DOES MENTAL PRACTICE OF FOOT MOVEMENT IMPROVE CORTICOSPINAL CONDUCTION AND MOTO
足部运动的心理练习是否可以改善皮质脊髓传导和运动
基本信息
- 批准号:7374282
- 负责人:
- 金额:$ 2.31万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2006
- 资助国家:美国
- 起止时间:2006-04-01 至 2006-11-30
- 项目状态:已结题
- 来源:
- 关键词:
项目摘要
This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Spinal cord injury (SCI) remains a major medical problem in the U.S. Over 11,000 new patients suffer and survive a new SCI each year(1), with U.S. prevalence of nearly a quarter million persons. SCI is compounded by numerous secondary medical problems. The lifetime cost in dollars varies with the age at SCI but exceeds 1-2 million dollars for most quadriplegics. In approximately half of all patients with SCI, the injury is said to be complete, meaning that none of the motor or sensory function below the level of SCI is controlled by the brain, instead arising solely from reflex or localized spinal cord events. In the other half of patients, injury is incomplete, meaning a fraction of the normal brain control of sub-lesional spinal cord events remains. Several lines of evidence suggest that, after SCI, behavioral deficits are often more severe than would be predicted from measures of anatomical injury. If true, this suggests the potential to improve motor status in the setting of a fixed lesion, even when deficits are severe. Evidence includes (1) Anatomical evidence: In most patients diagnosed with complete SCI, neuropathological observations suggest surviving anatomical connections between brain and spinal cord motor areas (2). Such patients have been termed discomplete (3). The minimum number of fibers in the lateral corticospinal tract of SCI patients with preserved voluntary motor function was 3,173 (normal 41,472); the mean number of fibers in this tract among complete SCI patients was not zero, but instead averaged 2,113. (2) Physiological evidence: Neurophysiological studies can demonstrate residual corticospinal tract function in some, alebit a minority, of patients with complete SCI. Transcranial magnetic stimulation (TMS) of motor cortex in these patients shows that electrical signals can be transmitted to spinal cord areas below the injury(4-6). (3) Analogous findings in patients with cortical stroke: We recently demonstrated that, among patients with stroke affecting the hand's primary motor cortex area, voluntary hand motor function was abolished when approximately 37%--and not 100%--of the normal hand motor cortex map was destroyed by the disease (7). (4) Reports of motor gains with extreme physiotherapy: After SCI (eg C. Reeve) (8) or stroke (reports of constraint induced therapy, eg a study from my lab by Schaechter et al (9)), motor status can be improved in patients with a fixed lesion and little or no movement. No recovery would be likely if initial plegia were due to ablation of all key motor substrates. The overall rationale of the proposed study is to explore the strategy that part of improving leg motor status in patients with a fixed SCI can come from increased cortical activity. Whether a patient has a chronic stable lesion or is part of incipient studies that will aim to restore corticospinal tract integrity, the brain remains a critical part of improving leg motor status. Current studies in my lab are measuring residual motor cortex function in ASIA A paraplegics. The proposed study will measure whether, among patients with severely reduced leg motor status due to SCI, increased brain activity within the leg's primary motor cortex area will be accompanied by improved corticospinal conduction and greater leg motor control. Numerous authors have emphasized that, to improve function after SCI, surviving motor tracts may need retraining or strengthening. The proposed training intervention, motor imagery, is selected because it is known to substantially activate movement-related networks including primary motor cortex--in the absence of movement (10-12). The primary aim of the proposed studies is not a clinical trial of a new therapy, but rather to generate insights into the relationship that increased motor cortex activity has with spinal cord neurophysiology and motor behavior in patients with leg motor deficits from a fixed SCI. SPECIFIC AIMS Definition of TMS-transcranial magnetic stimulation. A TMS coil gently set atop the scalp safely produces a magnetic field that activates an approximately 1 cm2 area of underlying cerebral cortex. TMS above motor cortex produces an electrical volley down the corticospinal tract. A typical response with current methods is a brief twitch in one muscle or muscle group. Definition of MEP-Motor evoked potential. The signal from TMS of motor cortex goes down the spine and activates spinal gray matter neurons, after which muscles in the respective body part subsequently change their potential-this is the MEP. In healthy controls, MEP after TMS of motor cortex is large enough to produce a visible muscle contraction. In patients with an injured central nervous system, however, MEP may be too slight to visibly contract a muscle; electromyography (EMG) methods can, however, detect the presence of MEP in such cases. In the proposed study, patients with severe or complete motor deficits due to SCI will undergo assessment of motor exam and TMS evaluation of motor system physiology before and after a 5 day treatment program focused on mental rehearsal of foot movements. Prior functional MRI (fMRI) studies with a hand version of this imagery program found activation of a broad sensorimotor network including primary sensorimotor cortex, cerebellum, and supplementary motor area. Also, the hand motor imagery program improved speed and accuracy of finger movements (10-12). Our current fMRI studies with imagined foot movement show consistent activation of a motor network that includes leg primary motor cortex. The SCI lesion will not change during the 5 days of motor imagery, and therefore any changes in motor behavior or physiology will arise from the strategy described in the study rationale, i.e., that increased cortical drive is expected to improve motor system function. THE SPECIFIC AIM OF THE PROPOSED STUDY is to test the hypothesis that 5 days of motor cortex activation, a known effect of the planned motor imagery intervention, will improve corticospinal tract function and voluntary motor control for a muscle distal to SCI: (1) Among 12 patients with chronic ASIA A-B SCI above T10 level, and therefore no infralesional voluntary motor control, an increased proportion of patients will show an MEP in tibialis anterior after 5 days of mental practice of foot movement, as compared to the proportion showing an MEP before the mental practice. Any restoration of voluntary motor control after the 5 days of practice will also be assessed. (2) Among 12 patients with chronic ASIA C SCI above T10 level, 5 days of mental practice of foot movement will reduce the TMS excitability threshold necessary to elicit MEP in tibialis anterior, increase the amplitude of these MEP, increase strength of foot dorsiflexion, and decrease time to complete foot tapping sequence pattern. (3) Among 12 healthy controls, 5 days of mental practice of foot movement will reduce the TMS excitability threshold necessary to elicit MEP in tibialis anterior, increase the amplitude of these MEP, increase strength of foot dorsiflexion, and decrease time to complete foot tapping sequence pattern. Experts have suggested that improved motor status after SCI might be achieved with interventions that "strengthen connections" (2) and "retrain residual pathways" (13). If we assume that mental practice will activate brain motor networks in SCI patients, as was found in prior studies of healthy controls by Dr. Lacourse, the hypothesis of this study can be restated as follows: in a system that consists of a normal brain and a fixed, incompletely destructive SCI, increased activity in relevant motor cortex regions will result in more signals traversing the SCI lesion and thus improved motor behavior. This does not say that all gains will be mediated by corticospinal tract; there are reasons to believe that propriospinal tract might contribute, and latency measures will help sort out this corollary issue. A component of peripheral nervous system improvement could conceivably contaminate some outcome measures, such as change in force, but would have no effect on MEP excitability thresholds. In some cases, a complete spinal cord transection may be present, with no chance for corticospinal tract function to change with treatment. However, studies suggest that a complete transection is an uncommon form of SCI.
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
数据更新时间:{{ journalArticles.updateTime }}
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
STEVEN Michael CRAMER其他文献
STEVEN Michael CRAMER的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('STEVEN Michael CRAMER', 18)}}的其他基金
ALZHEIMER'S DISEASE NEUROIMAGING PROTOCOL (ADNI)
阿尔茨海默病神经影像方案 (ADNI)
- 批准号:
8166904 - 财政年份:2009
- 资助金额:
$ 2.31万 - 项目类别:
EFFECTS OF DOPAMINE AND DOPAMINE RECEPTOR POLYMORPHISMS ON EXPERIENCE-DEPENDENT
多巴胺和多巴胺受体多态性对经验依赖性的影响
- 批准号:
8166936 - 财政年份:2009
- 资助金额:
$ 2.31万 - 项目类别:
GENETIC AND EXPERIENTIAL FACTORS INFLUENCING FUNCTIONAL ORGANIZATION OF MOTOR
影响运动功能组织的遗传和经验因素
- 批准号:
8166901 - 财政年份:2009
- 资助金额:
$ 2.31万 - 项目类别:
CLINICAL TRIAL: SAFETY OF REPETITIVE TMS IN CHRONIC SUBCORTICAL STROKE
临床试验:重复 TMS 在慢性皮质下中风中的安全性
- 批准号:
8166905 - 财政年份:2009
- 资助金额:
$ 2.31万 - 项目类别:
ALZHEIMER'S DISEASE NEUROIMAGING PROTOCOL (ADNI)
阿尔茨海默病神经影像方案 (ADNI)
- 批准号:
7951041 - 财政年份:2008
- 资助金额:
$ 2.31万 - 项目类别:
GENETIC AND EXPERIENTIAL FACTORS INFLUENCING FUNCTIONAL ORGANIZATION OF MOTOR
影响运动功能组织的遗传和经验因素
- 批准号:
7951037 - 财政年份:2008
- 资助金额:
$ 2.31万 - 项目类别:
CLINICAL TRIAL: SAFETY OF REPETITIVE TMS IN CHRONIC SUBCORTICAL STROKE
临床试验:重复 TMS 在慢性皮质下中风中的安全性
- 批准号:
7951042 - 财政年份:2008
- 资助金额:
$ 2.31万 - 项目类别:
SAFETY AND BETA-HCG + ERYTHROPOIETIN IN ACUTE STROKE
急性中风的安全性和 β-HCG 促红细胞生成素
- 批准号:
7951050 - 财政年份:2008
- 资助金额:
$ 2.31万 - 项目类别:
相似国自然基金
DACH1对糖尿病肾病足细胞脂质代谢的调控作用和机制研究
- 批准号:82370719
- 批准年份:2023
- 资助金额:49.00 万元
- 项目类别:面上项目
相似海外基金
Operant conditioning of sensory evoked potentials to reduce phantom limb pain
感觉诱发电位的操作性条件反射可减少幻肢痛
- 批准号:
10703170 - 财政年份:2023
- 资助金额:
$ 2.31万 - 项目类别:
Validation of Prenatal Rabbit Hypoxia Ischemia as a Model of Cerebral Palsy-induced Pain
产前兔缺氧缺血作为脑瘫引起的疼痛模型的验证
- 批准号:
10813313 - 财政年份:2023
- 资助金额:
$ 2.31万 - 项目类别:
Mapping spatiotemporal dynamics during enterovirus infection across cells and tissues
绘制肠道病毒跨细胞和组织感染过程中的时空动态
- 批准号:
10875953 - 财政年份:2022
- 资助金额:
$ 2.31万 - 项目类别:
Effects of exercise during platinum chemotherapy on neuropathy: examining the interoceptive brain system and inflammation
铂类化疗期间运动对神经病变的影响:检查大脑内感受系统和炎症
- 批准号:
10684640 - 财政年份:2022
- 资助金额:
$ 2.31万 - 项目类别:
Pathogenesis and motor neuron degeneration of a novel disease associated with a P158A mutation in NAMPT
与 NAMPT P158A 突变相关的新型疾病的发病机制和运动神经元变性
- 批准号:
10563210 - 财政年份:2022
- 资助金额:
$ 2.31万 - 项目类别:
Prevention and treatment of paclitaxel-induced peripheral neuropathy
紫杉醇引起的周围神经病变的预防和治疗
- 批准号:
10578137 - 财政年份:2022
- 资助金额:
$ 2.31万 - 项目类别:
A Comprehensive Clinical fMRI Software Solution to Enable Mapping of Critical Functional Networks and Cerebrovascular Reactivity in the Brain
全面的临床 fMRI 软件解决方案,可绘制大脑中的关键功能网络和脑血管反应性
- 批准号:
10365573 - 财政年份:2022
- 资助金额:
$ 2.31万 - 项目类别:
Mapping spatiotemporal dynamics during enterovirus infection across cells and tissues
绘制肠道病毒跨细胞和组织感染过程中的时空动态
- 批准号:
10450337 - 财政年份:2022
- 资助金额:
$ 2.31万 - 项目类别:
Pathogenesis and motor neuron degeneration of a novel disease associated with a P158A mutation in NAMPT
与 NAMPT P158A 突变相关的新型疾病的发病机制和运动神经元变性
- 批准号:
10444087 - 财政年份:2022
- 资助金额:
$ 2.31万 - 项目类别: