RTMS AND MOTOR LEARNING TRAINING TO PROMOTE RECOVERY FROM HEMIPARESIS - PART 2

RTMS 和运动学习训练促进偏瘫康复 - 第 2 部分

• 批准号: 7951745
• 负责人: JAMES R. CAREY
• 金额: $ 2.16万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-12-01 至 2009-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7951745
• 关键词: Area; Clinical Research; Computer Retrieval of Information on Scientific Projects Database; Frequencies; Funding; Grant; Hand; Institution; Methods; Motor; Neurons; Neurorehabilitation; Paralysed; Pathway interactions; Recovery; Research; Research Personnel; Resources; Risk; Safety; Seizures; Source; Stroke; Training; United States National Institutes of Health; Work; depressed; hemiparesis; killings; motor learning; neuron loss; repetitive transcranial magnetic stimulation; stem

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. Paralysis following stroke stems not only from the loss of neurons killed by the stroke but also from the loss of neurons lying dormant in the stroke hemisphere. One of the reasons viable neurons become dormant (down-regulated) is because of excessive interhemispheric inhibition imposed on them through transcallosal pathways from the nonstroke hemisphere. Our challenge in neurorehabilitation is to restore excitability and voluntary control of these down-regulated neurons in the stroke hemisphere. Supression of the source of this excessive interhemispheric inhibition can be achieved with the noninvasive method called repetitive transcranial magnetic stimulation (rTMS). It is known that low-frequency rTMS has disruptive or depressant effects on the underlying neurons. Furthermore, recent work has shown that the depressant effect of low-frequenycy rTMS can be magnified and prolonged by preceding it with a period of high-frequency (6-Hz) priming rTMS. And so, it is logical to apply 6-Hz primed low-frequency rTMS to the non-stroke primary motor area (M1) to depress excitability in that hemisphere, thereby increasing excitability of M1 in the stroke hemisphere. But there is risk of inducing a seizure in people with stroke with this treatment, which may outweigh the potential goodness of the treatment. Thus, the aims of the proposed study are to determine the efficacy, mechanism, and safety of 5 treatments of 6-Hz primed low-frequency rTMS applied to the non-stroke hemisphere to promote recovery of the paretic hand. Furthermore, we will explore whether efficacy can be enhanced by combining the rTMS with motor learning training.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目和 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 中风后的瘫痪不仅源于中风杀死的神经元的丧失，还源于中风半球中休眠的神经元的丧失。 存活神经元变得休眠（下调）的原因之一是来自非中风半球的经胼胝体通路对它们施加过度的半球间抑制。 我们在神经康复方面的挑战是恢复中风半球中这些下调神经元的兴奋性和自主控制。 抑制这种过度半球间抑制的根源可以通过称为重复经颅磁刺激（rTMS）的非侵入性方法来实现。 众所周知，低频 rTMS 对底层神经元具有破坏性或抑制作用。此外，最近的研究表明，低频 rTMS 的抑制作用可以通过在其之前进行一段高频 (6-Hz) 启动 rTMS 来放大和延长。 因此，将 6 Hz 启动低频 rTMS 应用于非中风初级运动区 (M1) 以抑制该半球的兴奋性，从而增加中风半球 M1 的兴奋性是合乎逻辑的。 但这种治疗存在诱发中风患者癫痫发作的风险，这可能超过了治疗的潜在好处。因此，本研究的目的是确定 5 种 6 Hz 启动低频 rTMS 治疗应用于非中风半球以促进麻痹手恢复的功效、机制和安全性。 此外，我们将探讨是否可以通过将 rTMS 与运动学习训练相结合来提高疗效。