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 中风幸存者面临重大的长期健康后果，康复对改善至关重要 他们的恢复和生活质量。目前，在3-6个月后未恢复运动功能的患者为 不太可能显示进一步的恢复。白质介入的病变通常与恶化相关 结果。例如，皮质脊髓损伤（CST）病变会产生较差的运动缺陷和预兆 功能恢复差。脑部计算机界面介导的中风康复（BCI-SR）可以是强大的 康复工具。在BCI-SR中，患者学会了调节电极记录的局部脑活动。 这可用于控制矫形器以移动偏长的肢体。大多数BCI系统都使用受影响的信号 半球，试图在受伤的皮质中驱动可塑性。但是，中风限制后的残留脑功能 BCI-SR功效，使iPsilesional BCI难以在受伤最严重的患者中使用。在人类中 对比的BCI-SR设备已使用未受伤的半球来推动进一步的康复 传统的高原运动功能恢复。 中风后功能结果的临床预测不精确。静止状态功能连接（RSFC） 衡量在整个大脑的静止状态下血液氧气水平（粗体）波动的相关性，提供 中风后研究大脑网络重塑的强大工具。但是，人类研究调查大脑 中风后的重塑通常包括患有不同病变的患者，无法进入基线 允许RSFC比较前后的测量结果。动物研究可以通过 能够产生可复制，同质和特定的梗死，并允许收集基线 梗塞产生之前的测量。还没有充分的动物研究表征 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更改并测试BCI介导的 运动恢复高原后的康复策略。我们将在六个恒河神的CST中产生均匀的病变 猕猴和自然恢复三个月后，驱动对侧BCI-SR。在每个灵长类动物中，我们都会 在病变，CST病变后和相反期间，在基线时收集静息状态功能MRI BCI-SR。然后，我们将确定与CST病变相对应的RSFC的急性和慢性变化 恢复和脑部计算机介导的康复。通过这些方法，我们试图验证 新型中风康复策略的功效，同时为恢复相关的变化提供见识 RSFC。