| 摘要: | 非侵入式腦刺激（NIBS）已經是一種臨床上廣泛應用的治療方法，又可分為經顱磁刺激（TMS）與經顱電刺激（TES）。非侵入式腦刺激也已由國內外政府機構與許多研究證實甚至可作為替代藥物治療的有效方式，並具有無痛、無創傷、副作用降低以及安全性高等優點。在這兩種系統中，雖然經顱磁刺激已經被臨床廣泛接受，且具有定位精準的優點，但是對於深部的腦區卻沒有辦法刺激到，因此必須搭配經顱電刺激才能達到好的治療效果。
基於以上理由，本研究設計並實現了一套搭配經顱電刺激的便攜式重複性經顱磁刺激(rTMS)裝置，相較於目前商業使用上的磁刺激裝置，此裝置體積較小、方便攜帶並且成本較低。本裝置同時具備無線藍芽控制功能，使用者可透過手機或電腦與裝置連接來調整頻率、脈衝寬度、刺激持續時間以及刺激間隔等刺激參數。使用者也可自行編程新增所需的刺激參數或自行調節刺激強度，增加使用者的操作便利性。本研究也針對此裝置進行了初步的人體試驗，透過受試者接受低頻重複性經顱磁刺激刺激前後的腦電圖（EEG）比較，驗證本裝置在刺激後確實能夠改變受試者的大腦皮質興奮性，達到一定刺激效果。
在經顱電刺激方面，本研究使用不同以往實驗的電極與電極擺放方式，進行以時間干涉的經顱交流電刺激（TI-tACS）設計，並於臨床豬隻動物實驗進行驗證。我們透過分析2支通道的顱內深部電極(SEEG)所收集的實驗中豬隻基礎狀態、注射藥劑誘發癲癇後以及接受TI-tACS刺激後腦波資訊，成功驗證TI-tACS對於癲癇的抑制效果。並透過實驗豬隻腦部組織切片病理圖，確認此次電刺激實驗不會對腦部組織造成損傷，驗證其生物安全性。
;Non-invasive brain stimulation (NIBS) has been widely used in clinical treaments. In some studies, NIBS is demonstrated as a posssible substitution for drug therapy. According to the stimulation types, NIBS has two main categories. One is the transcranial magnetic stimulation (TMS), and the the other one is the transcranial electrical stimulation (TES). Comparing the TMS with the TES system, though the TMS has been widely accepted in clinical use owing to its advantage of focal stimulation, however, the poor penetration depth of TMS limits its clinical applications and the TES is usually chosen in case of the need for deep brain stimulation.
Due to the aforementioned reasons, we have designed a portable NIBS device, which contains the dual functitons of the repetitive TMS (rTMS) and the TES. Our NIBS device has the features of small, portable and low cost which can be triggered throgh bluetooth connection. Users can conveniently adjust the stimulation parameters, such as stimulation frequency, pulse width, stimulation duration, stimulation interval, etc., on mobile phone or computer. Demonstration of the proposed NIBS has been done in a preliminary human study and an animal study on piggy. For rTMS part, subjects were requested to receive rTMS, 1Hz repetitive rate, for fifteen minutes. EEG signals from left and right sensorimotor area (C3 and C4 position) were recorded and the Mu rhythms were enhanced after stimulation.
For TES part, we developed time-interfering transcranial alternative current stimulation (TI-tACS) for sizure suppression on a piggy animal model. Two six-channel SEEG electrodes were placed in the left/right hippocampus regions to see the efficacy of seizure suppression using TI-tACS. The biopsy of the piggy’s brain has shown that no tissue damage resulted from TI-tACS was found and the seizure in piggy’s brain was successfully supressed. Our experimental results have shown the safety and effectiveness of our NIBS system. |
