Motor Control Deficits in Parkinson's Disease

帕金森病的运动控制缺陷

• 批准号: 6774316
• 负责人: Howard Poizner
• 金额: $ 20.86万
• 依托单位: RUTGERS THE STATE UNIV OF NJ NEWARK
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-07-01 至 2007-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6774316
• 关键词: Parkinson' s disease; abnormal involuntary movement; brain disorder chemotherapy; clinical research; computer human interaction; computer simulation; dopamine; human subject; human therapy evaluation; limb movement; neural information processing; neuromuscular function; neuropharmacology; patient oriented research; psychomotor function; sensory discrimination; space perception; visual feedback

DESCRIPTION (provided by applicant): Our findings in the current grant period have led us to hypothesize that a major difficulty for patients with Parkinson disease (PD) is in assembling and using new sensorimotor mappings or coordinations. These process play a major role both in ongoing motor performance and in the acquisition of new skills, in addition, our preliminary data are consistent with a general observation that these processes may be relatively resistant to current therapeutic modalities. Furthering our understanding of this deficit, examining its impact on motor learning, and investigating the ability of dopaminergic therapy to reverse this deficit are the guiding aims of this proposal. The present proposal presents three experiments that are designed to confirm and extend our hypothesis and to investigate the degree to which dopaminergic therapy is able to remediate these deficits. The first two experiments (Specific Aims 1 and 2) introduce the requirement that subjects learn to move within a virtual environment as a prerequisite to establishing the new sensorimotor coordinations necessary for accurate target acquisition. We require subjects to master distortions which create discrepancies between the apparent (virtual) and real (proprioceptively signaled) location of their arms and to generalize the resulting learning to untrained regions of this environment. By dissociating movements from their normal sensory correspondences, we will challenge subjects' abilities to reconfigure their sensorimotor coordinations. The third experiment (Specific Aim 3) challenges patients by requiring them to integrate different motor acts in order to acquire visually-presented, real targets by compensating for a mechanical perturbation of the trunk during a trunk-assisted reach. We have integrated and coupled our previously developed system for analysis and display of three dimensional movements with our newly developed virtual reality environment. We will examine not only subjects' accuracy, but also the path, timing, and structure of their movements under different conditions and types of imposed distortions, in order to measure both performance and learning when PD patients are OFF versus ON dopaminergic therapy. By contrasting the performance and capacities of PD patients on and off dopaminergic therapy to that of comparable normals, we can both obtain clues as to how to overcome PD dysfunction and gain an insight into the key role of the basal ganglia in movement.

描述（由申请人提供）：我们在当前资助期内的发现使我们假设帕金森病（PD）患者的主要困难在于组装和使用新的感觉运动映射或协调。这些过程在持续的运动表现和获得新技能方面都发挥着重要作用，此外，我们的初步数据与一般观察结果一致，即这些过程可能对当前的治疗方式相对有抵抗力。进一步了解这种缺陷，检查其对运动学习的影响，并研究多巴胺能疗法扭转这种缺陷的能力是该提案的指导目标。目前的提案提出了三个实验，旨在证实和扩展我们的假设，并研究多巴胺能疗法能够在多大程度上纠正这些缺陷。前两个实验（具体目标 1 和 2）引入了受试者学习在虚拟环境中移动的要求，作为建立准确目标捕获所需的新感觉运动协调的先决条件。我们要求受试者掌握扭曲，这些扭曲会造成手臂的明显（虚拟）位置和真实（本体感受信号）位置之间的差异，并将由此产生的学习推广到该环境中未经训练的区域。通过将运动与正常的感觉对应分离，我们将挑战受试者重新配置其感觉运动协调的能力。第三个实验（具体目标 3）要求患者整合不同的运动行为，以便通过在躯干辅助伸展过程中补偿躯干的机械扰动来获得视觉呈现的真实目标，从而对患者提出挑战。我们将之前开发的用于分析和显示三维运动的系统与新开发的虚拟现实环境集成并耦合。我们不仅要检查受试者的准确性，还要检查他们在不同条件和施加扭曲类型下运动的路径、时间和结构，以便衡量 PD 患者在多巴胺能治疗关闭与开启时的表现和学习情况。通过将接受多巴胺能治疗和未接受多巴胺能治疗的 PD 患者的表现和能力与可比较的正常人进行比较，我们可以获得如何克服 PD 功能障碍的线索，并深入了解基底神经节在运动中的关键作用。