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探究外周电刺激对中风幸存者皮质-肌肉功能连接的影响。

Investigating the Effects of Peripheral Electrical Stimulation on Corticomuscular Functional Connectivity Stroke Survivors.

作者信息

Lai Meei-I, Pan Li-Ling, Tsai Mei-Wun, Shih Yi-Fen, Wei Shun-Hwa, Chou Li-Wei

机构信息

a Department of Physical Therapy and Assistive Technology , National Yang-Ming University , Taipei , Taiwan.

出版信息

Top Stroke Rehabil. 2016 Jun;23(3):154-62. doi: 10.1080/10749357.2015.1122264. Epub 2016 Jan 13.

Abstract

BACKGROUND

Electrical stimulation (ES) in the periphery can induce brain plasticity and has been used clinically to promote motor recovery in patients with central nervous system lesion. Electroencephalogram (EEG) and electromyogram (EMG) are readily applicable in clinical settings and can detect real-time functional connectivity between motor cortex and muscles with EEG-EMG (corticomuscular) coherence.

OBJECTIVE

The purpose of this study was to determine whether EEG-EMG coherence can detect changes in corticomuscular control induced by peripheral ES.

METHODS

Fifteen healthy young adults and 15 stroke survivors received 40-min electrical stimulation session on median nerve. The stimulation (1-ms rectangular pulse, 100 Hz) was delivered with a 20-s on-20-s off cycle, and the intensity was set at the subjects' highest tolerable level without muscle contraction or pain. Both before and after the stimulation session, subjects performed a 20-s steady-hold thumb flexion at 50% maximal voluntary contraction (MVC) while EEG and EMG were collected.

RESULTS

Our results demonstrated that after ES, EEG-EMG coherence in gamma band increased significantly for 22.1 and 48.6% in healthy adults and stroke survivors, respectively. In addition, after ES, force steadiness was also improved in both groups, as indicated by the decrease in force fluctuation during steady-hold contraction (-1.7% MVC and -3.9%MVC for healthy and stroke individuals, respectively).

CONCLUSIONS

Our results demonstrated that EEG-EMG coherence can detect ES-induced changes in the neuromuscular system. Also, because gamma coherence is linked to afferent inputs encoding, improvement in motor performance is likely related to ES-elicited strong sensory input and enhanced sensorimotor integration.

摘要

背景

外周电刺激(ES)可诱导脑可塑性,已在临床上用于促进中枢神经系统损伤患者的运动恢复。脑电图(EEG)和肌电图(EMG)在临床环境中易于应用,并且可以通过脑电-肌电(皮质-肌肉)相干性检测运动皮层与肌肉之间的实时功能连接。

目的

本研究旨在确定脑电-肌电相干性是否能够检测外周电刺激引起的皮质-肌肉控制变化。

方法

15名健康年轻人和15名中风幸存者接受了40分钟的正中神经电刺激。刺激(1毫秒矩形脉冲,100赫兹)以20秒开-20秒关的周期进行,强度设置为受试者可耐受的最高水平,且不会引起肌肉收缩或疼痛。在刺激前后,受试者在50%最大自主收缩(MVC)下进行20秒的稳定拇指屈曲动作,同时采集脑电图和肌电图。

结果

我们的结果表明,电刺激后,健康成年人和中风幸存者的γ波段脑电-肌电相干性分别显著增加了22.1%和48.6%。此外,电刺激后,两组的力量稳定性也有所改善,稳定收缩期间力量波动的降低表明了这一点(健康人和中风患者分别为-1.7%MVC和-3.9%MVC)。

结论

我们的结果表明,脑电-肌电相干性能够检测电刺激引起的神经肌肉系统变化。此外,由于γ相干性与传入输入编码相关,运动表现的改善可能与电刺激引发的强烈感觉输入和增强的感觉运动整合有关。

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