High Density Surface EMG Assessment of Motor Unit Alterations after Stroke

描述(申请人提供)：本研究项目的长期目标是了解大脑半球中风后肌肉无力的复杂原因，并探索与痉挛-瘫痪肌肉相关的肌肉纤维丢失、痉挛和其他关键的内在特性变化的原因。具体地说，我们试图利用高密度表面肌电信号(EMG)记录和处理技术的最新进展来确定这些特征是否涉及上运动神经元损伤后不同运动单位成分的变化。基本的临床和研究问题将通过四个具体目标来解决。目的1是通过检测卒中幸存者静息瘫痪肌肉的自发放电模式，评估是否存在运动神经元的活动性变性或即将死亡的迹象。目的2是通过评估卒中幸存者瘫痪肌肉中运动单位数量的丢失来评估是否有脊髓运动神经元变性的证据。目的3是利用高密度表面肌电信号分解的最新进展，研究中风后运动单位控制特性的变化。目的4是使用一系列新的定量运动单位动作电位(MUAP)分析来检查中风后肌肉纤维萎缩、失神经/再神经支配的变化。除了该提案的主要范围外，还计划进行几项试点研究，以提取尽可能多的有用信息，以改善对中风患者运动单位特性的了解。这项利用新型高密度表面肌电信号技术进行的研究将加深我们对卒中后肌肉无力和其他相关变化的病理生理学的理解，从而为开发恢复正常肌肉功能的康复策略和装置提供指导。高密度表面肌电信号新技术的发现对卒中的诊断、检查和药物/治疗研究也具有重要的临床价值。

DESCRIPTION (provided by applicant): The long-term goal of this research project is to understand the complicated origins of muscle weakness after a hemispheric stroke, and also to explore the origins of the associated muscle fiber loss, contracture, and other key intrinsic property changes of the spastic-paretic muscles. Specifically, we seek to use the most recent advances in high density surface electromyogram (EMG) recording and processing techniques to determine whether these features involve alterations in different motor unit components after an upper motoneuron lesion. The basic clinical and research questions will be addressed via four specific aims. Aim 1 is to assess whether there is active motoneuron degeneration or signs of impending motoneuron death, by examining the patterns of spontaneous discharge in resting paretic muscles of stroke survivors. Aim 2 is to assess whether there is evidence for spinal motoneuron degeneration by estimating the motor unit number loss in paretic muscles of stroke survivors. Aim 3 is to examine alterations in motor unit control properties post stroke using recent advances in high density surface EMG decomposition. Aim 4 is to examine muscle fiber atrophy, denervation/reinnervation changes post stroke using a range of novel quantitative motor unit action potential (MUAP) analyses. Beyond the major scope of the proposal, several pilot studies are planned as well to extract as much useful information as possible for an improved understanding of motor unit property in stroke. The proposed research using novel high density surface EMG techniques will enhance our understanding of the pathophysiology of muscle weakness and other associated changes after stroke, thus providing guidance for the development of rehabilitation strategies and devices for restoration of normal muscle functions. The findings from the novel high density surface EMG techniques will also have important clinical value to diagnosis, examination and medication/therapy study of stroke.