Feasibility of Rehabilitation Robots and fMRI in Stroke

描述(由申请人提供)：广泛的长期目标：改善中风患者的康复和生活质量。 假设：经过优化设计的磁共振(MR)兼容机器人设备可以通过刺激初级运动皮质表征和细胞特性的可塑性，帮助中风引起的病理或创伤性改变的运动康复。具体目标：(1)构建新型MR兼容的康复力反馈机器人设备，并使用最佳功能磁共振成像(FMRI)方案在健康志愿者身上进行测试：(2)证明将这些机器人设备与fMRI相结合在评估中风患者康复方面的相关性。 与健康相关：越来越多的患者患有中风，这是现代社会导致残疾的主要原因。监测和验证中风康复治疗的有效性是具有挑战性的，因为它的生理要求包括外周和中枢神经系统的可塑性。在这项提案中开发和测试的最先进的功能性磁共振方法与新型MR兼容的机器人康复设备相结合，可以提供关于康复治疗有效性的准确、敏感和特定的信息，而不是传统的方法。 研究设计和方法：这项探索性研究将为使用最先进的MR系统使用新型IVR兼容机器人设备监测中风患者康复动作的可行性产生先导数据。适用于我们MR兼容机器人的适用于中风患者的任务将通过使用相控阵线圈的MR系统进行设计、测试和优化，以提高灵敏度和分辨率。FMRI将在6名健康的成年志愿者和6名中风患者身上进行；方法将得到优化，以测量自愿运动相关皮质区域的激活情况。 项目理由和意义：通过证明功能磁共振成像在监测中风患者康复操作有效性方面的有效性，这些研究最终可以为未来中风康复治疗的评估提供另一种方法。因此，预期的结果可能导致开发一种新的中风患者康复的优化方法；进一步发展该方法将成为阐明中风引起的病理和创伤变化的有价值的工具，并为中风患者的治疗提供独特的前瞻性信息。

DESCRIPTION (provided by applicant): Broad long-term objectives: To improve the rehabilitation and quality of life of stroke patients. Hypothesis: Optimally designed Magnetic Resonance (MR) compatible robotic devices can assist in movement rehabilitation of stroke-induced pathological or traumatic changes by stimulating plasticity of primary motor cortex representations and cell properties. Specific Aims: (1) To build novel MR compatible rehabilitation force-feedback robotic devices and tested them in healthy volunteers using an optimal functional MR imaging (fMRI) protocol: and (2) demonstrate the relevance of combining these robotic devices and fMRI for evaluating rehabilitation in stoke patients. Health relatedness: An increasing number of patients suffer from stroke, a major cause of invalidity in modern society. Monitoring and validating the effectiveness of stroke rehabilitation therapy is challenging, since its physiological requirements include both peripheral and central nervous system plasticity. State-of-the-art functional MR methods combined with novel MR compatible robotic rehabilitation devices, which are developed and tested in this proposal, can provide accurate, sensitive and specific information about the effectiveness of rehabilitation therapy beyond traditional approaches. Research design and methods: This exploratory study will generate pilot data for the feasibility of monitoring rehabilitation maneuvers in stroke patients with a state-of-the-art MR system using novel IvR compatible robotic devices. Stroke patient appropriate tasks suitable for our MR compatible robots will be designed, tested and optimized with an MR system that uses phased-array coils, to increase sensitivity and resolution. fMRI will be performed on 6 healthy adult volunteers and 6 stroke patients; and methods will be optimized to measure activation in voluntary movement-related cortical areas. Project rationale and significance: By demonstrating the utility of fMRI to monitor the effectiveness of rehabilitation maneuvers in stroke patients, these studies can ultimately provide an additional method for the future evaluation of stroke rehabilitation therapies. To this end, the anticipated results may lead to the development of a novel optimized method for stroke patient rehabilitation; and upon further development this method could become a valuable tool to illuminate stroke-induced pathological and traumatic changes, and to provide unique prospective information for stroke patient management.