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系統識別號 U0026-2407202016381400
論文名稱(中文) 急性期中風患者之雙腦間血氧震盪的同步性評估分析
論文名稱(英文) Evaluating Interhemispheric Synchronization with Hemodynamic Oscillation in Acute Stroke Patients
校院名稱 成功大學
系所名稱(中) 生物醫學工程學系
系所名稱(英) Department of BioMedical Engineering
學年度 108
學期 2
出版年 109
研究生(中文) 陸怡萱
研究生(英文) Yi-Hsuan Lu
學號 P86071189
學位類別 碩士
語文別 英文
論文頁數 47頁
口試委員 指導教授-陳家進
口試委員-林宙晴
口試委員-吳馬丁
口試委員-蔡育秀
口試委員-宋碧姍
中文關鍵字 急性中風  腦血流自動調控功能  血液動力學  雙腦同步性  基於小波轉換的相位相干 
英文關鍵字 acute stroke  cerebral autoregulation  hemodynamics  interhemispheric synchronization  wavelet-based phase coherence 
學科別分類
中文摘要 中風的血管病變和神經血管的重建和微血管流模式的大量變化有關,腦血流自動調控功能被視為在這過程中受到損傷,因此中風會導致雙腦的腦血流震盪無法同步,在各種腦造影技術中,近紅外光光譜儀(NIRS)最適合用來偵測受試者進行靜態或動態活動時雙腦間血流震盪的同步性變化,本研究的目的即是透過近紅外光光譜儀來評估急性中風期病人雙腦間腦血流震盪的同步性,分別量測其前額葉皮質(PFC)、運動輔助區(SMC)和運動皮質(M1),此研究分別在受試者中風後第7天和第14天量測其靜態和動態活動時的腦血流變化,我們根據其中風區域的大中小將受試者分為三組,在靜態量測時,受試者須盡量保持不動並持續量測五分鐘,除了幅度相干函數外,我們計算了基於小波轉換的NIRS訊號相位相干來評估雙腦的相位同步性,我們的結果顯示,在中風後的第14天,大區域中風組在0.06-0.15 赫茲區間和0.02-0.06赫茲區間的雙腦腦血流的相位相干性顯著的低於小區域中風組(控制組),在動態量測時,受試者被要求交替使用食指和中指以自訂節奏進行手指敲擊,在此量測中執行10組共320秒,每組進行手指敲擊10秒接著休息20秒,我們觀察發現在中區域中風組中的HbD (HbO-HbR) 比小區域中風組的HbD來得低,儘管他們並沒有顯著差異,為了更進一步探討急性中風期的病程,我們比較了兩個中風階段的MRI中的梗死體積和NIRS訊號中的HbD,結果顯示當受試者的梗死體積變小時,其HbD是上升的,這意味著神經元的活性隨著中風的恢復而增強。
我們偵測了急性中風病患在兩個不同時期的腦血流自動調控功能和神經元的活性,不同嚴重程度的中風其雙腦腦血流相干性的不同顯示了腦血流自動調控功能的損傷程度,再者不同急性中風時期可能反映了對腦神經元損傷的影響和事件相關光信號的反應,因此本研究提供了一個具有潜力的新方法來評估監測急性中風患者的復健進度。
英文摘要 In stroke, vascular pathology is related to the remodeling of the neurovascular and profound change of capillary flow pattern. The cerebral autoregulation (CA) is hypothesized to be damaged in stroke patient which may cause the imbalance in synchronization of hemodynamic oscillation within two hemispheres. Among various neuroimaging techniques, near-infrared spectroscopy (NIRS) is a promising neuro-imaging technique to explore the changes of inter-oscillatory synchronization in both resting and motor task conditions. The aims of this study were to evaluate the interhemispheric synchronization during hemodynamic oscillation in acute stroke patients. A twenty-channel NIRS system was used to measure the concentration of hemoglobin at prefrontal cortex (PFC), supplementary motor cortex (SMA) and primary motor cortex (M1) in both hemispheres. the measurement in resting state and motor task were conducted for acute unilateral stroke patients at 7th day and 14th day after stroke onset. According to infarct volume and region, the stroke patients were divided into three groups: large infarct volume (LIV), middle infarct volume (MIV) and small infarct volume (SIV). In resting state condition, subjects were asked to sit comfortably with minimum movement for 5 minutes. In addition to magnitude coherence function, the wavelet-based phase coherence (PC) of NIRS data was utilized to estimate the phase synchronization of both hemispheres. Our results showed that the PC value in 0.06-0.15 Hz interval and 0.02-0.06 Hz interval exhibited significant lower in the LIV group than the SIV group (control group) at 14th day after stroke onset. In motor task condition, subjects were asked to perform the finger tapping in a self-pace fashion using their index finger and middle finger alternatively. The tasks were executed at 10- second active followed by 20-second of resting. We observed that the lower HbD (HbO-HbR) was found in MIV stroke group compared to SIV stroke group. However, it did not reach significant level of difference. For further investigation of in the time-course change of acute stroke, we compare the infarct volume from MRI and HbD from NIRS at two stroke phases. The result showed that infarct volume decreased as the increase in the HbD. This indicates that functional neuron activity became stronger when stroke recovery improved. In conclusion, we examined the cerebral autoregulation and neuron activity in acute unilateral stroke patients at two different stroke phases. Different phase coherence of interhemispheric hemodynamics among LIV, MIV and SIV stroke patients group indicates altered impaired cerebral autoregulation. Moreover, different acute stroke phase might reflect the effects of brain neuron damage and response to the event-related optical signal.
論文目次 Contents
摘要 I
Abstract II
Contents IV
List of figures V
List of tables VII
Chapter 1 Introduction 1
1.1 Cerebral autoregulation 1
1.1.1 Common methods in investigating cerebral autoregulation 3
1.1.2 Impaired Cerebral Autoregulation in stroke 4
1.2 Neurovascular coupling 4
1.3 Phase synchronization 5
1.3.1 Synchronization between interhemispheric 5
1.3.2 Synchronization and analysis 6
1.4 Near-infrared spectroscopy 7
1.4.1 Neuroimaging techniques 7
1.4.2 General principles of NIRS 8
1.4.3 Types of spectrometer 10
1.5 The aim of the study 14
Chapter 2 Materials and Methods 15
2.1 Measurement of NIRS 15
2.2 Experimental design 16
2.3 Subjects recruitment 18
2.4 Data analysis 18
2.4.1 Pre-processing 18
2.4.2 Time-domain analysis 19
2.4.3 Frequency-domain analysis 20
2.5 Statistical analysis 24
Chapter 3 Result 25
3.1 Subject recruitment 25
3.2 Cerebral autoregulation during resting state 27
3.2.1 Interhemispheric correlation coefficient (IHCC) 27
3.2.2 Phase Coherence 32
3.3 Cerebrovascular reactivity during fingers tapping 36
3.3.1 Event-related optical signal 36
Chapter 4 Discussion and Conclusion 39
4.1 The IHCC of cerebral regulation 39
4.2 The interhemispheric phase coherence of [HbO] in different cortex regions 39
4.3 The interhemispheric phase coherence of [HbO] in different physiology oscillation interval 40
4.4 The hemodynamic response during fingers tapping 41
4.5 Conclusion and future work 42
References 44

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