律神經功能也已經成為評估健康的方法之一。目前普遍非侵入式的檢測自律神經方法為心律變異數 (HRV)，然而這個方法有一些限制，例如：無法即時顯示神經活性狀態。皮膚交感神經活性量測 (SKNA) 是一種新穎的方法，可以量測交感神經活性。目前已經應用在臨床上，但這個方法只局限於評估交感神經活性。目前已經有非侵入式交感神經活性直接量測的方法，但副交感神經量測的方法卻沒有，研發非侵入式的方法評估副交感神經活性勢在必行。根據解剖學，我們發現有一個副交感神經的分支位於外耳－耳迷走神經。先前關於耳迷走神經的研究都是利用經皮神經電刺激 (TENS)來增加迷走神經的活性。
本篇研究假設我們可以利用皮膚交感神經活性量測的技術，量測耳迷走神經的活性。我們透過不同的刺激方法使交感神經或副交感神經興奮，並透過觀察心跳的反應判斷神經的活性。為了量測耳迷走神經活性，我們設計一個能有彈性的耳電極以符合長時間的配戴。在實驗中，我們同時量測皮膚交感神經活性和耳迷走神經訊號，並觀察訊號與心跳變化之間的關係。根據實驗的結果表明，非侵入式量測耳迷走神經具有很高的潛力成為一種新的量測副交感神經活性的方法。

The function of the autonomic nervous system (ANS) influences most of the physiological mechanisms. A lot of research pointed out that the imbalance ANS was the one of reasons causes cardiovascular diseases. The evaluation of the ANS function was one of the methods to determine healthily. Currently, the popular non-invasive method to estimate the activities of the autonomic nervous system is the heart rate variability (HRV). However, HRV has some limitations, which include cannot provide real-time information on the ANS function. The skin sympathetic nerve activity (SKNA) is a novel method to evaluate sympathetic nerve system (SNS) activity. The SKNA technique has shown promise in clinical applications but is limited to evaluating SNS activities. To date, a direct non-invasive method for measuring the parasympathetic nerve system (PNS) function is urgently needed. According to anatomy, the auricular branch of the vagus nerve (aVN) is near the concha surface. The previous research about aVN was using transcutaneous electrical nerve stimulation to evoke the vagus nerve activity.
In this study, we hypothesize that we can measure PNS activity with the same technique developed for SKNA recording. We used the different stimulation to excite ANS or PNS activity, and observed the response of HR to confirm the situation of nerve activity. Flexible auricular electrodes were developed for continuous long-term recording of aVN activity. The SKNA and aVNA were simultaneously recorded during the experiment. The SKNA and aVNA can be obtained simultaneously, and they are correlated with the heart rate change during the physiological challenge. The aVNA has a high potential to be developed into a novel method to measure the PNS activity.

摘要 I
Abstract II
謝誌 III
Contents IV
List of figures VI
List of tables VII
Chapter 1. Introduction 1
1.1 Motivation and Background 1
1.2 Autonomic nervous system (ANS) 3
1.2.1 Sympathetic nervous system (SNS) 4
1.2.2 Parasympathetic nervous system (PNS) 4
1.3 The method of stimulation autonomic nervous system activity 5
1.3.1 Cold pressor test (CHT) 5
1.3.2 Cold face test (CFT) 5
1.3.3 Deep breathing (DB) 5
1.4 Skin sympathetic nerve activity 6
1.5 Related work 7
1.6 Research objectives 7
1.7 Thesis organization 8
Chapter 2. Methods 9
2.1 Subjects 9
2.2 Experiment environment 10
2.3 Data acquisition 11
2.4 Experiment protocol 12
2.5 The ear electrode 13
2.6 Statistical analysis 14
2.7 The system of the signal processing 15
2.7.1 The method of heart rate analysis 15
2.7.2 Signal optimization method 16
2.7.3 Burst definition method 17
Chapter 3. Results 18
3.1 The ear electrode 18
3.2 Comparison of the silver and standard ECG electrode patch 18
3.3 Analysis of the average HR and nerve activity 19
3.4 Analysis of the nerve burst during the stimulation 23
3.5 Analysis of the nerve activity in DB test 25
3.6 Comparison of different sampling rate setting 27
Chapter 4. Discussions 29
4.1 Stimulation effect on HR and nerve activity 29
4.2 The source of aVNA 29
4.2.1 Comparisons of SKNA and aVNA 29
4.2.2 Effect of DB test 30
4.3 The relationship with aVNA burst and HR change 30
4.4 Comparison of aVNA-R and aVNA-L 31
Chapter 5. Conclusions and Future work 33
References 34
Appendix 37

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