Structure and function of the fingers tendinous apparatus

手指腱装置的结构和功能

• 批准号: 9101987
• 负责人: Francisco J Valero-Cuevas
• 金额: $ 50.96万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-05-15 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9101987
• 关键词: Accounting; Advisory Committees; Aftercare; Automobile Driving; Behavior; Biomechanics; Botulinum Toxins; Brain; Cerebral Palsy; Clinical; Clonus; Data; Dystonia; Face; Feedback; Fingers; Functional disorder; Future; Goals; Grant; H-Reflex; Hand; Health; Hemiplegia; Human; Individual; Injection of therapeutic agent; Isometric Exercise; Joints; Knowledge; Lead; Length; Life; Literature; Maps; Measures; Mechanics; Mediating; Microprocessor; Modeling; Motor; Motor Neurons; Muscle; Muscle Fibers; Muscle function; Nervous system structure; Neuromechanics; Neurons; Outcome; Pathologic; Pathology; Pathway interactions; Patients; Performance; Phase; Physiological Processes; Physiology; Postoperative Period; Posture; Property; Proprioceptor; Rehabilitation therapy; Research; Scientist; Spinal; Spinal Cord; Spinal cord injury; Structure; Surgeon; System; Tendon Transfer; Tendon structure; Testing; Thalamencephalon; Time; Torque; Toxin; Work; botulinum; clinically relevant; indexing; joint function; motor control; neurophysiology; relating to nervous system; research study; somatosensory; spasticity; stretch reflex; symptomatology; theories

DESCRIPTION (provided by applicant): Our long-term goal is to reveal systematically how the musculotendon mechanics, spinal cord and brain interact to produce able and pathologic finger function. The prior grant revealed many necessary neuromechanical interactions for finger function and dysfunction. This compels and enables us to study spinal neurophysiology and neuromechanics as a step before tackling brain function. The immediate goals of our team of scientists and surgeons are to (i) test the extent to which the known somatosensory feedback and spinal interneuronal circuitry is sufficient, on its own, to account for critical features of fst isometric fingertip forces without requiring on-line supraspinal modulation; and (ii) understand how botulinum toxin (BTX) injections to reduce spasticity and dystonia in hemiplegic CP and iSCI interact with that circuitry. We will test theories of spinal reflexive and excitation-inhibiton mechanisms using synthetic analysis and physical implementation, which in our view is a strong test of our understanding of a system. That is, we will confront the very challenge the nervous system faces by controlling the tendons of cadaveric fingers with an autonomous neuromechatronic system of microprocessors and motors that implements the known motor and somatosensory spinal circuitry and muscle properties of healthy subjects and patients. Aim 1: Characterize H-reflex and performance of Single Joint and Whole Finger fast isometric tasks in control subjects, and pre-&post-BTX in patients. (Exploratory test on CP patients undergoing tendon transfers and musculotendon length changes will validate other physiological processes and model components in the later phases of the research.) Then, actuate tendons of cadaveric fingers to (i) find feasible tensions to replicate that performance and (ii) quantify robustness to errors in tendon tensions. Aim 2: Implement in real time the known connectivity and dynamics of spinal neurons, muscle proprioceptors and muscle fibers of a single afferented muscle. Validate against data in the literature. Single Muscle Hypothesis: Muscle function (e.g., tone, stretch reflex) emerges naturally from specific combinations of neuronal background activity and pathway gains. Test how physiologically tenable disruptions and BTX lead to, or mitigate, pathologic behavior (e.g., spasticity and clonus). Aim 3: Implement the hypothesized neural connectivity and dynamics across muscles to reproduce the H- reflex and performance of fast isometric tasks seen in control subjects, and pre-&post-BTX in patients. Replicating the behavior measured in Aim 1 by driving tendons of cadaveric index fingers will identify how clinically tenable disruptions lead to pathologic behavior, and the extent to which BTX (and preliminarily tendon transfers and musculotendon length changes) can mitigate those pathologies. a) Single Joint Hypothesis: Single-joint function (e.g., fast time-varying torques) emerges naturally from background activity and pathway gains across motoneuron pools of a pair of antagonist muscles. Test the emergence and BTX mitigation of single joint spasticity, clonus, instability, and deficits in single joint tasks. b) Whole Finger Hypothesis: The fast time-varying fingertip force tasks recorded in Aim 1 emerge naturally from physiologically tenable interactions across all finger muscles. Test the emergence and BTX mitigation of whole-finger spasticity, clonus, abnormal postures, and deficits in whole fingertip force tasks.

描述（由申请人提供）：我们的长期目标是系统地揭示肌腱力学、脊髓和大脑如何相互作用以产生可用的和病理性的手指功能。先前的资助揭示了手指功能和功能障碍的许多必要的神经机械相互作用。这迫使我们能够研究脊髓神经生理学和神经力学，作为解决大脑功能之前的一个步骤。我们的科学家和外科医生团队的近期目标是（i）测试已知的体感反馈和脊髓间神经元电路本身足以解释第一个等长指尖力的关键特征，而不需要在线脊髓上调制； (ii) 了解肉毒毒素 (BTX) 注射如何减少偏瘫 CP 和 iSCI 的痉挛和肌张力障碍与该回路的相互作用。我们将使用综合分析和物理实现来测试脊髓反射和兴奋抑制机制的理论，我们认为这是对我们对系统理解的强有力的考验。也就是说，我们将通过由微处理器和电机组成的自主神经机电系统控制尸体手指的肌腱，来应对神经系统面临的挑战，该系统实现了健康受试者和患者已知的运动和体感脊髓回路以及肌肉特性。目标 1：表征对照受试者以及患者 BTX 前后单关节和全手指快速等长任务的 H 反射和表现。 （对接受肌腱转移和肌肉肌腱长度变化的 CP 患者进行探索性测试，将在研究的后期验证其他生理过程和模型组件。）然后，驱动尸体手指的肌腱，以 (i) 找到可行的张力来复制该性能，以及 (ii) 量化稳健性 肌腱张力的错误。目标 2：实时实现单个传入肌肉的脊髓神经元、肌肉本体感受器和肌纤维的已知连接性和动力学。根据文献中的数据进行验证。单肌肉假说：肌肉功能（例如张力、牵张反射）是由神经元背景活动和通路增益的特定组合自然产生的。测试生理上可维持的破坏和 BTX 如何导致或减轻病理行为（例如痉挛和阵挛）。目标 3：实现假设的跨肌肉神经连接和动力学，以重现对照受试者以及患者 BTX 前后的 H 反射和快速等长任务的表现。通过驱动尸体食指肌腱来复制目标 1 中测量的行为，将确定临床上可行的破坏如何导致病理行为，以及 BTX（以及初步肌腱转移和肌肉肌腱长度变化）可以减轻这些病理的程度。 a）单关节假说：单关节功能（例如，快速时变扭矩）自然地从背景活动和一对拮抗肌运动神经元池的路径增益中产生。测试单关节任务中单关节痉挛、阵挛、不稳定性和缺陷的出现和 BTX 缓解。 b) 全手指假设：目标 1 中记录的快速随时间变化的指尖力任务自然地从所有手指肌肉的生理上可行的相互作用中产生。测试全指痉挛、阵挛、异常姿势和全指尖力量任务中缺陷的出现和 BTX 缓解。