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研究生: 陳政澤
Chen, Cheng-Tse
論文名稱: 大鼠長期使用閉迴路深顱電刺激器之癲癇抑制效能分析
A Long-term Analysis of the Close-loop Seizure Controller with Deep-brain Electrical Stimulation on Long-evans Rats
指導教授: 梁勝富
Liang, Sheng-Fu
學位類別: 碩士
Master
系所名稱: 電機資訊學院 - 資訊工程學系
Department of Computer Science and Information Engineering
論文出版年: 2014
畢業學年度: 102
語文別: 英文
論文頁數: 53
中文關鍵詞: 癲癇癲癇偵測腦電圖腦部刺激閉迴路長時間實驗
外文關鍵詞: Epilepsy, seizure detection, electroencephalogram (EEG), brain stimulation, closed-loop, long-term
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  • 癲癇是一種常見的神經系統疾病,世界上約有不到百分之一的人口患有這種疾病。然而至今已存在多種的治療方法可以根據個別的症狀對症下藥,像是抗癲癇藥物或是癲癇手術。但仍有大約四分之一的癲癇患者沒有辦法透過現存的醫療技術有效治療或是減輕他們的症狀。癲癇發生的主因是來自腦部的不正常放電。因此腦電波自然成為觀察、偵測癲癇、甚至更進一步開發治療方法的最佳工具。而多項以腦電圖為基礎開發的閉迴路式腦部電刺激系統已被提出且付諸實行,目前NeuroPace的RNS system已於2013年通過美國食品藥物管理局認證。而Medtronic的the Intercept™ Epilepsy Control System則於2012年五月結束試驗並於2013年通過美國食品藥物管理局的認證列為Class I recall。在兩年的實驗中,過半的受試者的癲癇頻率減少超過50%,另有14名受試者6個月沒有癲癇發作。這篇論文中我們觀察長時間使用閉迴路式的電刺激抑制系統所造成的影響,實驗採用天生便患有失神性癲癇的Long-Evans大鼠。在過程中,我們會紀錄下牠的生理現象,例如腦波訊號、體重變化,甚至大腦切片圖。透過仔細觀察各星期間棘狀放電波形的變化,並將其差異量化成各式的描述用指標與統計分析來說明實驗其間造成效果到底有多大。經過四週的實驗之後,八隻實驗鼠平均的癲癇發作時間跟癲癇發作次數均有明顯減少;經過兩個月的實驗後,三隻實驗鼠的癲癇發作時間跟癲癇發作次數相較於兩個禮拜的統計結果有更進一步的減少。

    Epilepsy, one of the most general neurological symptoms, occurs among 0.6-0.8% of the world’s population. Nowadays, thanks to medical advances, there already exists certain therapies, such as anti-seizure medication, respective surgical operation, that can be taken according to individual circumstances to ease it, but still for about a quarter of the patients not yet the sufficient treatment is available. Abnormal discharge in brain is what causing epilepsy to happen. Due to this fact, electroencephalogram (EEG) is the perfect tool to observe, measure, detect, and furthermore, develop treatment. Deep brain stimulation with close-loop control had already been proposed and put in practical; NeuroPace’s RNS has approved by FDA at November 2013. clinical trial. And another clinical trial of Medtronic’s InterceptTM finished at May 2012, with half of patients’ seizure counts reduced at least 50% and 14 patients were seizure-free for at least 6 months in 2 years, has classified as a Class I Recall at May 2013. The model animal in this experiment is Long-Evans rats with absence seizure. We observed the long term effects of applying the deep-brain stimulation with close-loop controller. We carefully recorded the EEG signal during the whole experiment, measured weight weekly, studied the spike-wave-discharge (SWD) form EEG records and tissue slice then calculated several indices to describe the phenomenon we discovered. 8 subjects’ seizure lasting time and seizure occurrence had both decreased. After 3 months seizure control, both seizure occurrence and seizure lasting time further decreased compare to the decrease after two weeks seizure control.

    摘要 i Abstract ii 誌 謝 iv Contents v List of Tables vii List of Figures viii Chapter 1. Introduction 1 1.1 Motivation 1 1.2 Seizure Type 2 1.2.1 Absence Seizure 3 1.3 Brain Stimulation for Epilepsy 4 1.4 Seizure Monitoring and Controlling System 5 1.5 Study Objective 5 1.6 Thesis Organization 6 1.7 Relative Works 6 1.7.1 Medtronic 6 1.7.2 RNS system 8 Chapter 2. Method 10 2.1 Animal Subjects and Surgery 10 2.2 Stimulation of Zona Incerta 10 2.3 Real-time Close-loop Seizure Monitor and Control System 13 2.4 Experimental Design 18 2.4.1 Pre-Evaluation 18 2.4.2 Long-Term Monitor/Control Recording 19 2.4.3 Daily record time 20 2.5 Data Pre-Processing 22 2.6 Analysis 22 2.7 Statistical Analysis 24 Chapter 3. Results 25 3.1 Weight 25 3.2 Duration Analysis 27 3.3 Frequency of Seizure Analysis 29 3.4 Waveform of Epilepsy Analysis 31 3.5 Long-term follow-up 33 Chapter 4. Discussion 36 Chapter 5. Future Work 41 Reference 42

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