Motor Control Deficits in Parkinson's Disease

帕金森病的运动控制缺陷

• 批准号: 7441304
• 负责人: Howard Poizner
• 金额: $ 38.63万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-07-01 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7441304
• 关键词: Affective; Basal Ganglia; Behavior; Behavioral; Body Surface; Classification; Complex; Condition; Deep Brain Stimulation; Dopamine; Dopaminergic Agents; EEF1A2 gene; Electrodes; Environment; Feedback; Functional disorder; Grant; Hand; Impairment; Implanted Electrodes; Invasive; Knowledge; Learning; Limb structure; Location; Maps; Mechanics; Medical; Modality; Motor; Movement; Operative Surgical Procedures; Outcome; Parkinson Disease; Patients; Performance; Pharmaceutical Preparations; Pharmacotherapy; Play; Prior Therapy; Process; Proprioception; Range; Relative (related person); Replacement Therapy; Robot; Role; Scheme; Sensory; Signal Transduction; Speed; Structure of subthalamic nucleus; System; Technology; Testing; Therapeutic; Touch sensation; Upper arm; Vision; Visual; design; grasp; implantation; motor control; motor learning; novel; research study; retinal rods; skills; virtual; virtual reality; visual feedback; visual motor

Understanding the range of dysfunctions in Parkinson's disease (PD), and the degrees to which they are reversible by pharmacological or electrophysiological treatments, can both increase our understanding of PD therapies and help illuminate critical functions of basal ganglia-cortical circuits in the control of movement. Our previous findings have led us to hypothesize that a major difficulty for patients with Parkinson disease (PD) is in assembling and using new sensorimotor mappings or coordinations. These processes play a major role both in ongoing motor performance and in the acquisition of new skills, and, we are finding, are not normalized with dopamine (DA) replacement therapy. The present proposal presents seven experiments that are designed to confirm and extend our hypothesis and to investigate the degrees to which deep brain stimulation to the subthalamic nucleus (STN DBS) and DA replacement therapy are able to remediate deficits in sensorimotor control, coordination, and learning. To contrast the effects of these therapies in the same patients, we will test PD patients ON versus OFF DA replacement prior to their having surgically implanted electrodes, and again after surgery ON and OFF deep brain stimulation (and off medications). The first 4 experiments examine the integration of visual and proprioceptive information, which may be particularly deficient in PD. Subjects will reach to 3D targets presented either visually or kinesthetically with a robot arm under various conditions of visual feedback. The next experiment introduces the requirement that subjects learn to move within a virtual environment as a prerequisite to establishing the new sensorimotor coordinations necessary for accurate target acquisition. We require subjects to master distortions that create discrepancies between the apparent (virtual) and real (proprioceptively signaled) location of their arms. By dissociating movements from their normal sensory correspondences, we will challenge subjects' abilities to reconfigure their sensorimotor coordinations. The final 2 experiments challenge patients by requiring them to integrate different motor acts into a complex motor sequence and to be able to compensate for a mechanical perturbation during such an action. By examining a full range of behaviors, and requiring coordinated motor acts, utilization of variable sensory information to guide behavior, and the learning new sensorimotor correspondences, we can come to a more systematic assessment of motor control in PD and its benefit by treatment. We feel that the approach we take of using such contemporary technologies as 3D immersive virtual realities and robot-guided 3D reaching in examining the degree to which medical versus surgical therapies can ameliorate dysfunctions in PD is unique.

了解帕金森氏病（PD）中功能障碍的范围以及它们的学位 通过药理学或电生理治疗可逆，都可以增加我们对PD的理解 疗法并有助于阐明基底神经神经皮质回路的关键功能。 我们以前的发现使我们假设对帕金森氏患者来说是一个重大困难 疾病（PD）是组装和使用新的感觉运动映射或协调。这些 流程在持续的运动性能和获得新技能方面都起着重要作用，我们 正在发现，未通过多巴胺（DA）替代疗法将其标准化。目前的提议礼物 旨在确认和扩展我们的假设并研究该学位的七个实验 对丘脑下核（STN DB）和DA替代疗法的深脑刺激能够 补充感觉运动控制，协调和学习的缺陷。与这些影响对比 同一患者的疗法，我们将对PD患者进行测试 手术植入电极，手术后再次进行深脑刺激（并关闭） 药物）。前4个实验检查了视觉和本体感受信息的整合， 可能特别缺乏PD。受试者将达到视觉上提出的3D目标或 在各种视觉反馈条件下，带有机器人臂的动力学。下一个实验引入了 主体学会在虚拟环境中学习作为建立的先决条件的要求 准确目标采集所需的新的感觉运动协调。我们要求受试者掌握 造成明显（虚拟）和真实（本体概念信号）之间差异的扭曲 他们的手臂的位置。通过将运动与正常的感觉对应关系分离，我们将 挑战受试者重新配置其感觉运动协调的能力。最后两个实验 通过要求患者将不同的运动作用整合到复杂的运动序列中，并 在这种动作过程中，能够补偿机械扰动。通过检查一系列 行为和需要协调的运动行为，利用可变感官信息来指导行为， 学习新的感觉运动对应关系，我们可以对 PD中的电动机控制及其通过治疗的好处。我们认为使用这种方法 当代技术是3D沉浸式虚拟现实和机器人引导的3D 检查医疗与手术疗法可以改善PD功能障碍的程度 是独特的。