The Respiratory-motor Coupling

描述(由申请人提供)：主要重点是检查呼吸-运动耦合的神经生理学基础，并排除潜在的替代方案。我们假设存在手指屈曲-呼气、手指伸展-吸气耦合。这种耦合的神经生理学基础是，强迫呼气增强了指屈肌和指伸肌的皮质脊髓兴奋性，而强迫吸气增强了主要是指伸肌的兴奋。为了验证这一假设，我们将在正常受试者的各种任务中使用经颅磁刺激(TMS)和神经肌肉电刺激(ES)来量化与自愿呼吸(目标1)相关的皮质脊髓兴奋性的变化。在目标2中，我们将研究可能的替代机制，即自主呼吸效应是机械转移的产物或双重任务的产物。总体而言，该项目的结果可能为手指屈伸-呼气、伸指-吸气耦合的内在神经生理学基础提供证据。其长期目标是将自主呼吸和手指肌肉之间内在的生理耦合应用于中风后手指伸展障碍的康复，例如，在自主呼吸的吸气相给予手指伸肌电刺激，有望达到最大的刺激效果。公共卫生相关性：拟议的研究将使用非侵入性工具，如经颅磁刺激(TMS)和神经肌肉电刺激(ES)，检查呼吸-运动耦合的潜在神经生理学机制。潜在的替代机制将被排除。这一新发现的中风康复现象的潜在临床应用被证明。

DESCRIPTION (provided by applicant): The primary focus is to examine the neurophysiologic basis of the respiratory-motor coupling and to rule out potential alternatives. We hypothesize that there is a finger flexion-expiration, finger extension-inspiration coupling. The neurophysiologic basis for this coupling is that forced expiration enhances corticospinal excitability for the finger flexors and finger extensors, while forced inspiration enhances activation primarily for the finger extensors. To test the hypothesis, we will quantify changes in corticospinal excitability associated with voluntary breathing (Aim 1) using transcranial magnetic stimulation (TMS) and neuromuscular electrical stimulation (ES) in a variety of tasks in normal subjects. In Aim 2, we will investigate potential alternative mechanisms that the voluntary breathing effects are artifacts of mechanical transfer or of dual tasking. Collectively, outcomes of this project are likely to provide evidence for the intrinsic neurophysiologic basis of the finger flexion-expiration, finger extension-inspiration coupling. The long-term goal is to apply the intrinsic physiological coupling between voluntary breathing and finger muscles to rehabilitation of finger extension impairment after stroke, e.g. electrical stimulation delivered to the finger extensors on the inspiratory phase of voluntary breathing is expected to maximize the stimulation effect. PUBLIC HEALTH RELEVANCE: The proposed research examines underlying neurophysiologic mechanisms of the respiratory-motor coupling using non-invasive tools will be used, such as transcranial magnetic stimulation (TMS) and neuromuscular electrical stimulation (ES). The potential alternative mechanisms will be ruled out. Potential clinical applications of this newly discovered phenomenon for stroke rehabilitation are demonstrated.