Degeneration of motoneurons caudal to spinal lesion

脊髓病变尾部运动神经元变性

• 批准号: 8301092
• 负责人: WILLIAM Zev RYMER
• 金额: $ 23.11万
• 依托单位: REHABILITATION INSTITUTE OF CHICAGO D/B/A SHIRLEY RYAN ABILITYLAB
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-02-01 至 2014-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8301092
• 关键词: Action Potentials; Acute; Amyotrophic Lateral Sclerosis; Articular Range of Motion; Atrophic; Cervical spinal cord injury; Cessation of life; Chronic; Clinical; Contracture; Data; Development; Diagnosis; Diagnostic; Disease; Disease Progression; Electric Stimulation; Electrodes; Frequencies; Functional disorder; Goals; Hand; Knowledge; Lesion; Longitudinal Studies; Measurement; Measures; Mechanics; Mediating; Methods; Motor; Motor Neurons; Movement; Muscle; Muscle Fibers; Muscle Weakness; Muscle fasciculation; Muscle function; Needles; Neurologic; Outcome; Paralysed; Paresis; Pattern; Pharmaceutical Preparations; Prevalence; Process; Property; Quadriplegia; Rehabilitation device; Relative (related person); Research; Rest; Skeletal Muscle; Spastic; Spinal; Spinal Injuries; Spinal cord injury; Spinal cord injury patients; Structure; Surface; Techniques; Testing; Time; base; density; effective therapy; improved; indexing; motor impairment; nerve supply; novel; rehabilitation strategy; reinnervation; restoration; white matter damage

DESCRIPTION (provided by applicant): The long-term goals of the proposed project are to understand the complicated origins of the spinal cord injury (SCI) induced muscle paresis, atrophy, weakness, and muscle contractures that often result in a limited range of joint motion and progressive changes in intrinsic muscle mechanical properties. In particular, our proposed research plan relies on several recently developed novel surface electromygram (EMG) techniques to investigate controversial concepts about caudal motoneuron degeneration after a spinal injury. Using motor unit number index measurements and high-density surface EMG recording and processing techniques, we will determine whether motor unit structure and function changes of paralyzed muscles, potentially due to caudal motoneuron degeneration, can be captured via three specific aims. Namely, we plan to assess whether there is evidence for motoneuron degeneration caudal to spinal injury using estimates of motor unit numbers in paralyzed muscles (Aim 1), and using the recorded spontaneous EMG activities in resting paralyzed muscles (Aim 2). In addition, we will examine alterations in motor unit action potential propagation patterns and innervation zones, as a marker of motoneuron loss and subsequent muscle fiber reinnervation in paralyzed muscles, thus providing secondary evidence for motoneuron degeneration caudal to spinal injury (Aim 3). The methods used in this study are noninvasive, potentially convenient to use, and offer valuable information beyond that provided by needle-based EMG and other routine electrophysiological methods. The findings from these novel methods will enhance our understanding of the pathophysiology of potential motoneuron degeneration in SCI. This will provide guidance for the development of rehabilitation strategies and devices for restoration of normal muscle functions. The findings from this study also have important clinical value for the diagnosis and treatment of spinal injury, improve outcome measurements, and help evaluate the effects of medication or therapies. PUBLIC HEALTH RELEVANCE: The proposed examination of spinal cord injury (SCI) patients using several novel surface EMG techniques will add new knowledge for understanding the complicated origins of the SCI induced muscle paresis, atrophy, weakness, contracture and other muscle mechanical changes, thus in turn providing guidance for the development of rehabilitation strategies and devices for restoration of normal muscle functions. The findings from the project will also have important clinical value to diagnosis and treatment of motor impairments from spinal injury.

描述（由申请人提供）：拟议项目的长期目标是了解脊髓损伤（SCI）引起的肌肉轻瘫、萎缩、无力和肌肉挛缩的复杂起源，这些肌肉挛缩通常导致关节活动范围受限和内在肌肉力学特性的渐进性变化。特别是，我们提出的研究计划依赖于几个最近开发的新的表面肌电图（EMG）技术，以调查有争议的概念，脊髓损伤后尾运动神经元变性。使用运动单位数量指数测量和高密度表面肌电图记录和处理技术，我们将确定是否运动单位的结构和功能变化的瘫痪肌肉，可能是由于尾部运动神经元变性，可以通过三个特定的目标捕获。也就是说，我们计划评估是否有证据表明脊髓损伤尾侧运动神经元变性，使用瘫痪肌肉中运动单位数量的估计值（目标1），并使用记录的静息瘫痪肌肉中的自发EMG活动（目标2）。此外，我们将检查运动单位动作电位传播模式和神经支配区的改变，作为运动神经元丢失和随后瘫痪肌肉中肌纤维再支配的标志，从而为脊髓损伤尾侧运动神经元变性提供次要证据（目的3）。本研究中使用的方法是非侵入性的，使用可能方便，并提供了有价值的信息以外的针为基础的肌电图和其他常规电生理方法。这些新方法的发现将增强我们对SCI中潜在运动神经元变性的病理生理学的理解。这将为恢复正常肌肉功能的康复策略和设备的开发提供指导。这项研究的发现对脊柱损伤的诊断和治疗也具有重要的临床价值，改善结果测量，并帮助评估药物或治疗的效果。 公共卫生关系：利用几种新的表面肌电图技术对脊髓损伤（SCI）患者进行检查，将为理解SCI引起的肌肉麻痹、萎缩、无力、挛缩和其他肌肉力学变化的复杂起源提供新的知识，从而反过来为恢复正常肌肉功能的康复策略和设备的开发提供指导。该项目的研究结果也将对脊柱损伤所致运动障碍的诊断和治疗具有重要的临床价值。