Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02PN40 Dublin, Ireland.
The Irish Longitudinal Study on Ageing, Trinity College Dublin, D02R590 Dublin, Ireland.
Sensors (Basel). 2022 Feb 24;22(5):1758. doi: 10.3390/s22051758.
Reports suggest that adults with post-COVID-19 syndrome or long COVID may be affected by orthostatic intolerance syndromes, with autonomic nervous system dysfunction as a possible causal factor of neurocardiovascular instability (NCVI). Long COVID can also manifest as prolonged fatigue, which may be linked to neuromuscular function impairment (NMFI). The current clinical assessment for NCVI monitors neurocardiovascular performance upon the application of orthostatic stressors such as an active (i.e., self-induced) stand or a passive (tilt table) standing test. Lower limb muscle contractions may be important in orthostatic recovery via the skeletal muscle pump. In this study, adults with long COVID were assessed with a protocol that, in addition to the standard NCVI tests, incorporated simultaneous lower limb muscle monitoring for NMFI assessment. To conduct such an investigation, a wide range of continuous non-invasive biomedical sensing technologies were employed, including digital artery photoplethysmography for the extraction of cardiovascular signals, near-infrared spectroscopy for the extraction of regional tissue oxygenation in brain and muscle, and electromyography for assessment of timed muscle contractions in the lower limbs. With the proposed methodology described and exemplified in this paper, we were able to collect relevant physiological data for the assessment of neurocardiovascular and neuromuscular functioning. We were also able to integrate signals from a variety of instruments in a synchronized fashion and visualize the interactions between different physiological signals during the combined NCVI/NMFI assessment. Multiple counts of evidence were collected, which can capture the dynamics between skeletal muscle contractions and neurocardiovascular responses. The proposed methodology can offer an overview of the functioning of the neurocardiovascular and neuromuscular systems in a combined NCVI/NMFI setup and is capable of conducting comparative studies with signals from multiple participants at any given time in the assessment. This could help clinicians and researchers generate and test hypotheses based on the multimodal inspection of raw data in long COVID and other cohorts.
报告表明，患有新冠后综合征或长期新冠的成年人可能受到直立不耐受综合征的影响，自主神经系统功能障碍可能是神经心血管不稳定（NCVI）的一个潜在原因。长期新冠还可能表现为持续疲劳，这可能与神经肌肉功能障碍（NMFI）有关。目前对 NCVI 的临床评估是在应用直立应激源（如主动（即自我诱导）站立或被动（倾斜台）站立测试）时监测神经心血管功能。下肢肌肉收缩可能通过骨骼肌泵在直立恢复中很重要。在这项研究中，对患有长期新冠的成年人进行了评估，评估方案除了标准的 NCVI 测试外，还结合了同时监测下肢肌肉的 NMFI 评估。为了进行这样的研究，采用了广泛的连续非侵入性生物医学传感技术，包括数字动脉光体积描记术以提取心血管信号、近红外光谱法以提取大脑和肌肉的局部组织氧合，以及肌电图以评估下肢肌肉的定时收缩。通过本文中描述和举例的方法，我们能够收集相关的生理数据，用于评估神经心血管和神经肌肉功能。我们还能够以同步的方式整合来自各种仪器的信号，并在进行联合 NCVI/NMFI 评估时可视化不同生理信号之间的相互作用。收集了多份证据，可以捕捉骨骼肌收缩和神经心血管反应之间的动态关系。该方法可提供神经心血管和神经肌肉系统在联合 NCVI/NMFI 方案中的综合功能概述，并能够在评估中随时对来自多个参与者的信号进行比较研究。这可以帮助临床医生和研究人员根据长期新冠和其他队列的原始数据的多模态检查生成和检验假设。
