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利用功能性电刺激抑制震颤。

Tremor Suppression Using Functional Electrical Stimulation.

出版信息

IEEE Trans Neural Syst Rehabil Eng. 2024;32:3289-3298. doi: 10.1109/TNSRE.2024.3453222. Epub 2024 Sep 11.

Abstract

Parkinson's disease (PD) and essential tremor are two major causes of pathological tremor among people over 60 years old. Due to the side effects and complications of traditional tremor management methods such as medication and deep brain surgery, non invasive tremor suppression methods have become more popular in recent years. Functional electrical stimulation (FES) is one of the methods used to reduce tremor in several studies. However, the effect of different FES parameters on tremor suppression and discomfort level, including amplitude, the number of pulses in each stimulation burst, frequency, and pulse width is yet to be studied for longer stimulation durations. Therefore, in this work, experiments were performed on 14 participants with PD to evaluate the effect of thirty seconds of out-of-phase electrical stimulation on wrist tremor at rest. Trials were conducted by varying the stimulation amplitude and the number of pulses while keeping the frequency and pulse width constant. Each test was repeated three times for each participant. The results showed an overall tremor suppression for 11 out of 14 participants and no average positive effects for three participants. It is concluded that despite the effectiveness of FES in tremor suppression, each set of FES parameters showed different suppression levels among participants due to the variability of tremor over time. Thus, for this method to be effective, an adaptive control system would be required to tune FES parameters in real time according to changes in tremor during extended stimulation periods.

摘要

帕金森病(PD)和特发性震颤是 60 岁以上人群病理性震颤的两个主要原因。由于传统震颤管理方法(如药物治疗和深部脑刺激手术)的副作用和并发症,近年来非侵入性震颤抑制方法变得更加流行。功能电刺激(FES)是几种研究中用于减少震颤的方法之一。然而,不同 FES 参数对震颤抑制和不适感水平的影响,包括振幅、每个刺激脉冲的数量、频率和脉冲宽度,对于更长时间的刺激持续时间尚未进行研究。因此,在这项工作中,对 14 名 PD 患者进行了实验,以评估 30 秒的相反电刺激对静息时手腕震颤的影响。通过改变刺激幅度和脉冲数量来进行试验,同时保持频率和脉冲宽度不变。每个测试都为每个参与者重复三次。结果表明,14 名参与者中有 11 名总体震颤得到抑制,而 3 名参与者没有平均积极效果。结论是,尽管 FES 在震颤抑制方面有效,但由于震颤随时间的变化,每组 FES 参数在参与者之间显示出不同的抑制水平。因此,为了使这种方法有效,需要一个自适应控制系统,根据延长刺激期间震颤的变化实时调整 FES 参数。

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