EFFECTS OF DBS ON POSTURE AND OROMOTOR CONTROL

DBS 对姿势和口运动控制的影响

• 批准号: 6838180
• 负责人: FAY BAHLING HORAK
• 金额: $ 22.65万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-03-01 至 2006-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6838180
• 关键词: Parkinson' s disease; adult human (21+); balance; basal ganglia; brain electrical activity; brain stem; dopamine; electrodes; electrostimulus; gait; human subject; human therapy evaluation; lenticular nucleus; levodopa; longitudinal human study; nervous system disorder therapy; neuropsychological tests; patient oriented research; performance; posture; psychomotor function; speech; subthalamus; swallowing; thalamic nuclei

DESCRIPTION (Adapted from the Applicant's Abstract): Balance, gait, speech, and swallowing deficits are major causes of disability in patients with Parkinson's disease (PD). In many patients, these "axial symptoms" are resistant to levodopa therapy. A potential advantage of deep brain stimulation (DBS) of globus pallidus internal (GPi) and the subthalamic nucleus (STN) could be improvement of these axial motor symptoms. Our long-term goal is to determine the effects off DBS on axial motor control in order to understand the role of the basal ganglia in centrally (voluntarily) and peripherally (automatically) initiated axial movements. We hypothesize that there are multiple motor outputs from the basal ganglia with differing sensitivity to dopamine and DBS. The goal of this project is to distinguish functionally different basal ganglia control mechanisms for the axial motor system by their unique patterns of response to DBS and levodopa when used separately and when used in combination. We hypothesize that DBS will he more effective than levodopa and that STN stimulation will be more effective than GPi stimulation for axial parkinsonian symptoms. This project will take advantage of a unique opportunity to rigorously quantify the effects of chronic DBS in radiologically-identified human basal ganglia in a randomized, double-blind study. These studies will quantify forces and movements in two types of postural and oromotor tasks: peripherally triggered, automatic responses to external cues and centrally-initiated voluntary movements. The specific aims are: (1) To determine how DBS affects centrally-initiated and peripherally-triggered postural control. (2) To determine how DBS affects centrally-initiated and peripherally-triggered oromotor control. (3) To investigate the interactions of DBS and levodopa treatment on postural and oromotor control. (4) To determine effects of the site (GPi versus STN) of DBS on postural and oromotor control. These experiments will quantify the efficacy of DBS and levodopa both separately and when combined for balance and oromotor deficits in patients with PD. Quantifying two types of postural and oromotor control in the same subjects will also substantially increase our understanding of the role of the basal ganglia in axial motor control.

描述（改编自申请人的摘要）：平衡、步态、言语和 吞咽障碍是帕金森病患者残疾的主要原因 疾病（PD）。在许多患者中，这些“轴性症状”对 左旋多巴疗法。深部脑刺激（DBS）的潜在优势 苍白球内部 (GPi) 和丘脑底核 (STN) 可能是 这些轴向运动症状的改善。我们的长期目标是确定 DBS 对轴向电机控制的影响，以了解其作用 基底神经节分为中枢（自愿）和外周（自动） 引发轴向运动。我们假设有多个电机输出 来自对多巴胺和 DBS 具有不同敏感性的基底神经节。目标 该项目的目的是区分功能不同的基底神经节控制 轴向电机系统的机制通过其独特的响应模式 DBS 和左旋多巴单独使用和联合使用时。我们 假设 DBS 比左旋多巴更有效，而 STN 对于轴性帕金森病，电刺激比 GPi 电刺激更有效 症状。该项目将利用一个独特的机会 严格量化慢性 DBS 对放射学鉴定的影响 一项随机、双盲研究中的人类基底神经节。这些研究将 量化两种类型的姿势和口腔运动任务中的力和运动： 外围触发，对外部提示的自动响应和 中央发起的自愿运动。 具体目标是： (1) 确定星展银行如何影响中央发起和 外周触发的姿势控制。 (2) 确定 DBS 如何影响 中枢启动和外周触发的口腔运动控制。 (3) 至 研究 DBS 和左旋多巴治疗对姿势和姿势的相互作用 口腔运动控制。 (4) 确定 DBS 位置（GPi 与 STN）的影响 关于姿势和口腔运动控制。这些实验将量化功效 DBS 和左旋多巴单独使用以及组合使用以保持平衡和口腔运动 PD 患者的缺陷。量化两种类型的姿势和口腔运动 对同一主题的控制也将大大增加我们的理解 基底神经节在轴向运动控制中的作用。