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。我们假设有一个手指屈曲-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，而强迫吸气主要增强了指伸肌的激活。为了验证这一假设，我们将使用经颅磁刺激（TMS）和神经肌肉电刺激（ES）在正常受试者的各种任务中量化与自主呼吸（Aim 1）相关的皮质脊髓兴奋性的变化。在目标2中，我们将研究自主呼吸效应是机械转移或双重任务的潜在替代机制。总的来说，这个项目的结果可能为手指屈曲-呼气，手指伸展-吸气耦合的内在神经生理学基础提供证据。长期目标是将自主呼吸与手指肌肉之间的内在生理耦合应用于卒中后手指伸指损伤的康复，例如，在自主呼吸吸气期对手指伸指肌进行电刺激，有望使刺激效果最大化。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机制。可能的替代机制将被排除在外。这一新发现的现象在脑卒中康复中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.