Mechanisms of Motor Receovery after Subtotal Brain Injury

脑部次全损伤后运动恢复的机制

• 批准号: 6851729
• 负责人: ROBERT J MORECRAFT
• 金额: $ 31.96万
• 依托单位: UNIVERSITY OF SOUTH DAKOTA
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-02-15 至 2009-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6851729
• 关键词: Macaca mulatta; arm; behavior test; brain injury; disease /disorder model; experimental brain lesion; functional ability; limb movement; longitudinal animal study; neural plasticity; psychomotor function; pyramidal tracts; stroke

DESCRIPTION (provided by applicant): Stroke is the leading cause of functional disability affecting greater than 780,000 people a year in the United States. The negative personal, social and economic impacts of this disease are staggering. In clinical practice, it is a common observation that variable levels of motor recovery occur following damage of the motor cortex or its descending pathways. Although there appears to be considerable functional plasticity in the adult brain, the mechanisms underlying motor recovery following subtotal brain injury remain poorly understood. In adult rhesus monkeys, our major goal is to test the hypothesis that a central mechanism of functional recovery of arm movement occurs through reorganization of the corticospinal projection from intact cingulate motor areas located ipsilateral to a subtotal brain lesion. At clinically significant time intervals, we will test this hypothesis by studying neuroplastic adaptations of the corticospinal projection from the arm areas of the rostral (M3) and caudal (M4) cingulate motor cortices following isolated resection of the ipsilateral arm areas of a) the primary motor cortex (M1); b) M1 and dorsolateral area 6 (LPMCd) and; c) M1, LPMCd and the supplementary motor cortex (M2). The first two lesion categories model the most common form of stroke, namely middle cerebral artery infarction. Hand recovery will be carefully tracked by analyzing 3-D hand trajectory during reaching, force control during grasping and lifting, and monitoring functional hand performance using 2 specialized assessment methods. This project will lead to a greater understanding of the role of the cingulate motor cortices in the recovery process of arm movement following ipsilateral damage to the frontal motor cortices. This work will also assess whether the integrity of spared corticospinal projections from intact motor areas positioned ipsilateral to a lesion of the cerebral cortex underlie functional restitution of hand movement control and whether long-term reorganization of intact corticospinal terminals accompany the recruitment of parallel cortical motor areas after subtotal brain injury. We will determine the type of motor/premotor cortical lesion that activates natural (i.e., non-therapeutic) recruitment of the cingulate corticospinal system, the timing of the activation process and how this affects the reaching and grasping process. This information will assist in establishing predictors to identify a large patient population that may develop favorably after stroke since the origin of the cingulate corticospinal projection is supplied by the anterior cerebral artery (ACA) and the ACA is spared in greater than 97% of all first time ischemic stroke victims. Furthermore, it will assist in guiding creative rehabilitative intervention approaches aimed at enhancing anterior cingulate participation in the recovery process.

描述（由申请人提供）：中风是功能性残疾的主要原因，在美国每年影响超过78万人。这一疾病对个人、社会和经济的负面影响是惊人的。在临床实践中，常见的观察结果是在运动皮层或其下行通路受损后发生不同水平的运动恢复。虽然成年人的大脑似乎有相当大的功能可塑性，但对次全脑损伤后运动恢复的机制仍知之甚少。在成年恒河猴中，我们的主要目标是检验这一假设，即手臂运动功能恢复的中枢机制是通过重组位于同侧的完整扣带回运动区的皮质脊髓投射到次全脑病变来实现的。在临床上有意义的时间间隔内，我们将通过研究在单独切除同侧臂区a）初级运动皮层（M1）; B）M1和背外侧区6（LPMCd）和（M2）后，头侧（M3）和尾侧（M4）扣带回运动皮层臂区的皮质脊髓投射的神经可塑性适应来检验这一假设。c）M1、LPMCd和辅助运动皮层（M2）。前两种病变类别模拟了最常见的中风形式，即大脑中动脉梗死。通过分析伸手过程中的3-D手轨迹、抓握和举起过程中的力控制以及使用2种专门评估方法监测功能性手表现，仔细跟踪手的恢复。这个项目将导致一个更好的理解扣带运动皮层的作用，在恢复过程中的手臂运动后，同侧额叶运动皮层损伤。这项工作还将评估是否完整的备用皮质脊髓的预测从完整的运动区定位同侧的大脑皮层病变的基础功能恢复的手运动控制，以及是否长期重组完整的皮质脊髓终端伴随招聘平行皮质运动区次全脑损伤后。我们将确定激活自然（即，扣带皮质脊髓系统的募集、激活过程的时机以及这如何影响到达和抓握过程。这些信息将有助于建立预测因素，以识别中风后可能顺利发展的大量患者群体，因为扣带皮质脊髓投射的起源是由大脑前动脉（ACA）提供的，并且超过97%的首次缺血性中风患者的ACA都幸免于难。此外，它将有助于指导创造性的康复干预方法，旨在提高前扣带回参与恢复过程。