Subthalamic deep brain stimulation to modulate vestibular heading perception in Parkinson’s disease.
丘脑深部脑刺激可调节帕金森病的前庭方向知觉。
基本信息
- 批准号:10316153
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-01-01 至 2024-12-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAffectAnatomyAreaAtlasesAxonBasal GangliaCell NucleusCerebellumClinicalComputer ModelsDataDeep Brain StimulationDisabled PersonsDiscriminationDistalDorsalElectrodesEquilibriumFall preventionFreedomFunctional disorderGaitGoalsHealthHumanImageImpairmentIndividualLateralLeadLocationMaintenanceMapsMeasuresMorbidity - disease rateMotionMotion PerceptionMovementMuscle HypertoniaNeural PathwaysNeurodegenerative DisordersNeurologicNeurologyOperative Surgical ProceduresOutcomeParkinson DiseasePathway interactionsPatientsPatternPerceptionPersonal SatisfactionPersonsPharmacotherapyPhysiologicalPhysiological ProcessesPhysiologyPlayProcessPsychophysicsResearchResearch PersonnelRoleSignal TransductionStructure of subthalamic nucleusSystemTechniquesTestingThalamic structureTissuesTremorVeteransVisionVisuospatialWalkingWorkdesigndisabling symptomequilibration disorderexperimental studyfallsfunctional independencehexapodimprovedinsightmilitary veteranmotor disordermultidisciplinarymultisensoryneuroimagingposture instabilitypreservationprogramsrecruitside effecttherapeutically effectivetractographyway findingwhite matter
项目摘要
Parkinson’s Disease (PD) is a common neurodegenerative disorder affecting human movements. PD is not
just a motor disease. It also results in impaired multi-sensory processing that is critical for encoding self-
orientation and self-motion. Ultimately, this leads to abnormal spatial navigation, lateral drifts while walking
(veering), postural instability and falls in about 70% of patients. Conventional pharmacotherapy or deep brain
stimulation (DBS) for PD are variably effective in treating these debilitating symptoms. DBS improves balance
dysfunction in some patients, while in some it does not affect balance or even makes it worse. Defining consistent
therapy requires a proper understanding of the mechanisms of navigational impairments in PD, and to know how
DBS modulates the balance function. A singular vision of our research program is: 1) To reveal the
physiological underpinnings of how DBS modulates the process by which multisensory integrated systems
govern perception of one’s own motion critical for spatial navigation, gait and balance in PD. 2) To be able to
consistently treat navigational impairments such as veering in PD patients with subthalamic nucleus (STN) DBS
while preserving its other benefits of treating tremor and increased muscle tone, and reducing pharmacotherapy
burden with bothersome side effects. With this goal the current Merit Review application focuses on the vestibular
system – the critical system for the perception of one’s own linear motion, i.e. vestibular heading perception –
the task that is has to be accurate for the proper control of balance, navigation, and averting falls. We
hypothesize that effects of STN DBS on vestibular heading perception and veering are dependent upon the
specific location of the active electrode contact within the STN and modulation of the cerebello-thalamic pathway
that is known to carry the vestibular signal and is in physical vicinity of the STN. In order to test this hypothesis
we will objectively measure one’s ability to perceive direction of linear motion (i.e., vestibular heading perception),
lateral drifts while walking (i.e., veering) that is common in PD, and then we will compare these objective
measures among three independent conditions – dorsal STN DBS, ventral STN DBS, and DBS off. The Aim 1
will examine the effects of the location of volume of tissue activation within the STN on the change in vestibular
heading perception and veering in human PD patients. We will collate physical location of the volume of tissue
activation from all patients when the change in vestibular heading perception and veering was found. These
locations, generating the probabilistic stimulation atlas, will provide insights about areas of STN that could
influence balance function in PD. The Aim 2 will examine the recruitment metrics of the axonal pathways
modulated by the STN DBS that correlates with change in vestibular heading perception and veering in PD
patients. It will directly examine the role of involvement of cerebello-thalamic pathway that is known to transmit
vestibular perception information and is in vicinity of the STN. In summary, by taking a top-down approach and
leveraging a multidisciplinary team of investigators studying human PD patients with STN DBS, neuroimaging,
and computational modeling; we will unravel mechanisms through which STN DBS modulates the vestibular
heading perception in PD. Finally we will apply this mechanistic understanding to design consistent and effective
therapeutic strategies utilizing DBS to prevent falls in PD.
帕金森病(Parkinson's Disease,PD)是一种常见的影响人体运动的神经退行性疾病。PD不
只是运动障碍它还导致受损的多感官处理,这是编码自我的关键,
定向和自我运动。最终,这会导致异常的空间导航,行走时的横向漂移
(转向)、姿势不稳和福尔斯跌倒。常规药物治疗或脑深部
用于PD的电刺激(DBS)在治疗这些使人衰弱的症状方面是非常有效的。DBS改善平衡
在某些患者中,它会导致功能障碍,而在某些患者中,它不会影响平衡,甚至会使其变得更糟。定义一致性
治疗需要正确理解PD导航障碍的机制,并了解如何
DBS调节平衡功能。我们研究计划的一个独特愿景是:1)揭示
DBS如何调节多感觉整合系统的过程的生理基础
控制对PD中空间导航、步态和平衡至关重要的自身运动的感知。2)为了能够
使用丘脑底核(DBS)持续治疗导航障碍,例如PD患者的转向
同时保留其治疗震颤和增加肌肉张力的其他益处,
带来的副作用为了实现这一目标,目前的Merit Review应用程序侧重于前庭
系统-感知自身线性运动的关键系统,即前庭航向感知-
该任务必须是精确的,以便适当地控制平衡、导航和避免福尔斯。我们
假设前庭定向刺激对前庭朝向知觉和转向的影响取决于
主动电极接触在小脑内的特定位置和小脑-丘脑通路的调制
其已知携带前庭信号并且在前庭的物理附近。为了验证这个假设
我们将客观地测量一个人感知线性运动方向的能力(即,前庭朝向感知),
行走时的横向漂移(即,转向),这是常见的PD,然后我们将比较这些目标
测量三种独立条件-背侧DBS、腹侧DBS和DBS关闭。目标1
将检查前庭内组织激活体积的位置对前庭功能变化的影响。
人类PD患者的航向感知和转向。我们将核对组织体积的物理位置
当发现前庭朝向知觉和转向的变化时,所有患者的激活。这些
位置,生成概率刺激地图集,将提供有关可能
影响PD平衡功能。Aim 2将检查轴突通路的募集指标
由与PD中前庭朝向感知和转向的变化相关的ODBS调制
患者它将直接检查小脑-丘脑通路的参与作用,
前庭感知信息,并在前庭附近。总之,通过采取自上而下的方法,
利用多学科的研究人员团队研究人类PD患者的DBS,神经成像,
和计算建模;我们将解开的机制,通过它的DBS调制前庭
PD中的航向感知。最后,我们将应用这种机械的理解,设计一致的和有效的
利用DBS预防PD患者福尔斯跌倒的治疗策略。
项目成果
期刊论文数量(0)
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Aasef G Shaikh其他文献
Aasef G Shaikh的其他文献
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{{ truncateString('Aasef G Shaikh', 18)}}的其他基金
Remote dynamic cycling for the customized off-site rehab in Parkinson’s disease.
用于帕金森病定制场外康复的远程动态循环。
- 批准号:
10424644 - 财政年份:2022
- 资助金额:
-- - 项目类别:
Deep brain stimulation for visuomotor function in Parkinson's disease
深部脑刺激对帕金森病视觉运动功能的影响
- 批准号:
10484282 - 财政年份:2022
- 资助金额:
-- - 项目类别:
Deep brain stimulation for visuomotor function in Parkinson's disease
深部脑刺激对帕金森病视觉运动功能的影响
- 批准号:
10655565 - 财政年份:2022
- 资助金额:
-- - 项目类别:
Remote dynamic cycling for the customized off-site rehab in Parkinson’s disease.
用于帕金森病定制场外康复的远程动态循环。
- 批准号:
10609837 - 财政年份:2022
- 资助金额:
-- - 项目类别:
Subthalamic deep brain stimulation to modulate vestibular heading perception in Parkinson’s disease.
丘脑深部脑刺激可调节帕金森病的前庭方向知觉。
- 批准号:
10015410 - 财政年份:2021
- 资助金额:
-- - 项目类别:
Subthalamic deep brain stimulation to modulate vestibular heading perception in Parkinson’s disease.
丘脑深部脑刺激可调节帕金森病的前庭方向知觉。
- 批准号:
10579821 - 财政年份:2021
- 资助金额:
-- - 项目类别:
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