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.

流行状况的患者称为帕金森氏病，震颤，僵化和缓慢 动作。除了对身体运动的影响外，帕金森氏病还会影响许多其他大脑 功能。视觉障碍在帕金森氏病患者中很常见 在给定的位置，无缝环顾四周，将眼睛从一个图像重新聚焦到另一个位置 在不同的深度。大约三分之二的帕金森氏病患者在两只眼睛的协调方面有问题。 重新聚焦在不同深度的必要动作，即异常的诱发双视力 和异常深度感知。帕金森氏病患者可用的大多数治疗选择仅限于 它们对震颤，僵化和缓慢的影响 - 对视觉功能的影响很差。轨道 鉴于大脑由于疾病而导致的大脑不断变化的状态，肌肉手术不是理想的治疗方法 退化性质。目前可用的深脑刺激策略对眼睛具有可变影响 动作和gergence函数。我们的研究计划旨在确定最佳疗法 使用深脑刺激来改善帕金森氏病中的Gergence眼动运动 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 检查深脑刺激对发生各种聚焦的能力的Gergence异常的影响 深度。使用最先进的高分辨率，研究级眼科设备，我们将研究如何深 脑刺激可以提高患者重新集中注意力和治疗影响深度异常的能力 洞察力。一旦我们确定了这些有利的变化，我们将将它们与刺激的解剖学相关联 位置在同一患者的大脑内。为此，我们将结合深脑的新型计算机模拟 刺激引起的电场覆盖在患者的磁共振图像上。知识 获得的将使我们找到最有益的刺激位置，以改善视力，同时提供改进 在震颤，僵化和缓慢的运动中。