脑电的非线性分析在生物反馈干预高血压前期血压中的应用

Efficiency and the Underlying Mechanism of Biofeedback Treatment on Prehypertension Using Electroencephalogram Nonlinear Analysis

背景对高血压前期进行早期干预可预防高血压的发病,非药物干预方法被认为是首选。目的探讨肌电生物反馈干预高血压前期的疗效及干预过程中脑电的非线性变化机制。方法40名高血压前期志愿者被分为生物反馈治疗组(n=20)和对照组(n=20)。生物反馈治疗组利用肌电生物反馈进行早期干预(10次,1次/3 d),并借助脑电非线性分析技术脑电近似熵(ApEn)对肌电生物反馈过程中脑功能的非线性机制进行探讨。对照组除不进行生物反馈外,其余同生物反馈治疗组。实验过程中,对照组有2例因学习紧张退出试验。结果肌电生物反馈治疗后受试者的基础肌电值明显降低。肌电生物反馈治疗可使收缩压下降10.4 mm Hg[治疗后(116.8±5.2)比治疗前(127.2±6.0)mm Hg,P<0.01],6月后随访的收缩压值为[(118.2±5.7)mm Hg],但舒张压下降不明显(与对照组比较,P>0.05)。肌电生物反馈过程中,生物反馈组脑电左右额极(Fp1、Fp2)、左右额(F3、F4)、左右颞前(F7、F8)导联的近似熵明显高于对照组(均P<0.05)。结论肌电生物反馈可有效地应用于高血压前期的早期干预,额前皮质可能是生物反馈过程中重要的功能整合部位。

Background Nonpharmacological intervention,which may be beneficial to prevent development of hypertension,is recommended to managing prehypertension.Objective To investigate the efficiency of electromyographic（EMG） biofeedback treatment on prehypertension and nonlinear changes of electroencephalogram（EEG） during treatment.Methods Forty volunteers with prehypertension were treated with（n=20,one time per 3 days,for 10 times） or without（control group,n=20） EMG biofeedback.The functional changes of brain activities during treatment were evaluated with EEG nonlinear analysis-approximate entropy（ApEn）.Two volunteers in the control group withdrew from the experiment due to busy study.Results The baseline values of EMG decreased after EMG biofeedback therapy.The systolic blood pressure（SBP） decreased by 10.4 mm Hg after EMG biofeedback treatment [after（116.8±5.2）vs before（127.2±6.0）mm Hg,P0.01].SBP remained at normal level during six months period of follow-up [（118.2± 5.7）mm Hg].There was no remarkable change in diastolic blood pressure（DBP）（P0.05 vs control）.Compared with the control group,the ApEn of biofeedback group at electrodes Fp1（left anterior frontal）,Fp2（right anterior frontal）,F3（left frontal）,F4（right frontal）,F7（left anterior temporal） and F8（right anterior temporal） increased significantly during biofeedback（P0.05）.Conclusion Biofeedback is an effective intervention to treat prehypertension.The anterior frontal lobe might be the central integration site during biofeedback training.