Date Approved

1-17-2017

Embargo Period

1-18-2018

Document Type

Thesis

Degree Name

MS Electrical and Computer Engineering

Department

Electrical and Computer Engineering

College

Henry M. Rowan College of Engineering

Advisor

Bouaynaya, Nidhal

Committee Member 1

Khandelwal, Meena

Committee Member 2

Derakhshan, Jamal Jon

Keywords

Deep tendon reflexes, Eclampsia, Electromyogram, Latency

Subject(s)

Electromyography; Eclampsia

Disciplines

Biomedical Engineering and Bioengineering | Electrical and Computer Engineering

Abstract

Eclampsia is a life-threatening neurological complication (seizures or coma) of pregnancy, and represents progression of pre-eclampsia (high blood pressure and protein in the urine isolated to pregnancy). Even though the exact mechanism of pre-eclampsia and its neurological manifestations have yet to be definitively established, it is known that there is a loss of inhibitory impulses between the cerebral cortex and the spinal cord resulting in exaggerated reflexes. In this work, we establish normative measures for deep tendon reflexes (DTR) during pregnancy. We quantified the surface electromyogram (EMG) at the knee and ankle of DTRs in 279 subjects. The signals were analyzed in the time, frequency and time-frequency domains, including normalization to patient characteristics. We uncovered two new phenomena. The first involves gradual prolongation of the reflex signal (termed latency) throughout pregnancy. The second is that the prolongation of latency is equal in the knee and ankle, allowing the conclusion that the prolongation is due to a delay in signal transduction at the synapse in the spinal cord. This delay likely represents central nervous system inhibition, either due to the effect of upper motor neurons in the spine, but more likely due to an inhibitory cortical effect (possibly hormonal). It is postulated that the quantification of the deep tendon reflex will allow patients with pre-eclampsia to be screened more effectively.

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