Characterizing the interaction between neural attention and somato-motor systems in non-demented patients with Parkinson's disease

帕金森氏病(PD)是一种进行性神经退行性疾病，在美国和全世界都面临着迫在眉睫的经济和社会挑战。尽管帕金森病患者主要是运动系统(即控制运动的大脑系统)的障碍，但众所周知，他们也表现出严重的注意力缺陷，这是我们将大脑资源引导到环境重要方面的能力。重要的是，这些问题并不是彼此孤立的，因为注意力问题与帕金森病患者跌倒的风险密切相关，这是导致该人群住院和重大伤害的最常见原因。事实上，基于注意力的治疗已经为帕金森病患者开发了，并取得了一定的成功，但患者结果存在很大的变异性。这种差异性在很大程度上是由于这些疗法缺乏特定的神经生理和认知靶点，因此更好地了解受影响的大脑系统对于改善患者的预后至关重要。目前的项目旨在识别和量化帕金森病患者注意障碍的脑基础，以及这些缺陷注意子系统和躯体运动系统之间相互作用的神经生理学基础。这项研究的主要目标将是为加强临床干预提供新的目标，如脑刺激和注意力训练疗法。这个项目的第二个目标是提供一个数据驱动的框架，用于评估帕金森病患者大脑中的注意力训练，以及这种训练对控制运动的大脑回路(即，躯体-运动网络)的影响。为了实现这些目标，将利用一系列创新的认知神经科学实验，结合先进的脑成像技术。这些数据将使用蒙特利尔的大型数据库(魁北克帕金森网络和蒙特利尔神经研究所临床生物成像和遗传库)收集，并使用西尔万·贝莱特教授开发的许多高度创新的信号处理技术进行分析，该技术安装在他在麦吉尔大学(BrainStorm；&GT；全球2.3万用户)的实验室中。这些研究将允许对帕金森病患者注意和躯体运动网络之间和内部的动态脑活动模式的作用进行新的研究。这将为注意力训练和脑刺激疗法提供新的靶点，同时也增强了我们对导致帕金森病的神经生物学异常的理解。我的研究项目的目的是了解(1)哪些注意神经系统优先受到帕金森病的影响，以及(2)这些注意子系统如何与已建立的与帕金森病相关的躯体-运动系统异常相互作用。这些发现将为评估治疗效果提供关键指标，并为治疗干预提供目标。随着帕金森病在全国和全世界的流行，迫切需要制定具体的干预目标，以最大限度地减少这种衰弱障碍对受影响者的个人层面以及广泛的社会经济层面的影响。

Parkinson’s disease (PD) is a progressive neurodegenerative disorder that presents a looming economic and societal challenge in the United States and worldwide. Despite being primarily a disorder of the motor system (i.e., the brain systems controlling movement), patients with PD are also known to exhibit profound deficits in attention, which is our ability to direct brain resources towards important aspects of the environment. Importantly, these issues are not isolated from one another, as attentional issues are robustly linked to risk of falls in patients with PD, which are the most common reason for hospitalization and major injury in this population. Indeed, attention-based therapies have been developed for patients with PD and have been moderately successful, but a great deal of variability exists in patient outcomes. This variability is largely due to the lack of specific neurophysiological and cognitive targets of these therapies, so a better understanding of the brain systems being affected is essential to improving patient outcomes. The current project aims to identify and quantify the brain- basis of attentional impairments in patients with PD, as well as the neurophysiology underlying the interactions between these deficient attentional sub-systems and somato-motor systems. The primary goal of this research will be to provide novel targets for enhanced clinical interventions, such as brain stimulation and attention-training therapies. A secondary goal of this project is to provide a data-driven framework for the assessment of attention- training in the brains of patients with PD, and the impact of this training on the brain circuits that control movement (i.e., somato-motor networks). To reach these goals, a series of innovative cognitive neuroscience experiments will be utilized, combined with advanced brain imaging techniques. These data will be collected using expansive data repositories available in Montreal (the Quebec Parkinson Network and the Montreal Neurological Institute Clinical Biological Imaging and Genetic Repository) and analyzed using a number of highly innovative signal processing techniques developed by Professor Sylvain Baillet in his state-of-the-art software housed in his laboratory at McGill University (Brainstorm; > 23,000 users worldwide). These studies which will allow for novel investigations of the role of dynamic brain activity patterns between and within attention and somato-motor networks in patients with PD. This will provide new targets for attention- training and brain stimulation therapies, while also enhancing our understanding of the neurobiological aberrations that contribute to PD. The aim of my research project is to understand (1) which attentional neural sub-systems are being preferentially affected by PD, and (2) how these attentional sub-systems interact with established PD-related somato-motor system aberrations. These findings will then provide key metrics for the assessment of treatment efficacy, as well as targets for therapeutic intervention. With the prevalence of PD rising both nationally and worldwide, concrete targets for intervention are desperately needed to minimize the impact of this debilitating disorder, both on the personal level for those affected, and broadly on a socio-economic scale.