The Role of the Cortex in Discoordination After Stroke

皮质在中风后协调障碍中的作用

• 批准号: 7183616
• 负责人: JULIUS P DEWALD
• 金额: $ 21.12万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-05-20 至 2010-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7183616
• 关键词: Area; Automobile Driving; Beer; Cells; Characteristics; Chronic; Coupling; Development; Elbow; Electrodes; Electromyography; Evaluation Studies; Force of Gravity; Foundations; Freedom; Generations; Head; Image; Individual; Intervention; Isometric Exercise; Joints; Laboratories; Limb structure; Literature; Measurement; Measures; Medial; Modeling; Motor; Movement; Muscle; Nature; Pattern; Phase; Protocols documentation; Reflex action; Research Personnel; Role; Scalp structure; Severities; Shoulder; Signal Transduction; Site; Source; Specificity; Stroke; Therapeutic Intervention; Time; Torque; Training; Upper Extremity; Upper arm; Week; Work; chronic stroke; density; hemiparetic stroke; indexing; novel; programs; reconstruction

DESCRIPTION (provided by applicant): Loss of independent control of joint movement in the impaired limb is a cardinal sign of stroke that is expressed in the form of stereotypic multi-joint movement patterns. Work from our laboratory has produced evidence for a loss of certain muscle coactivation patterns and associated abnormal shoulder/elbow torque coupling in the paretic arm of individuals with hemiparetic stroke. The general aim of this proposal is to elucidate the role of sensorimotor cortices in the loss of independent joint control of the paretic upper limb following stroke. We propose to study 20 individuals with chronic stroke and 20 control subjects to identify and quantify the characteristics of sensorimotor cortical activity related to the generation of isometric shoulder abduction/adduction and elbow flexion/extension torques. We hypothesize that an increased overlap of sensorimotor cortical activity is present in individuals with stroke (Aim 1). This aim will be realized using a 6 degree of freedom (DOF) load cell to provide simultaneous measurements of elbow and shoulder torques while measuring EEC from 163 scalp sites and EMG from 10 muscles in each arm. We postulate and have provided preliminary evidence for a significant overlap between cortical activity related to shoulder abduction and elbow flexion torque generation in chronic stroke subjects while not in able-bodied subjects. Subsequently, we plan to elucidate the relationship between the overlap of cortical activity and abnormal shoulder/elbow torque coupling in the paretic arm (Aim 2). We postulate that an increase in the overlap of cortical current activity is a reason for the abnormal torque coupling and serves as a predictor of the severity of discoordination in individuals with stroke. Finally, we propose to investigate the effect of a novel multidegree of freedom isometric training protocol on the overlap of cortical activity in individuals with stroke (Aim 3). Results from our recent work, using this training protocol, have shown a reduction in abnormal torque coupling between shoulder and elbow following an eight week intervention in all stroke subjects (n=7). We postulate and have provided preliminary evidence for a reduction in cortical-activity overlap in concurrence with a training-induced reduction in abnormal torque coupling. In conclusion, the combination of multichannel EEG imaging with a well controlled isometric elbow/shoulder torque generating task in subjects with chronic hemiparetic stroke is unmatched in the current literature. This study will provide new indices in the evaluation and study of discoordination as well as dynamic information on cortical plasticity in individuals with chronic hemiparetic stroke undergoing an upper extremity physical intervention. As such, the proposed study will substantially enhance our understanding of mechanisms driving discoordination in hemiparetic stroke and will provide foundations for further scientific inquiry into the development of more effective therapeutic interventions.

描述（由申请人提供）：受损肢体关节运动的独立控制丧失是卒中的主要体征，表现为刻板的多关节运动模式。我们实验室的工作已经提供了证据，证明在轻偏瘫中风患者的轻瘫手臂中，某些肌肉共激活模式和相关的异常肩/肘扭矩耦合丢失。这个建议的总体目的是阐明感觉运动皮层在中风后瘫痪上肢失去独立关节控制中的作用。我们建议研究20名慢性中风患者和20名对照组，以确定和量化与等长肩外展/内收和肘关节屈曲/伸展扭矩生成相关的感觉运动皮层活动的特征。我们假设，增加重叠的感觉运动皮层活动是目前在个人与中风（目的1）。这一目标将实现使用6自由度（DOF）负荷传感器，以提供肘部和肩部扭矩的同时测量EEC从163头皮网站和EMG从10肌肉在每只手臂。我们假设，并提供了初步的证据之间的显着重叠皮质活动有关的肩外展和肘部屈曲扭矩的产生在慢性中风的科目，而不是能够-身体的主题。随后，我们计划阐明皮质活动重叠与瘫痪手臂异常肩/肘扭矩耦合之间的关系（目标2）。我们推测，皮层电流活动的重叠增加是异常扭矩耦合的一个原因，并作为中风患者不协调的严重程度的预测。最后，我们建议调查一种新的多自由度等距训练方案对脑卒中患者皮层活动重叠的影响（目的3）。我们最近的工作结果，使用这种训练方案，已经显示在所有中风受试者（n=7）中，在八周的干预之后，肩和肘之间的异常扭矩耦合减少。我们假设，并提供了初步的证据，减少皮质活动重叠的同时，训练引起的减少异常扭矩耦合。总之，多通道EEG成像与控制良好的等长肘/肩扭矩生成任务相结合的慢性轻偏瘫卒中受试者是目前文献中无法比拟的。这项研究将提供新的指标，在评估和研究的不协调以及动态信息的大脑皮层可塑性的慢性偏瘫中风患者接受上肢物理干预。因此，这项拟议的研究将大大提高我们对轻偏瘫中风中驱动失调的机制的理解，并将为进一步科学探究开发更有效的治疗干预措施提供基础。