Functional connectivity associated with motor recovery after internal capsule lesions

与内囊损伤后运动恢复相关的功能连接

• 批准号: 10464388
• 负责人: Shashank Amit Anand
• 金额: $ 4.68万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10464388
• 关键词: Acute; Address; Adult; Affect; Animals; Area; Behavioral; Bilateral; Biology; Blood; Blood Vessels; Brain; Cause of Death; Chronic; Chronic Phase; Clinical; Collection; Corticospinal Tracts; Coupled; Defect; Devices; Diffusion; Electrodes; Endothelin-1; Face; Feedback; Fiber; Functional Magnetic Resonance Imaging; Generations; Goals; Health; Human; Image; Implant; Industry; Infarction; Injury; Internal Capsule; Intervention; Learning; Lesion; Limb structure; Macaca; Macaca mulatta; Measurement; Measures; Mediating; Medical; Modeling; Motor; Motor Cortex; Orthotic Devices; Outcome; Oxygen; Paresis; Patients; Performance; Phase; Physiology; Primates; Quality of life; Recovery; Recovery of Function; Rehabilitation device; Rehabilitation therapy; Residual state; Rest; Scanning; Seeds; Signal Transduction; Stroke; Survivors; System; Technology; Testing; arm; base; blood oxygen level dependent; brain computer interface; brain remodeling; chronic stroke; clinically relevant; clinically significant; efficacy validation; functional outcomes; graph theory; gray matter; haptic feedback; improved; injured; insight; motor function improvement; motor function recovery; motor impairment; motor recovery; nonhuman primate; novel; post stroke; rehabilitation strategy; response; restoration; robotic device; stroke recovery; stroke rehabilitation; stroke survivor; stroke therapy; tool; white matter

Project Summary Stroke survivors face significant long-term health consequences, with rehabilitation being essential to improve their recovery and quality of life. Currently, patients who do not restore motor function after 3-6 months are unlikely to show further recovery. Lesions with white matter tract involvement typically correlate with worse outcomes. For example, corticospinal tract lesions (CST) lesions produce worse motor deficiencies and portend poor functional recovery. Brain-computer interface mediated stroke rehabilitation (BCI-SR) can be a powerful rehabilitation tool. In BCI-SR, a patient learns to modulate localized brain activity that is recorded by electrodes. This can be used to control an orthosis to move the paretic limb. Most BCI systems utilize signals from affected hemisphere, attempting to drive plasticity in injured cortex. However, residual brain function after stroke limits BCI-SR efficacy, making ipsilesional BCI difficult to use in patients with the worst injuries. In humans, contralesional BCI-SR devices have used the uninjured hemisphere to drive further rehabilitation after the traditional plateau in motor function recovery. Clinical predictions of functional outcome after stroke are imprecise. Resting state functional connectivity (rsFC) measures the correlation of blood oxygen level-depending (BOLD) fluctuations at rest across the brain, providing a powerful tool to study brain network remodeling after stroke. However, human studies investigating brain remodeling after a stroke typically include patients with diverse lesions and do not have access to baseline measurements that allow rsFC comparison pre- and post-stroke. Animal studies could address both issues by enabling the generation of replicable, homogenous, and specific infarcts and by allowing collection of baseline measurements prior to infarct generation. There is also an absence of adequate animal studies characterizing rsFC changes associated with BCI rehabilitation strategies. Our project goal is to further characterize rsFC changes associated with CST lesions and test a BCI-mediated rehabilitation strategy after motor recovery plateaus. We will generate uniform lesions in the CST of six Rhesus macaques and after three months of natural recovery, drive contralesional BCI-SR. In each primate, we will collect resting-state functional MRI at baseline before lesioning, after CST lesioning, and during contralesional BCI-SR. We will then identify acute and chronic changes in rsFC that correspond with CST lesioning, innate recovery, and brain-computer-interface mediated rehabilitation. Through these approaches, we seek to validate the efficacy of a novel stroke rehabilitation strategy while providing insight into recovery-associated changes in rsFC.

项目摘要 中风幸存者面临着重大的长期健康后果，康复对于改善 恢复和生活质量。目前，在3-6个月后不能恢复运动功能的患者， 不太可能进一步复苏。累及白色束的病变通常与更严重的 结果。例如，皮质脊髓束病变（CST）病变产生更严重的运动缺陷，并预示着 功能恢复差。脑机接口介导的中风康复（BCI-SR）可以是一个强大的 康复工具。在BCI-SR中，患者学会调节由电极记录的局部大脑活动。 这可以用于控制矫形器以移动麻痹肢体。大多数BCI系统利用受影响的信号 大脑半球，试图驱动受损皮层的可塑性。然而，中风后的残余脑功能 BCI-SR的有效性，使得同病灶BCI难以用于损伤最严重的患者。在人类中， 对侧损伤的BCI-SR设备使用未受伤的半球来驱动术后的进一步康复。 传统的高原运动功能恢复。 临床上对卒中后功能预后的预测是不准确的。静息状态功能连通性 测量大脑休息时血氧水平依赖性（BOLD）波动的相关性，提供 研究中风后脑网络重塑的有力工具。然而，人类研究大脑 中风后的重塑通常包括具有不同病变的患者，并且无法获得基线 测量，允许rsFC比较中风前和中风后。动物研究可以解决这两个问题， 使得能够产生可复制的、同质的和特异性的梗死，并且通过允许收集基线 在梗塞产生之前进行测量。也缺乏足够的动物研究， 与BCI康复策略相关的rsFC变化。 我们的项目目标是进一步表征与CST病变相关的rsFC变化，并测试BCI介导的 运动恢复平台期后的康复策略。我们将在六只恒河猴的CST中产生均匀的损伤 猕猴和三个月的自然恢复后，驱动对侧损伤的BCI-SR。在每一个灵长类动物，我们将 收集基线时病变前、CST病变后和对侧病变期间的静息态功能MRI 然后，我们将识别与CST病变、先天性和非先天性病变相对应的rsFC的急性和慢性变化。 康复和脑机接口介导的康复。通过这些方法，我们试图验证 一种新的中风康复策略的有效性，同时提供对恢复相关变化的洞察， rsFC。