High Density Surface EMG Assessment of Motor Unit Alterations after Stroke

描述（由申请人提供）：本研究项目的长期目标是了解半脑卒中后肌肉无力的复杂起源，并探索痉挛性麻痹肌肉相关肌纤维丢失、挛缩和其他关键内在特性变化的起源。具体来说，我们试图使用高密度表面肌电图（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病变后不同运动单元成分的改变。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是通过检查中风幸存者静息麻痹肌的自发放电模式，评估是否存在活跃的运动神经元变性或即将发生的运动神经元死亡的迹象。目的2是通过估计中风幸存者麻痹肌的运动单位数损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分解的最新进展来检查中风后运动单元控制特性的变化。目的4是使用一系列新颖的定量运动单位动作电位（MUAP）分析来检查中风后肌纤维萎缩、去神经支配/再神经支配的变化。除了提案的主要范围之外，还计划进行几项试点研究，以提取尽可能多的有用信息，以提高对中风运动单元特性的理解。采用新型高密度表面肌电技术的研究将增强我们对中风后肌肉无力的病理生理学和其他相关变化的理解，从而为恢复正常肌肉功能的康复策略和设备的开发提供指导。这种新型的高密度表面肌电技术的发现对脑卒中的诊断、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.