Plasticity of Audiovisual Movement Representations: Implications for Limb Apraxia

描述（由申请人提供）：Brenda Hanna-Pladdy博士是堪萨斯大学医学中心（KUMC）兰登老龄中心和精神病学系的临床神经心理学家和助理教授。该提案的目的是促进候选人在中风恢复机制和功能磁共振成像技术方面的科学发展，使她成为独立的临床科学家。Landon老龄化中心和KUMC的Hoglund脑成像中心将为候选人提供理想的环境，以研究有助于熟练运动和中风后失用症恢复的神经机制。本研究计划的长期目标是探索运动表征在实践系统中的多感官性质，以确定康复目标。IDE失用症（IMA）是一种常见于左半球（LH）卒中后的技能性运动障碍，可能导致日常环境中的严重残疾。与主要导师（Nudo博士）的合作将使候选人通过扩大候选人在中风恢复和神经可塑性方面的科学背景，并促进她的研究和granimetry技能，为独立学术生涯的发展奠定基础。共同导师将提供fMRI技术和中风（Savage博士）的病变症状映射，以及熟练运动障碍（Haaland博士）的神经解剖学和临床方面的指导。拟议的研究将利用事件相关的功能磁共振成像研究，旨在区分区域参与检索时空特征的熟悉的工具/对象（没有实际的运动）时，引起的听觉，视觉和多感官线索。这些激活模式将与测量LH中风患者（有和没有失用症）和正常对照中的运动轨迹质量的行为范例相关，以确定将听觉运动线索添加到视觉线索（即，多感觉线索）可以提供对运动表示的更好访问。其目的是：（一）表征感官线索如何促进检索的对象动作功能，（二）阐明的神经基板的实践和多感官性质的运动表示，及（iii）评估功能适应视听运动表示后LH中风。这些数据将阐明失用症的功能和解剖学基础，并有助于确定适当的感觉线索，中风后肢体失用症的康复。 公共卫生相关性：这项研究将对公共卫生产生广泛的影响，因为中风是长期残疾的主要原因，使许多受害者在没有援助的情况下无法在环境中独立运作，从而导致大量的社会和财政成本。IMA是LH卒中后常见的一种障碍，直接影响对环境中物体的有效操作，并已证明对独立性的影响。因此，IMA康复计划的发展将显着提高功能独立性和生活质量的中风幸存者。

DESCRIPTION (provided by applicant): Dr. Brenda Hanna-Pladdy is a clinical neuropsychologist and Assistant Professor in the Landon Center on Aging and Department of Psychiatry at the University of Kansas Medical Center (KUMC). The purpose of this proposal is to foster the scientific development in stroke recovery mechanisms and fMRI skills of the candidate, so that she may become an independent clinical scientist. The Landon Center on Aging and the Hoglund Brain Imaging Center at KUMC will provide the candidate with the ideal setting to investigate the neural mechanisms subserving skilled movements and the recovery of apraxia following stroke. The long-term objective of this research plan is to explore the multisensory nature of movement representations in the praxis system in order to identify rehabilitation targets. Ideomotor apraxia (IMA) is a skilled movement disorder that is common after left hemisphere (LH) stroke, and may contribute to significant disability in the everyday environment. The collaboration with the primary mentor (Dr. Nudo) will allow the candidate to obtain the foundation for the development of an independent academic career by expanding the candidate's scientific background in stroke recovery and neuroplasticity, and promoting her research and grantsmanship skills. The co-mentors will provide mentorship in fMRI techniques and lesion-symptom mapping in stroke (Dr. Savage), and neuroanatomical and clinical aspects of skilled movement disorders (Dr. Haaland). The proposed study will utilize an event-related fMRI study designed to distinguish regions involved in retrieving the spatiotemporal features of familiar tools/objects (without actual movement) when elicited by auditory, visual and multisensory cues. These activation patterns will be correlated to a behavioral paradigm measuring the quality of movement trajectories in LH stroke patients (with and without apraxia) and normal controls to determine if the addition of auditory motion cues to visual cues (i.e., multisensory cues) may provide better access to movement representations. The aims are the following (i) to characterize how sensory cues facilitate the retrieval of object action features, (ii) to elucidate the neural substrates of praxis and the multisensory nature of movement representations, and (iii) to evaluate functional adaptation in audiovisual movement representations following LH stroke. This data will elucidate the functional and anatomical basis for apraxia, and help identify appropriate sensory cues for rehabilitation of limb apraxia following stroke. PUBLIC HEALTH RELEVANCE: This research will have broad impact on public health, as stroke is a leading cause of long-term disability, and leaves many of its victims unable to function independently in the environment without assistance leading to substantial social and fiscal costs. IMA is a disorder common after LH stroke that directly affects effective manipulation of objects in the environment, and has demonstrated impact on independence. Thus, development of a rehabilitation program for IMA will significantly improve functional independence and quality of life for stroke survivors.