Motor Planning in Children with Cerebral Palsy

描述(申请人提供)：在美国，几乎每1000名出生的儿童中就有4名患有脑性瘫痪(CP)，给我们的社会带来的总经济负担接近每个儿童100万美元。尽管多年来的研究已经将CP中出现的运动障碍分类，但这些知识并没有转化为创新和有效的干预措施。至少部分问题是，大多数治疗方法都集中在纠正可能影响运动模式执行的运动损伤缺陷，而忽视了运动表现的其他特征。这项建议旨在通过调查一个研究不足的地区，主要是CP儿童的行动计划，为制定有效的干预措施奠定新的基础。这项建议的目的是为我们开发创新治疗策略的长期目标奠定基础，以最大限度地提高CP儿童学习新的运动技能的能力。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为CP儿童的运动规划和执行服务的神经过程。这项建议的具体目的是(1)量化CP儿童和典型发育(TD)儿童在执行等长伸膝任务时在感觉运动皮质内制定和执行运动计划的差异，以及(2)确定TD儿童和典型发育(TD)儿童在制定和执行运动计划与膝关节表现之间的定量关系。简而言之，我们的研究设计包括CP儿童和TD儿童在力量水平为其最大自愿力的5%-30%之间执行等长伸膝任务，同时使用脑磁图评估运动规划和执行阶段感觉运动皮质内的神经振荡活动。这项提议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，阻止与随机)和/或运动想象是否改善了CP儿童的运动规划和执行。从我们提议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。在完成本申请中建议的工作后，我们将能够果断地说明患有脑瘫的儿童是否存在运动规划缺陷，如果是，则可以估计它们对执行运动命令的潜在影响。这些发现将为治疗方法是否应该侧重于教授患有脑瘫的儿童计划他们的行动的新策略提供新的见解。好了！

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. !