Progressive Changes in Brain Activation in Paraplegia

截瘫患者大脑激活的渐进变化

• 批准号: 6957942
• 负责人: Donald R. Humphrey
• 金额: $ 35.38万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-01 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6957942
• 关键词: body movement; clinical research; electromyography; foot; functional magnetic resonance imaging; human subject; neural information processing; paraplegia; psychomotor function; rehabilitation; sensorimotor system

DESCRIPTION (provided by applicant): In pilot research using fMRI, we found that voluntary activation of primary motor cortical (Ml) foot/leg areas was retained in paraplegics (Ps) up to 10 yrs after injury, with overlap developing between Ml hand and foot areas (since confirmed by others). More extensive analyses of our scans from 14 Ps and 4 control subjects (Ss) have revealed, however, more striking changes in brain activation patterns than previously reported. Moreover, these changes develop progressively over 15-25 yrs after spinal injury. In control Ss, brain activation is well lateralized and confined to distinct areas during unilateral foot or hand movement. By 6 months to 2 yrs after spinal injury, however, attempts to move one foot now activates supplementary motor and premotor cortex, basal ganglia, and cerebellum bilaterally. By 3-6 yrs after injury, there is some return toward normal patterns of activation in the Ml and SMA, but greater activation now occurs bilaterally in the basal ganglia and in frontal premotor and association cortex. By 12-25 yrs after injury, these changes are much more pronounced. Ml regions previously active during attempted foot movement are now silent, as are previously activated regions of the posterior cerebellum. But bilateral activation increases further in basal ganglia and in premotor/association cortex, and spreads even to hippocampal, limbic, and parieto-occipital-temporal, "higher-order association areas". Thus, we find more global and progressive changes in brain activity when attempts are made to move a paralyzed limb than has been reported in previous studies, where all Ps were analyzed as a single group. But our sample is small. A new study is needed, therefore, in which larger groups with differing injury durations are studied for greater statistical reliability, and in which improved motor tasks and kinematic measures allow for better control of movement parameters and effort. This study will expand our knowledge of how the brain changes progressively over decades to altered communication with the sensorimotor periphery, and could aid in the intelligent design of future therapies.

描述（由申请人提供）：在使用功能磁共振成像的初步研究中，我们发现截瘫患者（Ps）在受伤后10年内保留了初级运动皮层（Ml）足/腿区域的自主激活，Ml手部和足部区域之间出现重叠（自其他人证实以来）。然而，我们对14名P和4名对照受试者（S）的扫描进行了更广泛的分析，发现大脑激活模式的变化比以前报道的更显著。此外，这些变化在脊髓损伤后15-25年内逐渐发展。在控制Ss，大脑激活是很好的偏侧化，并局限于不同的领域，在单侧的脚或手的运动。然而，在脊髓损伤后6个月到2年，尝试移动一只脚会激活辅助运动和运动前皮质、基底神经节和双侧小脑。在损伤后3-6年，在Ml和SMA中存在朝向正常激活模式的一些恢复，但是在基底神经节和额叶运动前区和联合皮质中现在出现双侧更大的激活。在受伤后12-25年，这些变化更加明显。先前在尝试足部运动期间活跃的Ml区域现在是沉默的，就像先前激活的小脑后部区域一样。但是，双侧激活在基底神经节和运动前/联合皮层进一步增加，甚至扩散到海马，边缘系统和顶叶-枕叶-颞叶，“高阶联合区”。因此，我们发现更多的全球性和渐进性的变化，在大脑活动时，试图移动瘫痪的肢体比以往的研究，其中所有的Ps作为一个单一的组进行了分析。但我们的样本很小。因此，需要进行一项新的研究，研究具有不同损伤持续时间的较大群体，以获得更大的统计可靠性，并改进运动任务和运动学测量，以便更好地控制运动参数和努力。这项研究将扩大我们对大脑如何在几十年内逐渐改变以改变与感觉运动外周的交流的知识，并有助于未来治疗的智能设计。