Progressive Changes in Brain Activation in Paraplegia

截瘫患者大脑激活的渐进变化

• 批准号: 7066081
• 负责人: Donald R. Humphrey
• 金额: $ 34.55万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-01 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7066081
• 关键词: body movement; clinical research; electromyography; foot; functional magnetic resonance imaging; human subject; neural information processing; paraplegia; psychomotor function; rehabilitation; sensorimotor system

DESCRIPTION (provided by applicant): In pilot research using fMRI, we found that voluntary activation of primary motor cortical (Ml) foot/leg areas was retained in paraplegics (Ps) up to 10 yrs after injury, with overlap developing between Ml hand and foot areas (since confirmed by others). More extensive analyses of our scans from 14 Ps and 4 control subjects (Ss) have revealed, however, more striking changes in brain activation patterns than previously reported. Moreover, these changes develop progressively over 15-25 yrs after spinal injury. In control Ss, brain activation is well lateralized and confined to distinct areas during unilateral foot or hand movement. By 6 months to 2 yrs after spinal injury, however, attempts to move one foot now activates supplementary motor and premotor cortex, basal ganglia, and cerebellum bilaterally. By 3-6 yrs after injury, there is some return toward normal patterns of activation in the Ml and SMA, but greater activation now occurs bilaterally in the basal ganglia and in frontal premotor and association cortex. By 12-25 yrs after injury, these changes are much more pronounced. Ml regions previously active during attempted foot movement are now silent, as are previously activated regions of the posterior cerebellum. But bilateral activation increases further in basal ganglia and in premotor/association cortex, and spreads even to hippocampal, limbic, and parieto-occipital-temporal, "higher-order association areas". Thus, we find more global and progressive changes in brain activity when attempts are made to move a paralyzed limb than has been reported in previous studies, where all Ps were analyzed as a single group. But our sample is small. A new study is needed, therefore, in which larger groups with differing injury durations are studied for greater statistical reliability, and in which improved motor tasks and kinematic measures allow for better control of movement parameters and effort. This study will expand our knowledge of how the brain changes progressively over decades to altered communication with the sensorimotor periphery, and could aid in the intelligent design of future therapies.

描述（由申请人提供）：在使用fMRI的试点研究中，我们发现初级运动皮质（Ml）足/腿区域在受伤后10年内仍保留在截瘫（Ps）中，Ml手和足区域之间出现重叠（已被其他人证实）。然而，我们对14名Ps和4名对照受试者（Ss）的扫描结果进行了更广泛的分析，结果显示，大脑激活模式的变化比之前报道的更为惊人。此外，这些变化在脊髓损伤后15-25年内逐渐发展。在对照组中，在单侧脚或手运动时，大脑的激活被很好地侧向化并局限于不同的区域。然而，在脊髓损伤后6个月至2年，尝试移动一只脚会激活双侧辅助运动和前运动皮层、基底神经节和小脑。损伤后3-6年，Ml和SMA的一些激活恢复到正常模式，但更大的激活现在发生在双侧基底神经节和额叶前运动皮层和联合皮层。受伤后12-25年，这些变化更为明显。先前在尝试足部运动时活跃的Ml区域现在是沉默的，正如先前激活的小脑后部区域一样。但双侧基底神经节和运动前/联合皮层的激活进一步增加，甚至扩散到海马、边缘和顶枕颞“高阶联合区”。因此，我们发现，当尝试移动瘫痪肢体时，大脑活动的全局性和进行性变化比以前的研究报道的要多，在以前的研究中，所有的p都被作为一个单独的组来分析。但是我们的样本很小。因此，需要一项新的研究，在更大的群体中研究不同的损伤持续时间，以提高统计可靠性，并改进运动任务和运动学测量，以便更好地控制运动参数和努力。这项研究将扩大我们对几十年来大脑如何逐渐改变与感觉运动外围的交流的认识，并有助于未来治疗方法的智能设计。