STN STIMULATION--NEURAL CONTROL OF MOVEMENT AND POSTURE

描述（改编自申请人摘要）：高频刺激 丘脑底核（subthalamic nucleus，简称NNA）显著改善了所有的临床症状。 帕金森病（PD）的运动症状。然而， 客观的数据，以确定哪些特点的运动和 姿势受到神经刺激的影响，这是什么神经机制 完成了本申请的长期目标是获得 客观的神经生理学数据有关的机制， 脑电刺激改变了介导脑电活动的空间和时间模式， 人类有计划的运动和姿势。手术后的患者 成功，定义为统一运动评分降低30% 帕金森氏病评定量表，将参加一系列实验 旨在研究运动和姿势的神经控制。的 目标I的实验将使用肌电图（EMG）和运动分析 技术，以确定哪些方面的力量，运动和站立平衡 通过电刺激改善、恶化或不变。的影响 还将刺激与药物对对照的影响进行比较 力量和运动。假设是，无论是刺激， 药物可以使运动控制正常化，而电刺激不能 规范站立平衡控制。目标2将使用 脑电图（EEG）技术，以测试是否 刺激引起的运动和步态启动变化伴随着 大脑皮层活动的空间和时间模式的变化 内部和外部产生的移动提示。这个假设是 神经刺激并不能使正常的神经通路正常化 但确实允许其他途径更好地补偿。目标3 将联合收割机EEG技术与通过四极电极的刺激相结合 植入到大脑皮层的区域，以检查 有效的刺激。拟议实验的结果将 促进我们对大脑皮层在运动功能中的作用的理解， 基底神经节作用的改进模型的发展 运动和姿势的控制，从而有助于改善治疗 治疗帕金森病

DESCRIPTION (Adapted from the Applicant's Abstract): High frequency stimulation of the subthalamic nucleus (STN) dramatically improves all of the clinical motor symptoms of Parkinson's Disease (PD). However, there are limited objective data available to determine which characteristics of movement and posture are affected by STN stimulation, and by what neural mechanisms this is accomplished. The long-term objective of this application is to obtain objective neurophysiological data relating to the mechanisms by which effective STN stimulation alters the spatial and temporal patterns of activity mediating planned movement and posture in humans. Patients in whom STN surgery is successful, as defined by a 30% reduction in the motor score of the Unified Parkinson's Disease Rating Scale, will take part in a series of experiments designed to investigate the neural control of movement and posture. The experiments in Aim I will use electromyographic (EMG) and motion analysis techniques to identify which aspects of strength, movement and standing balance are improved, worsened or unchanged by STN stimulation. The effects of STN stimulation will also be compared with the effects of medication on the control of strength and movement. The hypothesis is that neither STN stimulation nor medication normalizes the control of movement, and STN stimulation does not normalize the control of standing balance. Aim 2 will use electroencephalographic (EEG) techniques to test whether STN stimulation-induced changes in movement and gait initiation are accompanied by changes in the spatial and temporal patterns of cortical activity in response to both internally and externally generated cues to move. The hypothesis is that STN stimulation does not normalize the pathways that are normally influenced by the STN but does allow other pathways to compensate better. Aim 3 will combine EEG techniques with stimulation through the quadripolar electrodes implanted in the region of the STN to examine the pathways activated by effective STN stimulation. The findings of the proposed experiments will advance our understanding of the role of the STN in motor function, assist in the development of improved models of the role of the basal ganglia in the control of movement and posture, and thereby contribute to improved treatments for Parkinson's disease.