吞咽障碍的高密度动态肌电评估及康复研究

Swallowing is one of the basic functions of human life to be lived and continued. Swallowing disorder or dysphagia is one of the severe syndromes in the patents who suffered from stroke, brain trauma, which may severely affect their daily activities, even their life. During swallowing, the contractions of swallowing muscles will generate electric signals that could be measured with surface electrodes. Since the surface myoelectric signals, which are generally called electromyography (EMG), closely correlate with the swallowing functions, they should provide very important information for the diagnosis and rehabilitation of normal swallowing and dysphagia. Currently, it is limited to accurately diagnose the swallowing disorders and evaluate their functions by using the EMG signals due to lacking of enough EMG information and proper analysis methods. In this project, we propose to use a high-density data acquisition system to measure the EMG signals of swallowing muscles in real time in both the subjects with a normal swallowing and the patents with a dysphagia. Using the high-density dynamic EMG recordings, we will investigate the relationships between EMG features and swallowing functions. And the mechanism of swallowing muscle synergy will be explored during normal swallowing and dysphagia, which could help us determine the targeted swallowing muscle(s) that may cause the swallowing disorders. Then we will develop the new rehabilitation methods for patents with swallowing disorders based on these findings above, which possibly achieves a targeted-muscles-based rehabilitation technique. With the successful implementation of this project, it is expected to find the novel methods for the accurate and non-invasive diagnosis and functional evaluation of swallowing disorders and to provide the new mechanism and techniques for the development of more efficient rehabilitation methods for patents with a swallowing disorder.

吞咽是人类维持生命的基本功能之一。作为脑卒中、脑外伤的并发症，吞咽障碍严重影响患者的日常生活，甚至危及生命。吞咽时吞咽肌产生的电生理活动与吞咽功能密切相关，因此，从体表采集的肌电将为吞咽功能的检测、诊断及其康复提供重要信息。由于缺乏对吞咽肌电活动信息的全面、实时检测及分析，目前还不能对吞咽障碍进行精确检测和功能评估，导致基于肌电的吞咽功能康复效果不佳。本项目拟利用多通道肌电采集系统，实时采集正常及异常吞咽情况下吞咽肌电信号，获得高密度的动态吞咽肌电信息，研究吞咽肌群动态肌电与吞咽功能的对应关系；探索吞咽过程中吞咽肌群的协同工作机制，了解吞咽障碍受损肌群和受损程度；进而研究针对吞咽障碍受损肌群的功能康复方法，实现吞咽功能的目标康复治疗。本项目的顺利实施，有望为吞咽障碍患者提供更加准确、无创的吞咽功能检测和评估方法，并为吞咽功能的康复提供新的理论方法和技术手段。

吞咽是人类维持生命的基本功能之一，涉及20多对肌肉的协同运动以及感觉系统和运动系统的平衡协调，是一个复杂的生理过程。吞咽过程中吞咽肌肉收缩产生的电生理活动与吞咽功能密切相关，从体表采集的肌电为吞咽功能的检测、诊断及其康复提供了重要信息。由于传统研究缺乏对吞咽肌电活动信息的全面、实时检测及分析，目前还不能对吞咽障碍进行精确检测和功能评估，导致基于肌电的吞咽功能康复效果不佳。针对这些局限性，本项目利用多通道肌电采集系统，采集不同吞咽任务下正常受试者的吞咽肌群高密度电信号，建立了动态高密度肌电电势图，对比不同量、不同浓度、不同头位下的肌电分布特性，了解吞咽肌群动态肌电与吞咽功能的对应关系；对吞咽过程的高密度肌电电势图作分期处理，分析吞咽不同周期所对应肌电变化特征，研究咽期颈部左右侧肌电的协同性，并采用非负矩阵分解和统计学方法对吞咽肌群的肌肉协同数量和协同结构进行分析，解析吞咽肌群的协同工作机制；招募吞咽障碍受试者，采集其特定吞咽动作下的高密度肌电，建立吞咽异常电势图与正常电势图进行对比分析，采用数字信号处理方法，定位受损肌群，为研究针对吞咽障碍受损肌群的功能康复方法提供依据；对比吞咽障碍患者康复治疗前后的吞咽高密度肌电特征，验证新技术的有效性和可靠性。本项目的顺利实施，为吞咽障碍患者提供更加准确、无创的吞咽功能检测和评估方法，并为吞咽功能的康复提供新的理论方法和技术手段，可为开发新一代快速精确的吞咽障碍诊断设备提供实验基础和技术依据。