Hand Sensorimotor Function and Carpal Tunnel Syndrome

描述（由申请人提供）：腕部正中神经易受压迫，导致腕管综合征（CTS）。CTS是最常见的压迫性神经病变，对国家卫生保健、工人生产力和生活质量有着巨大的影响。尽管CTS发病率高，公共卫生成本高，但我们对CTS的认识有限，CTS的管理有待改进。这个项目的中心概念是手的感觉运动功能对周围正中神经病变敏感，中枢神经系统受到CTS的影响，导致相关的感觉运动缺陷。我们将用新的生物力学和神经生理学研究中可量化的感觉运动数据来研究这一概念。该项目有三个目标，包括生物力学、神经生理学和转化研究。第一个目的是研究cts诱导的病理动力学和病理动力学表现，使用灵巧的手动任务，拇指反对，伸手捏，精确握，和手指按压。第二个目的是通过评估皮质肌耦合和拉伸反射来研究慢性周围神经病变（即CTS）对中枢神经系统的神经生理学意义。第三个目标是使用机器学习和分类算法识别CTS病例的新的生物力学和神经生理学标记。本项目的研究结果将阐明CTS的病理机制和行为表现，并有助于制定新的诊断、评估、康复和治疗策略。更一般地说，CTS作为一种慢性神经病是研究周围和中枢神经系统感觉运动机制的有效模型。此外，本项目开发的方法也适用于其他神经肌肉疾病。

DESCRIPTION (provided by applicant): The median nerve is susceptible to compression in the wrist, leading to carpal tunnel syndrome (CTS). CTS is the most common compression neuropathy and have an immense impact on national health care, worker productivity, and quality of life. Despite its high prevalence and public health cost, our understanding of CTS is limited, and the management of CTS awaits improvement. The central notion of this project is that hand sensorimotor function is sensitive to peripheral median neuropathy and that the central nervous system is affected by CTS, causing the associated sensorimotor deficit. We will investigate this notion with quantifiable sensorimotor data from novel biomechanical and neurophysiological studies. This project has three aims consisting of biomechanical, neurophysiological and translational research. The first aim is to investigate CTS-induced pathokinematic and pathokinetic performance using dexterous manual tasks of thumb opposition, reach-to-pinch, precision grip, and finger pressing. The second aim is to investigate the neurophysiological implications of chronic peripheral neuropathy (i.e., CTS) on the central nervous system by evaluating corticomuscular coupling and stretch reflex. The third aim is to identify novel biomechanical and neurophysiological markers for CTS cases using machine learning and classification algorithms. The results of this project will elucidate the pathological mechanisms and behavioral manifestations of CTS and aid in the development of new strategies for diagnosis, evaluation, rehabilitation, and treatment of this disorder. More generally, CTS as a chronic neuropathy serves as an effective model to study sensorimotor mechanisms of the peripheral and central nervous systems. In addition, the methodology developed in this project is applicable to other neuromuscular disorders. PUBLIC HEALTH RELEVANCE: Carpal tunnel syndrome is highly prevalent and costly. One of the distinct consequences of carpal tunnel syndrome is that patients experience inexplicable dropping of objects and clumsiness while performing simple daily tasks. In this project, we propose to study the sensorimotor deficit using novel biomechanical and neurophysiological experiments. The results of this project will elucidate the pathological mechanisms and manifestations of carpal tunnel syndrome. This project is clinically translational to aid in the development of new strategies for diagnosis, evaluation, rehabilitation, and treatment of this disorder.