RU2559759C1 - Method for determining hemispheric asymmetry in ergotropic and trophotropic function control - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to physiology. A heart rate, a systolic blood pressure and a diastolic blood pressure are measured simultaneously, and a blood minute output index, a cardiac cycle period, an ejection time and s normalised heart rate are calculated. The above values are used to derive an ergotropic control index (EI) by formula. If EI≤1, the trophotropic control is considered to prevail, whereas the hemisphere of higher activity is stated to be responsible for the tropotrophic control. EI≥1.3 shows the pronounced prevalence of the ergotropic control, whereas the hemisphere of higher activity is stated to be responsible for the ergotropic control. If EI falls within the range of 1.0<EI<1.3, the moderate intensity of the ergotropic control functions is stated, whereas an ergotropic hemisphere is detected after doing physical exercises.

EFFECT: method enables increasing the determination reliability of the hemispheric asymmetry that is ensured by assessing the intensity of work of the ergotropic control mechanisms.

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Description

The invention relates to medicine, in particular to the determination of indicators reflecting functional interhemispheric asymmetry (FMA) of the brain (GM) in the regulation of ergotropic and trophotropic functions. Back in the 60s. of the last century, leading researchers of the autonomic nervous system came to the conclusion that there was no sympathetic and parasympathetic departments at the superegmental level and the expediency of introducing dividing suprasegmental systems into ergotrophic (providing adaptations to changing environmental conditions) and trophotropic (ensuring maintaining homeostatic equilibrium) [2]. At present, the presence of FMA GM, which is manifested in the interaction of the hemispheres with these systems, is becoming increasingly evident [5, 6, 7]. To study such a PMA, a simultaneous comparative assessment of both the current activity of the hemispheres of the GM and the severity of ergotrophotropic regulation is necessary.

One of the methods for comparing the current activity of the hemispheres of the GM is the method of recording the level of constant potential (SCP) of the brain at the symmetric points of the temporal regions [4, 5, 10]. The main source of brain AMS generation are potentials of vascular origin, created by the blood-brain barrier and reacting to pH in the blood flowing from the brain. The concentration of hydrogen ions in the vessels of the brain depends on the intensity of energy metabolism, because acids are the final product of energy metabolism. This circumstance allows you to use the SCP to assess cerebral energy metabolism. An increase in AMR corresponds to a decrease (acidotic shift) in cerebral pH.

The temporal areas of the SCP lead in the analysis of the organization of a dynamic FMA associated with ergotrophotropic regulation are some of the most informative, because apparently associated with asymmetry of the autonomic nervous system [6, 8]. Sympathetic and parasympathetic fibers coming from the ventromedial nucleus of the thalamus most often intersect asymmetrically. In this case, usually (but not always! - note of the authors of the application), most sympathetic fibers are sent to the right insular cortex, and parasympathetic fibers to the left. It is in relation to the temporal (insular) cortex that the most striking effect of the multidirectional influence of the right and left hemisphere on the activity of the autonomic nervous system is shown [9].

When comparing interhemispheric activity, monopolar and bipolar methods of abduction of SCP are equivalent in their results [4, 5, 10]. In the case of the monopolar method of AC lead, the positive electrodes of various recording channels are installed on the symmetric points of the temporal zone of the right and left hemispheres, and the negative electrode on the reference point is the right hand. In this case, a more active hemisphere corresponds to a larger value of SCP. In the case of bipolar interhemispheric lead of the SCP, the negative electrode is installed on the left, and the positive on the symmetric point of the temporal zone of the right hemisphere. In this case, a negative SCP indicates a greater activity of the left hemisphere, and a positive one indicates a greater activity of the right hemisphere of GM.

Registration of SCP is not the only method with which you can compare the current activity of the symmetrical regions of the hemispheres of the GM. The most common method for studying the bioelectric activity of GM is the method of recording an electroencephalogram (EEG) [3]. But to give an integrated assessment of the current activity of the hemispheres at the points of registration of the EEG is a non-trivial task. On the EEG, an increase in activity is manifested primarily in a change in the spectral characteristics of the signal associated with a decrease in the amplitudes of harmonics of the α-rhythm and, at small amplitudes of harmonics of other slow-wave rhythms, is accompanied by a decrease in the amplitude characteristics of the signal. However, there is the possibility of comparing the current activity of the symmetrical zones of the hemispheres, based on a comparison of the "average values" of the digitized EEG signal, which characterize the shift of the average signal value relative to the zero line. This method, as with the registration of SCP, can be carried out both with monopolar recordings of EEGs in the symmetric zones of the right and left hemispheres, and by recording bipolar interhemispheric leads of the EEG. In the case of registration of monopolar leads, active positive (+) electrodes are located on the symmetric zones of the right and left hemispheres. After recording and digitizing the EEG signal, the average values of these signals are calculated (characterizing the shift of the average signal value relative to the zero line). A more active zone (corresponding to a larger SCP value) has a smaller value of the average value of the EEG signal (greater electronegativity).

In the case of registration of the EEG by the bipolar method in the presence of 2 detection channels, the EEG is simultaneously recorded, in which the positive (+) active electrode of one lead is located next to the negative (-) active electrode of the second lead in the studied area of one hemisphere, and the paired active electrodes of opposite polarity are located similarly on the studied area of the opposite hemisphere. In the case of single-channel EEG recording in a bipolar way, sequential double registration is performed with a change in the location of the active electrodes: first, the positive active electrode is installed in the studied area of one hemisphere, and the negative active electrode in the symmetric zone of the opposite hemisphere; then their location changes places. Reference electrodes are located at their usual points. After recording and digitizing the EEG signal, the average values of these signals are calculated. In those cases when the positive active electrode is located above the more active zone (with a larger SCP value), the calculated average value of the EEG signal has a smaller value (it is more electronegative).

However, for analysis and conclusions about the real state of brain FMA in the regulation of ergo and trophotropic functions, it is not enough to know the asymmetry of indicators characterizing the current activity of the GM hemispheres in the temporal regions. It is necessary to simultaneously and accurately determine the severity of the current ergotrophic - trophotropic regulation.

The well-known "Method for assessing the psychophysiological state of the human body" [1], taken as a prototype. The essence of this method is that at rest they measure the bioelectromagnetic reactivity index (BEMR) at symmetrical points on the skin surface of the right and left temporal areas of the head, determine the dominant hemisphere of the brain (right or left), which corresponds to a larger value of the BEMR index. Then they exert physical activity on the body, after which they repeatedly measure the BEMR index at symmetrical points on the skin surface of the right and left temporal regions of the head and determine the dominant hemisphere of the brain. After this, the tone of the predominant part of the autonomic nervous system is determined. If, after exposure to physical activity, the old cerebral hemisphere remained dominant, then in the initial state of the body the prevalence of the tone of the sympathetic part of the autonomic nervous system is ascertained. If, after exposure to the body by physical activity, the other hemisphere of the brain became dominant, then in the initial state of the body the prevalence of the tone of the parasympathetic section of the autonomic nervous system is ascertained.

Those. In this method, the values of the BEMR indices associated with microcirculation and metabolic rate before and after exercise reflect the dynamics of interhemispheric asymmetry of blood supply to the cerebral hemispheres. But the same physical activity in different subjects requires different stresses in the work of ergotrophic regulation mechanisms. In order to guarantee compliance of the applied physical load with the required level of activation of ergotrophic regulation mechanisms, it is necessary to have a reliable indicator of the tension of these ergotrophic mechanisms, which is not in the described method.

The solution to the problem of determining the severity of the current ergotrophotropic regulation and justification is carried out as follows. The subject is measured heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), then:

1) calculate the index of minute volume of blood (IMOK), showing how many BCC in 1 minute passes through the circle of blood circulation:

IMOK = (GARDEN + DBP) · TPI / DBP / (TSC-TPI),

where SBP is systolic blood pressure; DBP - diastolic blood pressure; TSC - the period of the cardiac cycle, calculated by the formula TSC = 60 / heart rate; Tpi - the period of exile, calculated by the formula: Tpi = 0.268 · TSC ^0.36 ≈ TSC · 0.109 + 0.159; 2) calculate the normalized indicator of heart rate (LSS) by the formula:

LFSS = (HR-15) / 50;

3) calculate the index of ergotropic regulation (IE) by the formula:

IE = ((IMOK ² + LChSS ² ) / 2) ^1/2 .

If IE ≤1, then trophotropic regulation prevails; if 1 <IE≤1,3 - this is a moderate severity of ergotropic regulatory functions; if IE ≥ 1.3, this is a pronounced predominance of ergotropic regulatory functions.

The aim of the proposed method for determining the functional asymmetry of the cerebral hemispheres in the regulation of ergotrophic and trophotropic functions is to increase the reliability of the results of such studies through the use of physiologically sound estimates of the intensity of the ergotropic regulation mechanisms.

This goal is achieved by the fact that the test subject at rest and after physical exertion conducts simultaneous determination of the ratio of ergotrophotropic functions in the regulation of the circulatory system and a more active hemisphere in symmetrical temporal regions.

To determine the ratio of ergotrophotropic functions in the regulation of the circulatory system, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure are measured, and then the ergotropic regulation index (IE) is calculated by the formula:

IE = ((IMOK ² + LChSS ² ) / 2) ^1/2 ,

where IMOK - index of minute volume of blood

IMOK = (GARDEN + DBP) · TPI / DBP / (TSC-TPI),

where SBP is systolic blood pressure; DBP - diastolic blood pressure; TSC - the period of the cardiac cycle, calculated by the formula TSC = 60 / heart rate; Tpi - the period of exile, calculated by the formula: Tpi = 0.268 · TSC ^0.36 ≈ TSC · 0.109 + 0.159; LFSS - a normalized indicator of heart rate

LFSS = (HR-15) / 50.

To determine a more active hemisphere in the symmetric temporal regions, either registration of AMR or EEG, or methods for comparing blood supply (for example, according to the level of microcirculation - BEMR indices) are used.

When comparing interhemispheric activity using the SCP method, both monopolar and bipolar methods of SCP diversion can be used. In the case of the monopolar method of AC lead, the positive electrodes of various recording channels are installed on the symmetric points of the temporal zone of the right and left hemispheres, and the negative electrode on the reference point is the right hand. In this case, a more active hemisphere corresponds to a larger value of SCP. In the case of bipolar interhemispheric lead of the SCP, the negative electrode is installed on the left, and the positive on the symmetric point of the temporal zone of the right - the hemisphere. In this case, a negative SCP indicates a greater activity of the left hemisphere, and a positive one indicates a greater activity of the right hemisphere of GM.

When comparing the interhemispheric activity of the temporal regions by the method of “average EEG values”, it is also possible to carry out both monopolar and bipolar EEG derivations. In the case of registration of monopolar leads, active positive (+) electrodes are located on the symmetric zones of the right and left hemispheres. After recording and digitizing the EEG signal, the average values of these signals are calculated (characterizing the shift of the average signal value relative to the zero line). A more active zone (corresponding to a larger SCP value) has a smaller value of the average value of the EEG signal (greater electronegativity).

In the case of registration of the EEG by the bipolar method in the presence of 2 detection channels, the EEG is simultaneously recorded, in which the positive (+) active electrode of one lead is located next to the negative (-) active electrode of the second lead in the studied area of one hemisphere, and the paired active electrodes of opposite polarity are located similarly on the studied area of the opposite hemisphere. In the case of single-channel EEG recording in a bipolar way, sequential double registration is performed with a change in the location of the active electrodes: first, the positive active electrode is installed in the studied area of one hemisphere, and the negative active electrode in the symmetric zone of the opposite hemisphere; then their location changes places. Reference electrodes are located at their usual points. After recording and digitizing the EEG signal, the average values of these signals are calculated. In those cases when the positive active electrode is located above the more active zone (with a larger SCP value), the calculated average value of the EEG signal has a smaller value (it is more electronegative).

When comparing the interhemispheric activity of the temporal regions in terms of blood supply in our case, we used the method of registering BEMR indices. The more active hemisphere was determined by the larger BEMR index measured by the sensor at the right and left symmetric points of the temporal zone.

A hemisphere with greater activity in the temporal region with IE≤1 is defined as more specialized in interacting with trophotropic regulation mechanisms, and a hemisphere with more activity in the temporal region with IE ≤1.3 - with ergotrophic ones.

The implementation of the method is as follows.

The proposed method consists in simultaneously determining, on the one hand, the more active hemisphere of GM in symmetrical temporal regions, and, on the other hand, the ratio of ergotrophotropic functions in the regulation of the circulatory system by heart rate and blood pressure, both at rest and after exercise.

In the case of determining a more active hemisphere at the symmetric points of the temporal zones by the SCP registration method, it is possible to use devices of the Neuroenergometer type [5], Neuroenergocartograph (NEK - [10]), and in the case of using the bipolar SCP method, when one recording channel is enough SCP, - AMEA apparatus [10].

In the case of the monopolar method of AC lead, the positive electrodes of various recording channels are installed on the symmetric points of the temporal zone of the right and left hemispheres, and the negative electrode on the reference point is the right hand. In this case, a more active hemisphere corresponds to a larger value of SCP. In the case of bipolar interhemispheric lead of the SCP, the negative electrode is installed on the left, and the positive on the symmetric point of the temporal zone of the right hemisphere. In this case, a negative SCP indicates a greater activity of the left hemisphere, and a positive one indicates a greater activity of the right hemisphere of GM.

In the case of determining a more active hemisphere at the symmetric points of the temporal zones by the EEG recording method and then calculating the average value of the EEG signal, any certified and connected to a computer electroencephalographs or biopotential amplifiers with an EEG recording function (for example, in our case, a 4-channel biopotential amplifier MP30B-CE (Biopac Systems, Inc.).

In the case of registration of monopolar leads, active positive (+) electrodes are located on the symmetric zones of the right and left hemispheres. After recording and digitizing the EEG signal, the average values of these signals are calculated (characterizing the shift of the average signal value relative to the zero line). A more active zone (corresponding to a larger SCP value) has a smaller value of the average value of the EEG signal (greater electronegativity).

In the case of registration of the EEG by the bipolar method in the presence of 2 detection channels, the EEG is simultaneously recorded, in which the positive (+) active electrode of one lead is located next to the negative (-) active electrode of the second lead in the studied area of one hemisphere, and the paired active electrodes of opposite polarity are located similarly on the studied area of the opposite hemisphere. In the case of single-channel EEG recording in a bipolar way, sequential double registration is performed with a change in the location of the active electrodes: first, the positive active electrode is installed in the studied area of one hemisphere, and the negative active electrode in the symmetric zone of the opposite hemisphere; then their location changes places. Reference electrodes are located at their usual points. After recording and digitizing the EEG signal, the average values of these signals are calculated. In those cases when the positive active electrode is located above the more active zone (with a larger SCP value), the calculated average value of the EEG signal has a smaller value (it is more electronegative).

In the case of determining a more active hemisphere at the symmetric points of the temporal zones by comparing the indicators reflecting the microcirculation level, you can use the Lira-100 apparatus (registration certificate No. ФСР 2008/02890 dated 06/24/08), which determines the bioelectromagnetic reactivity indices (BEMR) of living tissue . The values of the BEMR indices are closely related to the real microcirculation and the intensity of metabolic processes, and the asymmetry of the temporal zones BEMR indices reflects the dynamics of the interhemispheric asymmetry of the blood supply to the cerebral hemispheres [1]. The temporal zone with greater activity corresponds to a larger value of the BEMR index.

To determine heart rate, GARDEN, DBP, any devices certified for this can be used.

To determine the ratio of trophotropic and ergotropic functions in the regulation of the circulatory system, the ergotropic regulation index (IE) is calculated by the formula:

IE = ((IMOK ² + LChSS ² ) / 2) ^1/2 ,

where IMOK - index of minute volume of blood

IMOK = (GARDEN + DBP) · TPI / DBP / (TSC-TPI),

where SBP is systolic blood pressure; DBP - diastolic blood pressure; TSC - the period of the cardiac cycle, calculated by the formula TSC = 60 / heart rate; Tpi - the period of exile, calculated by the formula: Tpi = 0.268 · TSC ^0.36 ≈ TSC · 0.109 + 0.159; LFSS - a normalized indicator of heart rate

LFSS = (HR-15) / 50.

If at rest IE ≤1, then trophotropic regulation prevails, and the hemisphere with greater activity is defined as responsible for trophotropic regulation.

If IE ≥1, then ergotropic regulation prevails, the severity of which is determined by the numerical value of this index.

If IE> 1.3 is a pronounced predominance of ergotropic regulation, and the hemisphere with greater activity is defined as responsible for ergotropic regulation.

If 1 <IE <1.3 - this means a moderate severity of ergotropic regulation. In this case, it is impossible to reliably determine the hemisphere responsible for the regulation of trophotropic or ergotropic functions. In this case, the determination of the ergotropic hemisphere is carried out after exercise, when IE> 1.3.

The implementation of the method is illustrated by the following examples.

Example 1. Subject Kh.I.G., 19 years old.

At rest: heart rate - 61 bpm, SBP - 128 mmHg, DBP - 73 mmHg

The temporal zone of the left hemisphere was more active according to the SCP (AMEA apparatus). A comparative assessment of the current activity of the temporal zones by calculating the average EEG value and depending on the level of microcirculation (BEMR indices on the Lira-100 apparatus) gave similar results (see Table 1).

Table 1 Activity Comparison Method SCP (mV) positive electrode on the right, neg. - left The average value of the EEG (μV) positive electrode in the temporal region BEMR indices left on right left on right value -1.8 -19.5 +20.7 0.116 0.105 Great activity left left left

IE calculation:

TSC = 60 / HR = 60/61 = 0.9836

Tpi ≈ TSC0.109 + 0.159 = 0.983610.109 + 0.159 = 0.266

IMOK = (GARDEN + DBP) · TPI / DBP / (TSC-TPI) = (128 + 73) · 0.266 / 73 / (0.9836-0.266) = 1.021

LFSS = (HR-15) / 50 = (61-15) / 50 = 0.92

IE = ((IMOK ² + LFSS ² ) / 2) ^1/2 = ((1,021 ² +0,92 ² ) / 2) ^1/2 = 0,97 (pronounced predominance of trophotropic regulation).

After physical activity (20 squats in 30 s):

Heart rate - 94 beats / min, SBP - 174 mm Hg, DBP - 84 mm Hg

The right temporal region became more active in SCP. A comparative assessment of the current activity of the temporal zones by calculating the average EEG value and depending on the level of microcirculation (BEMR indices on the Lira-100 apparatus) gave similar results (see Table 2).

table 2 Activity Comparison Method SCP (mV) positive electrode on the right, neg. - left The average value of the EEG (μV) positive electrode in the temporal region BEMR indices left on right left on right Value +13.6 +4.7 -21 0.121 0.130 Great activity on right on right on right

IE calculation:

TSC = 60 / HR = 60/94 = 0.638

Tpi ≈ TSC0.109 + 0.159 = 0.63810.109 + 0.159 = 0.228

IMOK = (GARDEN + DBP) · TPI / DBP / (TSC-TPI) = (174 + 84) · 0.228 / 84 / (0.638-0.228) = 1.713

LFSS = (HR-15) / 50 = (94-15) / 50 = 1.58

IE = ((IRIC NCHSS ² + ^{2) / 2) 1/2 = (} (1.713 2 +1.58 2) / 2) 1/2 = 1.648 ( expressed ehrgotropnyh regulation).

Conclusion: in this subject, the left hemisphere is more specialized in interacting with trophotropic regulatory systems, and the right one with ergotropic ones (the most common variant of functional interhemispheric asymmetry when interacting with trophotropic and ergotropic regulation systems).

Example 2. Test I.M.M., 19 years old.

At rest: heart rate - 73 bpm, SBP - 115 mmHg, DBP - 72 mmHg

The temporal zone of the right hemisphere was more active in SCP. A comparative assessment of the current activity of the temporal zones by calculating the average EEG value and depending on the level of microcirculation (BEMR indices on the Lira-100 apparatus) gave similar results (see Table 3).

Table 3 Activity Comparison Method SCP (mV) positive electrode on the right, neg. - left The average value of the EEG (μV) positive electrode in the temporal region BEMR indices left on right left on right value +12.2 +13 -9 0,120 0.134 Great activity on right on right on right

IE calculation:

TSC = 60 / heart rate = 60 / 73-0.8219

Tpi ≈ TSC0.109 + 0.159 = 0.82190.109 + 0.159 = 0.2486

IMOK = (GARDEN + DBP) · TPI / DBP / (TSC-TPI) = (115 + 72) · 0.2486 / 72 / (0.8219-0.2486) = 1.126

LFSS = (HR-15) / 50 = (73-15) / 50 = 1.16

IE = ((IMOK ² + LChSS ² ) / 2) ^1/2 = ((1,126 ² +1,16 ² ) / 2) ^1/2 = 1,14 (moderate severity of ergotropic regulation).

After physical activity (20 squats in 30 s):

Heart rate - 142 bpm, SBP - 154 mm Hg, DBP - 96 mm Hg

The left temporal region became more active in SCP. A comparative assessment of the current activity of the temporal zones by calculating the average EEG value and depending on the level of microcirculation (BEMR indices on the Lira-100 apparatus) gave similar results (see Table 4).

Table 4 Activity Comparison Method SCP (mV) positive electrode on the right, neg. - left The average value of the EEG (μV) positive electrode in the temporal region BEMR indices left on right left on right value -6.4 -5.4 +11 0.137 0.131 Great activity left left left

IE calculation:

TSC = 60 / HR = 60/142 = 0.4225

Tpi ≈ TSC0.109 + 0.159 = 0.42250.109 + 0.159 = 0.205

IMOK = (GARDEN + DBP) · TPI / DBP / (TSC-TPI) = (154 + 96) · 0.205 / 96 / (0.4225-0.205) = 2.455

LFSS = (HR-15) / 50 = (142-15) / 50 = 2.54

IE = ((IMOK ² + LChSS ² ) / 2) ^1/2 = ((2,454 ² + 2,54 ² ) / 2) ^1/2 = 2,498 (pronounced ergotropic regulation).

Conclusion: this test subject has a more specialized left hemisphere for interacting with ergotropic regulatory systems.

BIBLIOGRAPHY

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Claims (1)

A method for determining the functional asymmetry of the cerebral hemispheres in the regulation of ergotropic and trophotropic functions, including determining the more active hemisphere in the symmetrical temporal regions of the brain using one of the electrophysiological methods, characterized in that both measure heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP), calculate the ergotropic regulation index (IE) according to the formula:
IE = ((IMOK ² + LChSS ² ) / 2) ^½ ;
where IMOK - index of minute volume of blood;
IMOK = (GARDEN + DBP) · TPI / DBP / (TSC-TPI);
TSC - the period of the cardiac cycle, calculated by the formula TSC = 60 / heart rate;
Tpi - the period of exile, calculated by the formula: Tpi = TSC · 0.109 + 0.159;
LFSS - normalized indicator of heart rate - LFL = (HR-15) / 50;
when IE values ≤1 determine the prevalence of trophotropic regulation, and the hemisphere with greater activity as responsible for trophotropic regulation;
with IE values ≥1.3 determine the pronounced predominance of ergotropic regulation, and the hemisphere with greater activity as responsible for ergotropic regulation;
with IE values in the range of 1.0 <IE <1.3, moderate severity of ergotropic regulatory functions is determined; in this case, the determination of ergotropic hemisphere is carried out after exercise.