博碩士論文 106827003 詳細資訊




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姓名 張芷茜(Chih-Chien Chang)  查詢紙本館藏   畢業系所 生物醫學工程研究所
論文名稱 重複間斷性Theta爆發刺激對手部運動之腦波的影響
(The effect of repeated iTBS on brain activities during hand movements)
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摘要(中) Theta 爆發刺激(TBS)是指重複性經顱磁刺激(rTMS)的特定程序被證明為調節神經最有效的方法,而TBS或TMS會引起動作誘發電位(MEPs)振幅的變化。本論文主要研究藉由給予受測者每3分鐘重複3次的重複間段性TBS(repeated- intermittent Theta burst stimulation, repeated-iTBS)刺激左側初級運動皮層(LM1),來探討左側及右側MEPs與大腦震盪的相關性。
共21名健康的受測者參加實驗,每位受測者在repeated-iTBS刺激前後進行右手肩關節前屈(Shoulder flexion)運動並且分別量測腦電波圖(EEG)及左右側MEPs。
結果顯示21名受測者中,有15名受測者的左側MEPs(平均變化= -26.26%; p <0.001)和右側MEPs(平均變化= -19.83%; p = 0.070)均降低,顯示兩邊半球的皮質興奮性降低。repeated-iTBS刺激後,左側M1的beta頻帶(16 Hz ~ 30 Hz之EEG)有顯著的降低,並與左側MEPs在5分鐘時的振幅變化有正相關(r = 0.65;p = 0.014)。而右側M1則增加,立即改變左側MEPs,兩者呈現負相關(r = -0.63,p = 0.01)。除此之外,在右手運動過程中,施打於LM1的repeated-iTBS可以調節受測半球之左側MEPs且間接影響對側,使對側未受刺激半球之右側MEPs亦有變化,分別調節神經網路變化。並且刺激前左右側M1的Beta連結及原有的Beta連結與repeated-iTBS刺激後MEPs的變化有相關。
總而言之,repeated-iTBS可以有效地使受測半球與非受測半球受到抑制改變,且分別調節與左右側MEPs相關的神經網路變化。這些研究結果可以作為repeated-iTBS運用於運動的參考。
摘要(英) The theta burst stimulation (TBS) is a specific protocol for repetitive transcranial magnetic stimulation (rTMS).It has proven to be the most effective protocol to induce the neuroplasticity.TBS or TMS causes changes in the amplitude of motor evoked potentials (MEPs).The main study was to investigate the aftereffects by given to subjects iTBS repeated every 3 minutes for 3 times (repeated-iTBS) over the left primary motor cortex (LM1), and means of the amplitudes of MEPs evoked from the left (LMEPs) and right (RMEPs) M1 and their correlation with the brain oscillation.
21 healthy subjects participated in the experiment. Each subject performed right-hand shoulder flexion and extension action before and after repeated iTBS stimulation with 2 sessions, and measured the electroencephalogram (EEG) and MEPs.
The results showed that 15 of 21 subjects had decreased left MEPs (mean change = -26.26%; p <0.001) and right MEPs (mean change = -19.83%; p = 0.070), meaning both hemispheres cortical excitability is reduced. After repeated-iTBS, the beta activities (16 Hz ~ 30 Hz) of the LM1 were significantly reduced, and were positively correlated with the amplitude change of the left MEPs at 5 minutes (r = 0.65; p = 0.014). Also, the RM1 increased, and the left MEPs were immediately changed in a negative correlation (r = -0.63, p = 0.01). In addition, during the right-hand movement, repeated-iTBS over LM1 induce the left MEPs of the conditioned hemisphere and indirectly affect the opposite side, also change the right MEPs of the unconditioned hemisphere, and respectively modulate the neuronal network changes in both hemispheres. Last, MEPs changes after repeated-iTBS were correlated with the pre-LM1 and pre-RM1 beta power. The beta were correlated with intrinsic connection strengths.
In summary, repeated-iTBS can effectively change the conditioned hemisphere, unconditioned hemisphere, and neural network which was related to MEPs. These results can be used as a reference for repeated-iTBS in motor cortox.
關鍵字(中) ★ 腦電波圖
★ 動作誘發電位
★ 可塑性
★ Theta 爆發刺激
關鍵字(英) ★ EEG
★ MEPs
★ plasticity
★ transcranial magnetic stimulation
論文目次 摘要 I
Abstract II
致謝 IV
目錄 V
圖目錄 VII
表目錄 IX
第一章 緒論 1
1.1 研究背景與動機 1
1.2 研究目的 1
1.3 論文架構 2
第二章 文獻回顧 3
2.1 腦電波與臨床研究 3
2.1.1 腦電波圖與國際10-20系統 3
2.1.2 腦電波圖之頻帶 5
2.2 經顱磁刺激(Transcranial magnetic stimulation, TMS) 5
2.3 間斷性Theta爆發刺激(intermittent Theta burst stimulation, iTBS) 6
2.4 動作誘發電位(Motor evoke potential, MEP) 7
2.5 經顱磁刺激與運動皮質研究 10
第三章 實驗設計與研究方法 12
3.1 受測者條件 12
3.2 實驗設備 13
3.3 實驗流程 14
3.4 腦波實驗 16
3.5 研究資料處理 16
3.6 動態因果模型(Dynamic causal modelling, DCM) 17
3.6.1 動態因果模型建構 20
3.6.2 DCM特徵分析 22
第四章 研究結果 24
4.1 運動神經誘發電位(MEPs)統計結果 24
4.2 初級運動區腦波統計結果 28
4.3 MEPs與初級運動區之Beta頻帶之間的相關性 33
4.4 初級運動皮質(M1)之動態因果模型結果 44
4.5 施打repeated-iTBS前後顯著相關連結 49
4.6 腦內網路連結與MEP之相關性 52
第五章 討論與結論 63
5.1 repeated-iTBS的抑制效果與對神經所造成的效果 63
5.2 施打於LM1的repeated-iTBS可以調節受測半球且對未受測半球亦有調節 63
5.3 原有的Beta連結會影響受repeated-iTBS刺激後MEPs的變化 65
5.4 MEP測量位置與EEG實驗動作之大腦運動控制非同一區塊 65
5.5 結論 66
第六章 未來展望 69
參考文獻 70
附件 77
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指導教授 陳純娟 審核日期 2020-1-20
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