Involuntary Movement: Physiological Analysis

这个项目的目标是了解不同的不自主运动障碍的潜在生理机制。我们使用的工具包括临床神经生理学方法，如脑电图，肌电图，经颅磁刺激和神经成像与正电子发射断层扫描和功能磁共振成像。该科目前正在进行的项目包括震颤、抽搐、心因性运动障碍和阵发性运动障碍的研究。 需要新的药物来治疗原发性震颤。使用震颤加速度计和临床震颤测试，我们已经表明，1-辛醇，作为一个单一的剂量，可以安全地使用（高达64毫克/公斤），它显着减少震颤的良性原发性震颤。我们现在已经开始了一项使用辛醇更长时间的研究。我们还计划研究辛醇的药代动力学。 我们一直在以许多不同的方式研究抽搐的生理学。使用BOLD功能磁共振成像，我们正在研究在抽动和抽动模拟抽动症和慢性抽动障碍患者的大脑区域被激活。以前的研究已经使用神经成像来显示抽搐和抽搐抑制期间的大脑激活。通过研究病人的自然抽搐以及病人对抽搐的自愿模仿，我们希望找到在产生抽搐的冲动和随之而来的自动运动时，大脑的哪些区域可能被激活。我们还使用血流PET来尝试定义抽搐产生的解剖结构。在这种情况下，我们使用睡眠状态作为基线，这样我们就可以有一个基本上没有抽搐和抽搐冲动的状态。 我们已经进行了一项研究，观察阵发性运动源性肌张力障碍的人，以更好地描述临床条件。与此同时，一位校外合作者试图找到负责的突变基因。 我们已经开始探索心因性运动障碍的病理生理学，包括震颤和肌阵挛。我们正在做脑电图和神经成像研究，试图确定大脑中负责运动启动的部分。

The goal of this project is to understand the underlying physiological mechanisms of different involuntary movement disorders. The tools we use include clinical neurophysiological methods such as electroencephalography, electromyography, and transcranial magnetic stimulation and neuroimaging with positron emission tomography and functional magnetic resonance imaging. Currently active projects in the Section include studies of tremor, tic, psychogenic movement disorders and paroxysmal movement disorders. New drugs are needed for treatment of essential tremor. Using tremor accelerometry and clinical tremor testing we have shown that 1-octanol, as a single dose, can be safely used (up to 64 mg/kg) and that it significantly reduces tremor in benign essential tremor. We have now started a study using octanol for longer periods of time. We are also planning to study the pharmacokinetics of octanol. We have been approaching the physiology of tics in many different ways. Using BOLD fMRI, we are examining what brain regions are activated during tics and tic imitations in patients with Tourette's syndrome and chronic tic disorder. Previous studies have used neuroimaging to show brain activation during tics as well as tic suppression. By studying both the patient's natural tics as well as the patient's voluntary imitation of the tic, we hope to find what brain areas may be activated in generating the urge to tic and the automatic movement that follows. We are also using blood flow PET to try to define the anatomy for tic generation. In this situation, we are using a sleep state for baseline so that we can have a state largely free of both tics and urge to tic. We have conducted a study looking at persons with paroxysmal kinesiogenic dystonia to characterize the condition better clinically. Simultaneously, there are attempts by an extramural collaborator to find the responsible mutated gene. We have begun to explore the pathophysiology of psychogenic movement disorders including tremor and myoclonus. We are doing EEG and neuroimaging studies trying to identify the parts of the brain responsible for movement initiation.