Motor Planning in Children with Cerebral Palsy

描述（由申请人提供）：在美国出生的每1000名儿童中几乎有4名患有脑瘫（CP），我们社会的总经济负担是每个孩子近100万美元。尽管多年的研究已经对CP中出现的运动障碍进行了分类，但这些知识并没有转化为创新和有效的干预措施。问题的至少一部分在于，大多数治疗方法都集中于补救可能影响运动模式执行的运动损伤缺陷，而不关注运动表现的其他特征。该提案旨在通过调查一个研究不足的领域，为制定有效的干预措施奠定新的基础;主要是CP儿童的运动规划。该提案的目的是为我们的长期目标开发创新的治疗策略，可以最大限度地提高CP儿童学习新运动技能的能力。为了实现这一目标，我们实施了一种创新的方法，使用脑磁图（MEG）神经成像方法和神经行为方法来识别CP儿童运动规划和执行的神经过程。本提案的具体目的是（1）量化CP儿童和典型发育（TD）儿童在执行等长伸膝任务时感觉运动皮层内运动计划的制定和执行的差异，以及（2）确定TD儿童和CP儿童运动计划的制定和执行与膝关节性能之间的定量关系。简而言之，我们的研究设计包括CP儿童和TD儿童在其最大随意力的5-30%之间的力水平下执行等长膝关节伸展任务，因为我们同时使用MEG来评估运动规划和执行阶段感觉运动皮层内的神经振荡活动。从这个提议中产生的新知识将为我们未来的研究提供重要的垫脚石，我们将使用尖端的神经成像技术来评估反馈、训练（例如，阻塞与随机），和/或运动想象改善了CP儿童的运动计划和执行。从我们提出的和未来的实验中产生的知识有可能改变目前用于CP儿童的治疗趋势。在完成本申请中的拟议工作后，我们将能够明确地说明CP儿童是否存在运动规划缺陷，如果存在，则估计其对运动命令执行的潜在影响。这些发现将提供新的见解，治疗方法是否应该侧重于教导CP儿童规划运动的新策略。!

DESCRIPTION (provided by applicant): Almost four out of every 1000 children born in the United States have cerebral palsy (CP), with the total economic burden to our society being nearly one million dollars per child. Despite years of studies that have catalogued the motor impairments seen in CP, this knowledge has not translated to innovative and effective interventions. At least part of the problem is that the majority of treatment approaches have focused on remedying the motor impairment deficits that may affect the execution of the movement pattern, without attention to other features of motor performance. This proposal aims to develop a new foundation for developing effective interventions by investigating an under-studied area; mainly, the planning of movement in children with CP. The aims of this proposal are a stepping-stone for our long-term goal of developing innovative treatment strategies that can maximize the ability of children with CP to learn new motor skills. To meet this goal, we have implemented an innovative approach that that uses magnetoencephalography (MEG) neuroimaging methods and neurobehavioral methods to identify the neural processes that serve motor planning and execution in children with CP. The Specific Aims of this proposal are (1) to quantify the differences in formulation and execution of the motor plan within the sensorimotor cortices of children with CP and typically-developing (TD) children as they perform an isometric knee-extension task, and (2) to determine the quantitative relationship between formulation and execution of the motor plan and performance of the knee joint in TD children and children with CP. In brevity, our study design consists of children with CP and TD children performing an isometric knee extension task at force levels between 5-30% of their maximum voluntary force, as we concurrently use MEG to evaluate neural oscillatory activity within the sensorimotor cortices during the motor planning and execution stages. The new knowledge generated from this proposal will provide a vital stepping-stone for our future investigations, which will use thee cutting-edge neuroimaging techniques to assess if the type of feedback, training (e.g., blocked versus random), and/or motor imagery improves the motor planning and execution in children with CP. The knowledge generated from our proposed and future experiments has the potential to alter the current course of therapeutic trends that are used with children with CP. Upon completion of the proposed work in this application, we will be able to decisively state if there are motor planning deficits in children with CP, and if so estimate their potential impact on the execution of the motor command. Such findings will provide new insight on whether treatment approaches should focus on teaching children with CP new strategies for planning their movements. !