Cov teebmeem ntawm Corticospinal Tract Homology Ntawm Faremus Personalized Neuromodulation Relieving Fatigue nyob rau hauv Ntau Yam Sclerosis: A Pov Thawj-of-Concept Study Part 1
Aug 31, 2023
Abstract: Lub Hom Phiaj: Kev qaug zog hauv ntau yam sclerosis (MS) yog ib qho kev mob tshwm sim tsis tu ncua, uas tuaj yeem kho tau los ntawm cov neuromodulation uas tsis muaj kev cuam tshuam, uas nthuav tawm tsuas yog cov kev mob tshwm sim tsis txaus ntseeg. Ib 5-hnub transcranial direct-tam sim no stimulation, 15 min ib hnub twg, anodically tsom lub somatosensory sawv cev ntawm tag nrho lub cev tiv thaiv ib tug loj occipital cathode tau zoo tiv thaiv MS qaug zog (kev qaug zog nyem nyob rau hauv ntau yam sclerosis, Faremus kho). Txoj kev tshawb fawb pov thawj tam sim no tau sim cov kev xav ua haujlwm uas Faremus S1 neuromodulation hloov kho homology ntawm qhov tseem ceeb thiab tsis yog-dominant corticospinal (CST) circuit recruitment. Cov txheej txheem: CST homology tau soj ntsuam los ntawm Fréchet kev ncua deb ntawm morphologies ntawm lub cev muaj zog (MEPs) evoked los ntawm transcranial magnetic stimulation nyob rau hauv homologous sab laug- thiab sab tes xis cov leeg ntawm 10 fatigued MS cov neeg mob ua ntej thiab tom qab Faremus. Cov txiaj ntsig: Thaum tsis muaj qhov hloov pauv hauv MEP nta xws li qhov sib txawv ntawm ob sab ntawm lub cev lossis raws li kev cuam tshuam ntawm kev kho mob, Faremus hloov pauv hauv kev coj noj coj ua CST's homology. Faremus cuam tshuam rau homology tau tshwm sim ntau dua li kev hloov pauv hauv cov neeg tseem ceeb thiab tsis muaj feem cuam tshuam. Cov ntsiab lus: Faremus-hais txog CST hloov pauv txuas ntxiv qhov cuam tshuam ntawm qhov sib npaug ntawm hemispheric homologs rau homology ntawm lub cev sab. Nrog rau txoj haujlwm no, peb pab txhawb rau kev txhim kho cov kev ntsuas tshiab network-rhiab heev uas tuaj yeem muab kev nkag siab tshiab rau hauv cov txheej txheem ntawm kev ua haujlwm ntawm cov kab mob neuronal hauv qab cov tsos mob.
Cistanche tuaj yeem ua raws li kev tiv thaiv kev qaug zog thiab lub zog ua kom muaj zog, thiab cov kev tshawb fawb sim tau pom tias decoction ntawm Cistanche tubulosa tuaj yeem tiv thaiv daim siab hepatocytes thiab endothelial hlwb puas hauv cov nas ua luam dej hnyav, txhawb kev qhia ntawm NOS3, thiab txhawb cov kab mob siab glycogen. synthesis, yog li exerting los tiv thaiv qaug zog. Phenylethanoid glycoside-nplua nuj Cistanche tubulosa extract tuaj yeem txo cov ntshav creatine kinase, lactate dehydrogenase, thiab lactate qib, thiab nce qib hemoglobin (HB) thiab piam thaj hauv ICR nas, thiab qhov no tuaj yeem ua lub luag haujlwm tiv thaiv kev qaug zog los ntawm kev txo qis cov leeg nqaij. thiab ncua lub lactic acid enrichment rau lub zog cia hauv nas. Compound Cistanche Tubulosa ntsiav tshuaj ua rau lub sijhawm ua luam dej hnyav, nce siab glycogen cia, thiab txo qis qib urea tom qab kev tawm dag zog hauv cov nas, qhia nws cov nyhuv tiv thaiv kev qaug zog. Lub decoction ntawm Cistanchis tuaj yeem txhim kho kev ua siab ntev thiab ua kom lub cev qaug zog hauv kev tawm dag zog nas, thiab tuaj yeem txo qhov siab ntawm cov ntshav creatine kinase tom qab kev tawm dag zog thiab ua kom lub cev nqaij daim tawv nqaij ntawm cov nas ib txwm muaj tom qab kev tawm dag zog, uas qhia tau hais tias nws muaj cov teebmeem. ntawm kev txhim kho lub cev muaj zog thiab tiv thaiv qaug zog. Cistanchis kuj tseem ua rau lub sijhawm muaj sia nyob ntawm cov nas uas muaj nitrite-poisoned thiab txhim kho lub siab ntev tiv thaiv hypoxia thiab qaug zog.
Nyem rau Fatigue Uas
【Yog xav paub ntxiv:george.deng@wecistanche.com / WhatsApp:8613632399501】
Ntsiab lus: transcranial direct-tam sim no stimulation (tDCS); transcranial hluav taws xob stimulation (tES); transcranial magnetic stimulation (TMS); corticospinal kab mob; ntau yam sclerosis (MS); tshuaj precision
1. Taw qhia
1.1. MS Fatigue
Ntau tus kab mob sclerosis (MS) yog ib tus kab mob neurodegenerative mob ntev, feem ntau yog tsav los ntawm cov txheej txheem inflammatory, uas ua rau cov kab mob demyelinating pom nyob rau hauv cov teeb meem dawb thiab grey thoob plaws hauv nruab nrab paj hlwb [1]. Qhov pib ntawm tus kab mob no feem ntau yog nyob ntawm 20 mus rau 40 xyoo ntawm lub hnub nyoog thiab, nyob rau hauv nws cov kev kho mob tshwm sim feem ntau hu ua relapsing-remitting MS (RRMS), tshwm sim nrog mob reversible neurological deficits kav ntev li ob peb hnub los yog lub lis piam, thaum nyob rau hauv ib tug tsawg ntawm cov neeg mob. , muaj ib tug zuj zus zuj zus ntawm tus kab mob hu ua thawj MS (PPMS). Txawm li cas los xij qhov kev kho mob tshwm sim thiab theem ntawm tus kab mob, kev qaug zog ntev yog ib qho ntawm cov tsos mob cuam tshuam uas cuam tshuam rau lub neej txhua hnub txog li 80% ntawm cov neeg mob [2]. Txhais raws li "qhov txo qis hauv lub cev thiab / lossis kev puas siab puas ntsws uas tshwm sim los ntawm kev hloov pauv hauv nruab nrab, kev puas siab puas ntsws, thiab / lossis cov khoom nruab nrab" [3,4], qaug zog ua rau muaj kev nyuaj rau nws qhov kev ntsuam xyuas thiab kev kho mob, uas tseem yog txwv rau cov tshuaj, nrog cov pov thawj me me ntawm kev ua tau zoo thaum tseem qhia cov kev mob tshwm sim tsis zoo [5].
1.2. Vim li cas thiaj thov Excitatory Neuromodulation tshaj S1 hauv Kev Kho MS Fatigue
Xav txog cov yam ntxwv ntawm kev ua haujlwm tsis zoo ntawm MS qaug zog [6], muaj kev pom zoo hauv cov ntaub ntawv hais txog kev hloov pauv ntawm cov hluav taws xob neuronal hauv qib ntawm cov sensorimotor network [7]. Tshwj xeeb, MS cov neeg mob qaug zog ua rau pom qhov tsis txaus siab ntawm thawj somatosensory thiab post-central tes hauj lwm [8–11] nyob rau hauv sib piv rau hyperactivation thiab ntau excitability pom nyob rau hauv frontal cheeb tsam [12] thiab thawj lub cev muaj zog cortices (M1) ob qho tib si ntawm so thiab thaum lub sij hawm lub cev muaj zog tua. [13–15]. Yog li ntawd, kev qaug zog ntev, ua ke nrog ntau yam kab mob thiab cov tsos mob tshwm sim los ntawm kev hloov pauv neuronal hluav taws xob ua haujlwm, sawv tawm raws li lub hom phiaj tsim nyog rau kev kho mob siv electroceuticals [16,17], cov chav kawm tshiab ntawm cov khoom siv kho mob los ntawm kev muab khoom. ntawm hluav taws xob tam sim no los ntawm invasive lossis non-invasive neuromodulations. Ntawm cov uas tsis yog-invasive, transcranial direct-tam sim no stimulation (tDCS) muaj peev xwm ntawm modulating daim nyias nyias excitability ntawm neurons teej tug mus rau thoob plaws cortical tes hauj lwm los ntawm xa tsis muaj zog hluav taws xob tam sim no los ntawm electrodes nyob rau ntawm daim tawv nqaij, thaum kawg inducing ib tug hloov nyob rau hauv cortical excitability thaum xa. rau lub sijhawm txaus [18–21]. tDCS tau siv dav los kho MS qaug zog [22,23], ua pov thawj nws qhov tsim nyog hauv kev ua haujlwm nrog kev hloov pauv hauv qab no cov tsos mob ntsig txog lwm cov txheej txheem neurophysiological nrog ntau focal mechanisms ntawm kev txiav txim, xws li rov ua dua transcranial magnetic stimulation (rTMS), uas tau ua. pov thawj los ntawm kev txwv tsis pub siv hauv qhov xwm txheej no [24].
Raws li cov ntaub ntawv hais saum toj no ntawm lub hlwb hluav taws xob ua haujlwm ntawm MS qaug zog ua rau muaj kev cuam tshuam tsis zoo ntawm parietal-frontal kev sib txuas, peb tau hloov kho tDCS schema uas twb tau ua tiav kev txhim kho ntawm kev tiv thaiv kev qaug zog hauv cov neeg noj qab haus huv [25] siv kev cuam tshuam electroceutical tiv thaiv. qaug zog hauv MS hu ua Faremus (kev qaug zog hauv ntau yam sclerosis) [23,26–28].
Faremus yog tus kheej 5-hnub anodal tDCS (1.5 mA, 15 min hauv ib hnub) uas tsom mus rau tag nrho lub cev thawj thaj chaw somatosensory (S1) los ntawm cov ntaub ntawv txheej txheem ntawm shaping lub anodal electrode (35 cm2) raws li MRI- derived ib tus neeg cortical folding ntawm lub hauv paus sulcus kom tawm ntawm thawj lub cev muaj zog cortex (M1) thiab pre-central cheeb tsam unstimulated [29–31]. Lub cathode tshaj ob sab occipital qhov chaw yog ob-chaw electrode (7 × 10 cm2) kom tsis txhob muaj cov teebmeem inhibitory ntawm qhov muag cortices.
Kev qaug zog hauv MS tau raug tsom los ntawm ntau yam kev cuam tshuam cov txheej txheem ua haujlwm tDCS, nrog rau qhov sib txawv stimulation tsis thiab lub hom phiaj cortical [32,33]. Ntawm cov no, dorsolateral prefrontal cortex, M1, thiab S1 sawv cev rau feem ntau soj ntsuam. Txawm li cas los xij, qhov sib txawv vim muaj qhov sib txawv ntawm cov kev sib tham, qhov kev siv tam sim no thiab lub sijhawm, cov qauv loj, thiab cov txiaj ntsig kev ntsuas tsis pub cuam tshuam qhov twg tDCS tsis zoo dua. Txawm li cas los xij, cov txiaj ntsig ntawm qhov ntsuas tsis ntev los no thiab ntsuas ntsuas ntsuas los ntawm Gianni li al. [23] tsom rau chav kawm 1 RCTs uas muaj tDCS kev cuam tshuam tawm tsam cov tsos mob feem ntau cuam tshuam nrog neuronal hluav taws xob tsis sib npaug tau qhia tias Faremus ob sab S1 anodal stimulation tsis tu ncua pom kev kho mob tau zoo hauv kev txo qis qaug zog [23,26–28].
1.3. Qhov sib npaug ntawm Hemilateral Homologs yog qhov tseem ceeb rau kev ua haujlwm muaj peev xwm
Kev noj qab haus huv lub hlwb yog nyob ntawm qhov sib npaug ntawm cov cheeb tsam hemispheric homologous, qhib los ntawm cov tub ntxhais cerebral mechanism ntawm inter-hemispheric inhibition, ib qho tseem ceeb ntawm lub paj hlwb ua haujlwm tau los ntawm kev sib koom ua ke ntawm cov phiaj xwm cuam tshuam rau ib puag ncig / sab nraud inhibition tes hauj lwm tsom rau kev txhawb nqa kev sib txawv thiab kev sib koom ua ke. los ntawm kev sib npaug ntawm cov haujlwm ntawm ob lub hemispheres [34]. Kev sib cuam tshuam ntawm qhov kev ua ntawm homologous hemispheric thaj chaw tuaj yeem pom tau tias yog ib qho kev ua haujlwm ntawm cov txheej txheem uas txhawb nqa cov yas adaptation thiab kev kawm ntawm lub hlwb [35,36] nkag mus rau cov kev cai ntawm inhibition thiab excitation mechanisms uas txhawb kev ua haujlwm ntawm lub hlwb. lub cev ntu lawv tswj.
Raws li yav dhau los tau pom, MS cov neeg mob qaug zog tso tawm cov ntaub ntawv electrophysiological sib haum nrog cov kev hloov hauv zos ntawm lub cev excitatory-inhibitory mechanisms [7,13-15], theem nrab lossis ua rau qaug zog nws tus kheej, uas tseem cuam tshuam rau qhov tsis txaus ntseeg ntawm kev sib raug zoo ntawm kev sib raug zoo ntawm sensorimotor. cheeb tsam ob qho tib si thaum so [37] thiab thaum lub sij hawm txav txav [38–40]. Cov ntaub ntawv pov thawj no ua rau muaj cov tsos mob qaug zog ntxiv nrog kev hloov pauv hloov pauv kev sib cuam tshuam ntawm homologous cortical thaj chaw, thaum tsis muaj kev hloov pauv ntawm cov qauv parenchymal, ntxiv txhawb kev hloov pauv feem ntau ntawm cov sensorimotor system hauv MS qaug zog. Qhov tseem ceeb, thaj chaw somatosensory koom nrog hauv cov noob caj noob ces thiab kev kho mob qaug zog siv Faremus yog ib feem ntawm keeb kwm ntawm CSTs. Kwv yees li 60% ntawm cov fibers uas ua rau CST yog los ntawm pre-central gyrus [41] thiab li ntawm 30% los ntawm thawj thaj chaw somatosensory [42] thiab parietal operculum [43]. Ntxiv mus, ib qho kev tshawb fawb yav dhau los ntawm cov txheej txheem ntawm kev ua ntawm Faremus kev kho mob [11] tau pom tias qhov txo qis hauv cov qib qaug zog tau cuam tshuam nrog kev sib npaug ntawm kev ua haujlwm sib txuas hauv qhov tseem ceeb ntawm cov sensorimotor network (ob sab S1 thiab M1), ua rau ib qho kev txhawb zog tseem ceeb ntawm kev sib cuam tshuam ntawm ob thaj chaw homologous M1.
Ntawm cov hauv paus no, nws muaj peev xwm xav tias qhov cuam tshuam ntawm Faremus S1 neuromodulation, tsom mus rau normalizing cov qauv kev ua kom zoo nyob rau hauv cov thawj sensorimotor system, tuaj yeem ntes tau raws tag nrho cov hauv nruab nrab--peripheral CST txoj hauv kev raws li tau hais los ntawm TSM-induced MEP nta [ 44, 45] ib.
1.4. Corticospinal Tracts thiab MEP Morphology
Ib leeg-pulse supra-threshold TMS tshaj M1 yog dav siv los ntsuas qhov ua haujlwm ntawm CST raws li qhov tshwm sim ntawm cov mem tes nthuav tawm raws tus txha caj qaum kuaj pom ntawm cov leeg tsis sib xws nrog cov electrodes saum npoo raws li lub cev muaj zog (MEP) [46] .
Nyob rau hauv peb lub hom phiaj ntawm kev ntsuam xyuas kev sib tshuam (dominant vs. non-dominant) homology, peb muab qhov ntsuas raws li qhov zoo sib xws ntawm cov qauv kev xaiv neeg ua haujlwm raws li peb tau ua rau somatosensory evoked muaj peev xwm (SEPs) [47] thiab teb (SEFs) [48, 49] ntawm morphologies ntawm evoked teb, MEPs nyob rau hauv qhov kev tshawb fawb tam sim no. Analogously, thiab nyob rau hauv kev pom zoo nrog tsis ntev los no loj-scale kev ntsuam xyuas ntawm MEP morphology [50], ntawm no, peb tsom xam kom muaj nuj nqis yuav ua li cas Faremus kev kho mob hloov qhov sib npaug ntawm CST recruitment ntawm tseem ceeb thiab tsis-dominant lub cev sab raws li kev soj ntsuam los ntawm lub morphology zoo sib xws ntawm sab laug. - thiab sab tes xis leeg MEPs. Txog rau qhov kawg no, peb siv qhov kev ntsuas ntawm qhov zoo sib xws ntawm ob txoj kab nkhaus, Fréchet nrug [51,52], raws li peb twb tau ua hauv cov neeg ua haujlwm noj qab haus huv [53].
1.5. Kawm Aim
Los ntawm txoj kev tshawb fawb pov thawj-ntawm-lub tswv yim tam sim no, peb tsim cov kev xav ua haujlwm uas Faremus yuav hloov kho hauv kev coj noj coj ua ntawm homology ntawm ob CSTs. Peb tseem yuav soj ntsuam kev sib raug zoo ntawm inter-side MEP morphology zoo sib xws nrog rau sab hauv rau ob qho tib si tseem ceeb thiab tsis tseem ceeb CSTs. Rau qhov yooj yim, peb yuav xa mus rau qhov tseem ceeb CST, piv txwv li, los ntawm sab laug hemisphere mus rau sab tes xis, raws li DxDx thiab, piv txwv li, SnSn thiab DxSn rau cov intra-side non-dominant thiab inter-side CSTs, feem.
Nyob rau hauv rooj plaub ntawm kev hloov pauv ntawm kev ua ntej thiab tom qab Faremus, peb yuav sim seb puas muaj kev sib raug zoo ntawm cov kev hloov pauv uas tshwm sim los ntawm kev kho mob Faremus thiab kho cov tsos mob qaug zog.
2. Cov txheej txheem
Txhua txoj hauv kev tau ua los ntawm Kev Tshaj Tawm ntawm Helsinki. Pawg Neeg Saib Xyuas Kev Ncaj Ncees Lazio1—San Camillo Forlanini tau pom zoo cov txheej txheem sim (023/CE Lazio1, 11 Lub Ib Hlis 2016). Txhua tus neeg mob tau kos npe rau daim ntawv pom zoo ua ntej lawv tso npe.
2.1. Kawm Tsim
Txoj kev tshawb fawb pov thawj tam sim no tsom mus rau cov txheej txheem ntawm kev ua ntawm Faremus, thaum nws qhov kev ua tau zoo tau sim los ntawm ob qho kev ywj pheej ob qhov muag tsis pom kev, sham-tswj, crossover randomized controlled trials (RCTs) twb tau luam tawm [26,27]. Qhov txiaj ntsig ntawm RCT yog qhov txo qis ntawm qaug zog raws li ntsuas los ntawm kev hloov pauv kev qaug zog cuam tshuam qhov ntsuas (IFIS), daim ntawv nug validated nrog 21 yam tshuaj ntsuam xyuas kev qaug zog ntev nrog rau lub cev, kev txawj ntse, thiab kev puas siab puas ntsws [54].
Txoj kev tshawb no, ntxiv rau RCTs tseem ceeb ntawm kev ua tau zoo ntawm Faremus hauv kev txo qis MS qaug zog, ntsuas qhov cuam tshuam ntawm Faremus ntawm CST homology (Daim duab 1). Peb kwv yees qhov zoo sib xws ntawm sab laug thiab sab xis MEP morphologies ua ntej thiab tom qab Faremus.
TMS raws tu qauv tau ua tiav hauv lub hauv paus (T{{{0}}}; pre-Faremus, hnub ntawm thawj daim ntawv thov tDCS thiab ua ntej stimulation) thiab tom qab Faremus (T1; hauv 8 tus neeg mob, TMS raug tua rau hnub thib tsib, tos 4 teev tom qab qhov kawg ntawm tDCS stimulation, thiab hauv 2 tus neeg mob, nws raug tua rau hnub Monday tom qab, piv txwv li, 7 hnub tom qab T0). Txhua tus neeg mob tau txais kev sau ntawm TMS-induced MEPs los ntawm ob sab ntawm lub cev (saib daim duab 1 thiab 2).
Cov neeg mob tau raug xaiv yog tias kuaj pom tias muaj kev rov qab los-muab MS raws li Mc-Donald's cov txheej txheem [55] thiab ua raws li cov txheej txheem tsim nyog raws li hauv qab no.
Cov txheej txheem suav nrog yog raws li hauv qab no:
• Tsis muaj cov ntaub ntawv kuaj mob lossis hluav taws xob pov thawj ntawm cov kab mob ua haujlwm (NEDA) tsawg kawg 3 lub hlis ua ntej qhov kev kawm;
• Tsawg degree ntawm kev tsis taus raws li kwv yees los ntawm Expanded Disability Status Scale (EDSS, Kurtzke 1983) < 2.5;
• Kev qaug zog raws li kev kwv yees los ntawm mFIS > 30.
• Kev Cai cais tawm yog raws li nram no:
• Tam sim no lossis ua ntej (tsawg dua 12 lub lis piam ua ntej tso npe) raug rau cov tshuaj puas siab puas ntsws (antidepressant, anxiolytic, antipsychotics, anticonvulsants, thiab cov tshuaj myorelaxant);
• Kev sib koom ua ke ntawm lwm yam mob uas muaj feem cuam tshuam nrog kev qaug zog (piv txwv li, ntshav ntshav thiab cev xeeb tub);
• Tam sim no lossis ua ntej (tsawg dua 4 lub lis piam ua ntej tso npe) raug rau cov khoom tiv thaiv kev qaug zog;
• Keeb kwm ntawm qaug dab peg
Tus kws kho mob hlwb tau sau cov keeb kwm kho mob uas suav nrog lub sijhawm tus kab mob thiab tus nqi rov qab txhua xyoo, EDSS, thiab Beck Depression Inventory (BDI).
Kev Kho Mob Faremus (5-Hnub Anodal tDCS nrog tus kheej S1 Electrode)
Raws li cov ncauj lus kom ntxaws hauv [26,27], tus kheej electrode (lub cheeb tsam tus kheej tus kheej electrode, RePE) tau zoo li los ntawm lub hlwb anatomical MRI ntawm txhua tus neeg mob kom haum rau lub hauv paus sulcus thiab tsom mus rau tag nrho lub cev somatosensory sawv cev (Daim duab 1). Rau 5 hnub sib law liag, ib qho RePE anode tau raug muab tso rau ntawm neuronavigation [SofTaxic Neuronavigation System ver.2.0 (www.softaxic.com, EMS, Bologna, Ltalis)] hla lub hauv paus sulcus (5 hli anteriorly, 15 mm posteriorly), thiab tDCS tau thov rau 15 min hauv ib hnub, xa 1.5 mA tam sim no hla ntawm RePE anode (35 cm2) thiab lub kaum sab xis occipital cathode nyob nruab nrab ntawm Oz ntawm electroencephalographic thoob ntiaj teb system, nrog rau sab ntev ntawm txoj kab ntev ( 10 × 7 cm2).
2.2. MEP Collection thiab Analysis
Stimulation thiab kaw kev teeb tsa
Cov kev soj ntsuam tau pw ntawm ib lub rooj zaum xis nyob hauv ib chav nyob ntsiag to. Cov leeg nqaij cov cim (electromyogram, EMG) ntawm tus neeg sib tw lub paj hlwb (OP) ntawm sab xis thiab sab laug txhais tes tau hnov los ntawm ob lub electrodes (2.5 cm sib nrug) hauv plab-hluas montage. Peb tau ua ib leeg-pulse TMS los ntawm tus qauv focal coil txuas nrog SuperRapid module (The Magstim Company Ltd., Whitland, UK). Rau txhua qhov kev kawm, peb tau tshawb nrhiav lub kauj txoj hauj lwm evoking zoo MEP los ntawm contralateral OP, thiab peb ntsuam xyuas lub cev muaj zog so pib (RMT) - txhais raws li thoob ntiaj teb cov qauv raws li qhov siv eliciting MEPs nyob rau hauv 50 microV amplitude scale nyob rau hauv txog 50% ntawm 16 kev sim sib law liag [56]. TMS tau siv ntawm qhov kev siv zog hloov mus rau 120% ntawm RMT. TMS stimuli tau elicited nrog ib tug interpulse lub sij hawm random hloov ntawm 4 s thiab 6 s sau txog 20 repetitions rau txhua sab [57,58]. Qhov muaj MEPs tau ua rau qhov nruab nrab ntawm 18 ib sab.
2.3. MEP Morphology Zoo sib xws
Peb siv Fréchet nrug kwv yees siv hauv Matlab [59]. Qhov kev ncua deb ntawm Fréchet kwv yees qhov tsawg kawg ntawm txoj hlua ntev txaus los koom nrog ob lub ntsiab lus taug kev mus rau pem hauv ntej raws ob txoj kab nkhaus, xav txog tus nqi ntawm kev mus los rau ob qho tib si tsis tas yuav tsum zoo ib yam.
Txhawm rau kwv yees tus kheej zoo sib xws ntawm ob lub CST hemi-lub cev, peb ntsuas Fréchet kev ncua deb ntawm txhua 18 txoj cai thiab 18 sab laug OP MEPs, tau txais 324 DxSn MEP Fréchet nrug. Ib yam li ntawd, qhov kev kwv yees intra-sided muaj (n k ) nrog n=18 thiab k=2, ua rau 153 Fréchet nrug (rau txhua DxDx thiab SnSn)
2.4. Kev txheeb cais
Muab qhov muaj txiaj ntsig ntau, peb tsis tau tso siab rau Shapiro-Wilk kev sim rau qhov qub. Los ntawm kev tshuaj xyuas qhov kev faib tawm, peb pom cov lej loj ntawm cov neeg tawm sab nraud, thiab vim li no, peb hloov pauv qhov tseem ceeb ntawm Fréchet nyob deb li cas siv lub ntuj logarithmic muaj nuj nqi. Lub amelioration ntawm Gaussian haum tsis txaus siab; Yog li, kev tshuaj ntsuam xyuas tau ua los ntawm qhov tsis yog-parametric Wilcoxon-matched paired signed-rank tests.
Peb tau tshaj tawm qhov tshwm sim rau qhov tseem ceeb ntawm cov nyhuv ntawm p < 0.050.
Yuav kom ua raws li cov ntaub ntawv tam sim no, peb kuj tau soj ntsuam qhov latency thiab amplitude ntawm MEPs ntawm ob sab ntawm lub cev thiab qhov sib txawv ntawm sab nraud, tsom tshwj xeeb rau qhov sib txawv ntawm intra- thiab inter-lateral amplitude, sim cov kev xav tias Faremus. yuav hloov kho homology ntawm ob CSTs los ntawm kev hloov kho MEP zoo sib xws hauv kev coj ua lub cev.
Kev txheeb xyuas txheeb cais tau ua los ntawm SPSS 27.
2.5. Cov ntaub ntawv muaj
MEPs, Fréchet algorithms, tus kheej, thiab cov ntaub ntawv kho mob tsis qhia npe yuav muaj thaum thov.
3. Cov txiaj ntsig
Kaum qhov kev kawm nrog MS kev txom nyem los ntawm qaug zog nkag mus rau txoj kev tshawb no. Cov qib qaug zog txo qis tom qab hais txog ua ntej Faremus (Table 1, ob-tailed t-test rau cov qauv ua ke, t(9)=2.556, p=0.031) nrog 27% amelioration ntawm nruab nrab , raws li tau hais los ntawm mFIS feem pua hloov pauv, piv txwv li, qhov sib txawv ntawm mFIS cov qhab nia ua ntej thiab tom qab Faremus muab faib los ntawm mFIS cov qhab nia ua ntej nws (Table 1).
3.1. Faremus cuam tshuam rau MEP Morphology Zoo ib yam li qhov ntsuas ntawm Ob CSTs 'homology
Qhov tsis yog-parametric Wilcoxon ib sab kos npe-qib xeem (Pre> Post) qhia tias qhov sib nrug ntawm sab DxSn Fréchet deb ua ntej Faremus (txhais qib=5.414) siab dua tom qab Faremus (txhais tau tias qeb {{6 }}.061, Z=1.886, p=0.032; Daim duab 3A).
Kev sib piv sab hauv tsis tau qhia tias qhov kev ncua deb ntawm Fréchet ua ntej Faremus siab dua tom qab Faremus, xws li hauv DxDx (Z= 1.478, p=0.080) lossis SnSn piv (Z{{5}) }.255, p=0.423; Daim duab 3B, C).
【Yog xav paub ntxiv:george.deng@wecistanche.com / WhatsApp:8613632399501】
