Involuntary Movement: Physiological Analysis

该项目的目标是了解不同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，例如脑电图、肌电图、经颅磁刺激以及正电子发射断层扫描和功能磁共振成像的神经成像。该科目前正在进行的项目包括震颤、抽动、心因性运动障碍和阵发性运动障碍的研究。 需要新药来治疗原发性震颤。通过震颤加速测量和临床震颤测试，我们表明单剂量的 1-辛醇可以安全使用（最高 64 mg/kg），并且它可以显着减少良性特发性震颤的震颤。我们现在开始了一项长期使用辛醇的研究。我们还计划研究辛醇的药代动力学。 我们一直在以多种不同的方式研究抽动的生理学。使用 BOLD fMRI，我们正在检查抽动秽语综合征和慢性抽动障碍患者在抽动和抽动模仿过程中哪些大脑区域被激活。先前的研究已经使用神经影像学来显示抽动期间的大脑激活以及抽动抑制。通过研究患者的自然抽动以及患者对抽动的自愿模仿，我们希望找到哪些大脑区域可以被激活以产生抽动的冲动以及随后的自动运动。我们还使用血流 PET 来尝试定义抽动产生的解剖结构。在这种情况下，我们使用睡眠状态作为基线，这样我们就可以拥有一个基本上没有抽动和抽动冲动的状态。 我们进行了一项针对阵发性运动源性肌张力障碍患者的研究，以更好地临床表征该病症。与此同时，一名校外合作者试图寻找导致突变的基因。 我们已经开始探索包括震颤和肌阵挛在内的心因性运动障碍的病理生理学。我们正在进行脑电图和神经影像学研究，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.