藉心率變異和腦波之頻譜分析探討尿毒症患者中樞自律神經系統調節網路

Central autonomic network in uremics studied by spectral analysis of simultaneous heart rate variability and electroencephalography

劉立民(Li-Min Liou)

指導教授 ： 賴秋蓮

高雄醫學大學/醫學院/醫學研究所/碩士(2010年)

摘要

自律神經系統異常是尿毒症患者常見的併發症，也是尿毒症患者過高的心血管疾病相關死因之一，而如帕金森氏症、腦中風及蜘蛛網膜下腔出血等之中樞神經系統疾病，也常伴隨著自律神經系統異常。因此，在中樞神經系統應存在著一個自律神經系統的調節中樞，能與周邊自律神經系統交互作用來調節、控制自律神經系統。本研究藉同步記錄心率變異和腦波之頻譜分析，來探討尿毒症患者之中樞自律神經系統調節網路。
結果發現不論是在正常控制組或者是尿毒症患者，於大腦中樞神經系統都具有自律神經系統的調節中樞；但是，他們的位置是不同的。尿毒症患者，因為合併有自律神經系統異常，所以它的中樞自律神經系統的調節位置，不同於正常控制組的大腦顳葉 (temporal cortex)，而是轉移到大腦矢狀切面附近 (para-saggital area) 的位置。另外，本研究也發現交感神經系統的活性似乎和腦波alpha, theta, 和delta 頻帶的強度 (alpha, theta, delta EEG power) 有關，而副交感神經系統的活性似乎和腦波beta 頻帶的強度 (beta EEG power) 有關。

關鍵字

中樞自律神經系統網路 ； 尿毒症 ； 心律變異 ； 腦波圖 ； 頻譜分析

並列摘要

Autonomic dysfunction, which is common in uremics is one of the explanation of the excess cardiovascular mortality. Some central nervous system diseases may result in autonomic dysfunction, such as Parkinson’s disease and stroke. There may be a central autonomic network (CAN) connecting with the peripheral nervous system for modulating the autonomic function. We use spectral analysis of simultaneous heart rate variability and electroencephalography to investigate the CAN in uremics.
In conclusion, we found that there is CAN both in control and uremics. However, the CAN in control and uremics are different in location. We suggested that there is a switch from the use of temporal areas in control to para-sagittal areas in uremics with autonomic dysfunction. In addition, the sympathetic activity seems to correlate with alpha, theta, and delta EEG power, while the para-sympathetic activity correlates with beta EEG power.

並列關鍵字

central autonomic network ； uremia, heart rate variability ； electroencephalography ； spectral analysis

參考文獻

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