Vascular mechanisms and tDCS treatment of gait and posture in aging and age-related diseases

衰老和年龄相关疾病中步态和姿势的血管机制和 tDCS 治疗

• 批准号: 10165433
• 负责人: Azizah J. Jor'dan
• 金额: $ 24.58万
• 依托单位: UNIVERSITY OF MASSACHUSETTS BOSTON
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-03-15 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10165433
• 关键词: Acute; Adult; Aging; Alzheimer' s Disease; Blood; Blood Flow Velocity; Blood Vessels; Blood flow; Brain; Cerebrovascular Circulation; Clinical; Cognition; Cognitive; Complex; Diabetes Mellitus; Disease; Education; Elderly; Electrical Stimulation of the Brain; Electrodes; Equilibrium; Exhibits; Future; Gait; Gait speed; Goals; Hand; Impairment; Intervention; Learning; Left; Link; Magnetic Resonance Imaging; Measures; Methods; Motor; Musculoskeletal Equilibrium; Near-Infrared Spectroscopy; Nerve Degeneration; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Oxygen; Patients; Phase; Population; Posture; Prefrontal Cortex; Process; Quality of life; Randomized; Rehabilitation therapy; Research; Research Personnel; Scalp structure; Scientist; Speed; Task Performances; Techniques; Technology; Time Study; Transcranial Doppler Ultrasonography; Translating; Vascular resistance; Visit; Vulnerable Populations; Walking; Wireless Technology; Work; age effect; age related; career; cerebrovascular; cost; design; equilibration disorder; follow-up; functional improvement; functional outcomes; group intervention; improved; improved mobility; insight; middle cerebral artery; neuroimaging; neuronal excitability; neurophysiology; neuroregulation; new therapeutic target; placebo group; recruit; rehabilitation strategy; relating to nervous system; screening; sensor; skills; tool; translational research program; young adult

My career goal is to become a leading academic scientist with a research focus on the neurophysiology of balance disorders in aging and age-related disease. I will achieve this goal by leading a translational research program aimed at identifying the pathophysiological manifestation of aging and age-related disease that diminish the control of walking and standing, and their consequences on important clinical outcomes such as mobility. I will also work to translate these discoveries into future clinical interventions and practices that will improve mobility and quality of life within these populations. The control of gait and posture is dependent upon cognition and is linked to prefrontal brain function in healthy adults. The K99 phase research was designed to, for the first time, study the effects of aging, type 2 diabetes mellitus (DM) and Alzheimer's disease (AD) on prefrontal brain activation during standing and walking. Both DM and AD exaggerate age-related declines in gait and posture, and it is expected that this is caused at least in part by shared cerebrovascular complications; namely, a reduced ability to sufficiently activate the prefrontal cortex during these activities due to decrease blood flow and increased vascular resistance. With this information in hand, the proposed R00 phase research will then attempt to increase prefrontal brain activation using transcranial direct current stimulation (tDCS) in order to improve walking and standing in these patients. Thus, the following R00 Specific Aim will be completed: R00 Aim will determine, using a 10-day tDCS intervention, a) the effects of tDCS targeting the prefrontal cortex on gait and postural control and brain activation markers (i.e., blood flow, blood oxygenation), and b) the immediate and longer-term (i.e., over a one-month follow-up) effects on these outcomes in patients with DM or AD. Those who exhibit gait and postural control difficulties at baseline will be randomized into real or sham (i.e., control) tDCS intervention groups. We hypothesize that H1) the real tDCS group will exhibit an increase in gait speed when walking and reduction of postural sway speed when standing, and an increase in brain activation during these tasks, both immediately and over the 30-day follow-up period. Together, these discoveries will provide insight into the cerebrovascular control of gait and postural control in aging and age-related disease; and new therapeutic targets (i.e., blood flow and blood oxygenation) for balance rehabilitation. Moreover, it will identify tDCS as an important tool in balance research that may translate into a new low-cost and safe intervention for these vulnerable populations.

我的职业目标是成为一名顶尖的学术科学家，研究重点是