Online Tremor Suppression Using Electromyography and Low-Level Electrical Stimulation
Online Tremor Suppression Using Electromyography and Low-Level Electrical Stimulation
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DOI：
10.1109/tnsre.2014.2328296
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发表时间：
2015-05-01
影响因子：
4.9
通讯作者：
Farina, Dario
中科院分区：
文献类型：
--
作者：
Dosen, Strahinja;Muceli, Silvia;Farina, Dario
震颤是最常见的运动障碍之一。有很大比例的患者（约25%）目前的治疗没有达到显着的震颤减少。本文提出了一种震颤抑制策略，该策略从震颤起源的肌肉的肌电信号中检测震颤，并通过以异相方式向拮抗肌提供电刺激来抵消震颤。检测基于迭代希尔伯特变换，并且在运动阈值以上（运动刺激）和运动阈值以下（感觉刺激）递送刺激。该系统在6名主要腕关节屈曲/伸展震颤患者（4名帕金森病患者和2名原发性震颤患者）身上进行了测试，当使用运动和感觉刺激时，5名患者的平均震颤减少率分别为46%-81%和35%-48%。在一名患者中，该系统没有减弱震颤。这些结果表明，震颤衰减可以通过在运动阈值以下提供电刺激来实现，从而防止患者的肌肉疲劳和不适，这为开发震颤的替代治疗奠定了基础。
Tremor is one of the most prevalent movement disorders. There is a large proportion of patients (around 25%) in whom current treatments do not attain a significant tremor reduction. This paper proposes a tremor suppression strategy that detects tremor from the electromyographic signals of the muscles from which tremor originates and counteracts it by delivering electrical stimulation to the antagonist muscles in an out of phase manner. The detection was based on the iterative Hilbert transform and stimulation was delivered above the motor threshold (motor stimulation) and below the motor threshold (sensory stimulation). The system was tested on six patients with predominant wrist flexion/extension tremor (four with Parkinson disease and two with Essential tremor) and led to an average tremor reduction in the range of 46%-81% and 35%-48% across five patients when using the motor and sensory stimulation, respectively. In one patient, the system did not attenuate tremor. These results demonstrate that tremor attenuation might be achieved by delivering electrical stimulation below the motor threshold, preventing muscle fatigue and discomfort for the patients, which sets the basis for the development of an alternative treatment for tremor.