使用大腦皮質-肌肉同調性與嬰兒動作發展的關係研究

Abstract

介紹 大腦皮質-肌肉同調性是使用腦波及表皮肌電圖記錄及測量兩者的頻率同調性(coherence)，表示大腦皮質和肌肉功能性連結的程度。這是一種非侵入性的測量方法，研究自主性的動作。我們研究目的是大腦皮質-肌肉同調性是否可以用來評估嬰兒運動發展狀況。 方法 本研究收錄2-3個月大，正常出生史的嬰兒，觀察嬰兒早期的不安運動(fidgety movement)。使用腦波機紀錄當嬰兒在自主運動時的腦部運動皮質區(Cz)的腦波以及使用表面肌電圖貼片紀錄小腿脛前肌肌電圖，來計算大腦皮質-肌肉同調性。並於嬰兒6-7個月大時使用貝萊嬰兒發展量表評估運動發展狀況。 結果 我們收錄了20位嬰兒，平均月齡為2.4±0.3個月大，進行腦波以及表皮肌電圖的紀錄，分析其中18 位受試者的大腦皮質-肌肉同調性，發現11位出現顯著相關。同調性顯著性在腦波各個頻帶皆有出現，以γ頻帶的受試者稍多（7/11, 64%）。有15位受試者在平均月齡6.4±0.3個月大回診追蹤貝萊嬰兒發展量表，並無發現動作發展遲緩，但有4位是粗動作邊緣發展遲緩。比較有無大腦皮質-肌肉同調性相關和貝萊嬰兒發展量表粗動作正常發展和邊緣發展的差異。相關的統計結果並無出現顯著的差異。 結論 我們的研究顯示大部分(61%)正常嬰兒在2-3個月大時出現顯著大腦皮質-肌肉同調性。相對於動作邊緣發展的嬰兒，對於偵測正常發展嬰兒的敏感性不高(53%)。進一步研究也許可和真正發展遲緩的嬰兒作比較，評估大腦皮質-肌肉同調性在臨床使用的可行性。

Introduction Corticomuscular coherence (CMC) quantitatively measures the frequency correlation between electroencehalography (EEG) and surface electromyography (EMG), as an indicator of functional corticospinal connectivity between the primary motor cortex and limb muscles. These methods are non-invasive and suitable for investigating fidgety movements in infancy. The aim of our study is evaluating the association between CMC and early motor development in infancy Methods Twenty infants who were 2-3 months old, normal-delivery birth participated this study. EEG was recorded from the primary motor cortex area (Cz). Surface EMG was recorded from the right and left tibialis anterior muscles. The motor development was evaluated using the Bayley Scales of Infant Development, third edition (Bayley-III) at 6-7 months of age. Results We enrolled 20 infants, mean aged 2.4±0.3months for recording of EEG and surface EMG, and analyzed CMC in 18 of them. Eleven out of the 18 neonates (61%) showed significant CMCs and distributed in all frequency bands. The majority frequency band of CMC significance was gamma band (7 infants). Fifteen subjects, mean aged 6.4±0.3months were followed by Bayley-III. All of these infants had normal development including borderline gross motor development in 4. If we proposed borderline development as delay, there was no significant association between in Bayley-III developmental results and CMC significance using Fisher's exact tests. There was also no significant difference between gross motor scales in Bayley-III and CMC significance by independent student t-test. Conclusion Our study showed that the majority of normal infants were detected significant CMC at 2-3 months of age. Compared with the infants with borderline development, the sensitivity of normal development of infants is not high (53%). The availability of CMC is required by further study in developmental delay infants.