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球卒中后肌无力的复杂起源，并探索相关肌纤维丢失、挛缩和痉挛-麻痹肌肉的其他关键内在特性变化的起源。具体而言，我们寻求使用高密度表面肌电图（EMG）记录和处理技术的最新进展，以确定这些功能是否涉及上运动神经元损伤后不同运动单元组件的改变。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肉的自发放电模式来评估是否存在活动性运动神经元变性或运动神经元即将死亡的迹象。目的2是通过估计中风幸存者麻痹肌肉中运动单位数量的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图分解的最新进展来检查中风后运动单元控制特性的改变。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纤维萎缩、去神经支配/再神经支配的变化。除了建议的主要范围外，还计划进行几项试点研究，以提取尽可能多的有用信息，以更好地了解中风中的运动单位属性。使用新的高密度表面肌电图技术的拟议研究将提高我们对中风后肌无力和其他相关变化的病理生理学的理解，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。高密度表面肌电新技术的研究结果对脑卒中的诊断、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.