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
• 负责人: Aasef G Shaikh
• 金额: --
• 依托单位: LOUIS STOKES CLEVELAND VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10484282
• 关键词: Affect; American; Anatomy; Area; Atlases; Bilateral; Biophysics; Bradykinesia; Brain; Clinical; Computer Simulation; Data; Deep Brain Stimulation; Degenerative Disorder; Depth Perception; Diplopia; Distal; Dorsal; Electrodes; Equipment; Eye; Eye Abnormalities; Eye Movements; Functional disorder; Goals; Hypokinesia; Image; Impairment; Interdisciplinary Study; Knowledge; Left; Location; Magnetic Resonance Imaging; Maps; Measures; Mental Depression; Modeling; Motor; Movement; Movement Disorder Society Unified Parkinson' s Disease Rating Scale; Nature; Nerve Degeneration; Operative Surgical Procedures; Parkinson Disease; Patients; Pharmacotherapy; Positioning Attribute; Quality of life; Questionnaires; Research; Resolution; STN stimulation; Social Impacts; Therapeutic; Tissues; Tremor; Veterans; Vision; Visual impairment; Visual system structure; electric field; excessive anxiety; experimental study; gaze; improved; insight; military veteran; motor deficit; motor impairment; motor symptom; multidisciplinary; novel; orbit muscle; preservation; programs; progressive neurodegeneration; treatment response; visual motor; visual tracking; way finding

The sufferers of a prevalent condition called Parkinson's disease have tremors, rigidity, and slow movements. In addition to its effects on body movements, Parkinson's disease affects many other brain functions. Visual impairments are common in Parkinson's patients who have difficulties holding their eyes steady at a given location, seamlessly look around and read, and refocus their eyes from one image to the other placed at different depths. About two thirds of Parkinson's disease patients have problems coordinating two eyes' movements necessary to refocusing at different depths, i.e., abnormal vergence causing disabling double vision and abnormal depth perception. Most treatment options available to Parkinson's disease patients are limited to their effects on tremor, rigidity, and slowness – their impact on visual function is poorly understood. Orbital muscle surgeries are not ideal treatments given the brain's continually changing state due to the disease's degenerative nature. Presently available strategies of deep brain stimulation have variable effects on eye movements and vergence function. Our research program aims to identify the best possible therapeutic approach using deep brain stimulation to improve vergence eye movements in Parkinson's disease while continuing to offer its other benefits. Our multidisciplinary program has two aspects. One part of the study will examine the effects of deep brain stimulation on vergence abnormalities affecting their ability to focus at various depths. Using state-of-the-art, high-resolution, research-grade ophthalmic equipment, we will examine how deep brain stimulation can improve the patients' ability to refocus and treat vergence abnormalities affecting depth perception. Once we identify these favorable changes, we will correlate them with the stimulated anatomical location within the same patient's brain. To do so, we will combine novel computer simulations of deep brain stimulation-induced electrical field overlaid upon the patient's magnetic resonance images. The knowledge gained will allow us to find the most beneficial stimulation locations to improve vision while offering improvement in tremors, rigidity, and slow movements.

帕金森氏症是一种常见的疾病，患者会出现震颤、僵硬和缓慢的动作。 动作除了对身体运动的影响，帕金森病还影响许多其他大脑 功能协调发展的视觉障碍在帕金森患者中很常见，他们很难保持眼睛稳定 在一个给定的位置，无缝地环顾四周，阅读，并重新聚焦他们的眼睛从一个图像到另一个放置 在不同的深度。大约三分之二的帕金森病患者有协调双眼的问题。 在不同深度处重新聚焦所必需的运动，即，异常聚散导致丧失复视 和异常的深度知觉帕金森病患者可用的大多数治疗选择仅限于 它们对震颤、僵硬和迟钝的影响--它们对视觉功能的影响知之甚少。轨道 肌肉手术并不是理想的治疗方法，因为大脑的状态不断变化， 退化的本性目前可用的脑深部电刺激策略对眼睛有不同的影响 运动和聚散功能。我们的研究计划旨在确定最好的治疗方法， 一种使用深部脑刺激改善帕金森病患者聚散眼球运动的方法， 继续提供其他好处。我们的多学科计划有两个方面。研究的一部分将 检查脑深部电刺激对影响他们在各种情况下专注能力的聚散异常的影响， 深度使用最先进的高分辨率研究级眼科设备，我们将检查 脑刺激可以提高患者重新聚焦和治疗影响深度的聚散异常的能力， perception.一旦我们确定了这些有利的变化，我们将把它们与刺激的解剖结构联系起来。 位于同一患者的大脑内。为了做到这一点，我们将联合收割机结合新的计算机模拟大脑深处 在一些实施例中，刺激感应的电场覆盖在患者的磁共振图像上。知识 将使我们能够找到最有益的刺激位置，以改善视力，同时提供改善 颤抖僵硬动作缓慢