The Contribution of Eye-Hand Coordination Impairment to Functional Deficits in Stroke

眼手协调障碍对中风功能缺陷的影响

• 批准号: 10704112
• 负责人: John Ross Rizzo
• 金额: $ 25.12万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-13 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10704112
• 关键词: Abnormal coordination; Activities of Daily Living; Address; Affect; Area; Articular Range of Motion; Ataxia; Behavioral Paradigm; Brain; Caring; Clinical; Clinical assessments; Coupling; Data; Diffusion; Etiology; Eye; Eye Movements; Failure; Foundations; Future; Goals; Hand; Hand Strength; Hand functions; Impairment; Individual; Intervention; Knowledge; Lesion; Limb structure; Magnetic Resonance Imaging; Measurable; Measures; Mediating; Middle Cerebral Artery Infarction; Motor; Movement; Neuroanatomy; Paresis; Patients; Performance; Physical Rehabilitation; Process; Quality of life; Radial; Reaction Time; Recovery; Recovery of Function; Rehabilitation therapy; Research; Role; Saccades; Stroke; Structure; Survivors; System; Telephone; Testing; Time; Training; Translating; Translational Research; Upper Extremity; Visual; arm function; arm movement; direct application; disability; experience; eye hand coordination; functional independence; grasp; improved; limb movement; middle cerebral artery; motor deficit; motor impairment; motor recovery; neglect; neurological rehabilitation; oculomotor; post stroke; standard of care; stroke recovery; stroke rehabilitation; stroke survivor; tool; visual performance

PROJECT SUMMARY Current standard of care in post-stroke upper-limb motor training has measurably reduced impairment and increased both active range of motion and movement quality. However, such improvements rarely generalize to performance gains for activities of daily living and functional independence. One of the hallmarks of functional arm movement is the seamless integration of visual inputs and limb control, mediated by the ocular motor system. However, this important foundation of functional performance and recovery has not been incorporated into stroke rehabilitation. This gap exists because not enough is known about basic eye-hand coordination (EHC), associated neuroanatomy, and how EHC is affected by stroke. Our preliminary data provide strong evidence that specific eye-hand coordination deficits can result from MCA stroke. The eye-hand coordination system is currently not addressed in neurorehabilitation research or clinical rehabilitation because of a lack of understanding of the mechanisms that underlie this coordination and how such mechanisms may be affected by stroke. This proposal will examine the neuroanatomical foundations of eye-hand coordination and how these networks are affected by middle cerebral artery stroke. The results are expected to provide a foundation for improved understanding of eye-hand coordination in functional deficits and functional recovery, post-stroke. This advanced understanding should provide the basis for a line of translational research that will lead to new clinical assessments and interventions to address eye-hand coordination deficits in stroke survivors. This knowledge may, in turn, address the current gap between motor recovery and functional recovery in stroke survivors with eye-hand coordination dyscoordination (EHdC). Our primary hypotheses are that MCA stroke can produce deficits in EHC through damage to specific frontoparietal circuits, and that changes in these circuits can predict functional recovery following stroke. We will address these hypotheses through the following two Aims. In Aim 1, we will determine the contribution of EHdC to motor recovery and function in MCA stroke. Hypothesis: MCA stroke produces EHC deficits that interfere with functional upper-limb recovery and functional independence. Aim 2: To identify microstructural changes to frontoparietal networks related to motor recovery and EHdC in MCA stroke. Hypothesis: Microstructural integrity in MCA stroke will relate to dyscoordination (mistiming). The findings from this proposal will detail the functional neuroanatomy underlying eye-hand coordination, and the functional implications of lesions in this system to functional performance. This foundation of knowledge will provide for a translational line of research to determine contributions of eye-hand coordination to functional deficits and functional stroke recovery.

项目总结 中风后上肢运动训练的现行护理标准显著减少了损伤和 增加了活动的运动范围和运动质量。然而，这种改进很少能一概而论 到日常生活和功能独立活动的绩效收益。标志之一就是 功能性手臂运动是视觉输入和肢体控制的无缝结合，由眼睛调节 马达系统。然而，功能表现和恢复的这一重要基础并没有 纳入中风康复。这一差距的存在是因为对基本的眼手功能了解不够 协调(EHC)，相关的神经解剖学，以及EHC如何受到中风的影响。我们的初步数据 提供强有力的证据，证明大脑中动脉中风可能导致特定的眼手协调缺陷。眼-手 协调系统目前在神经康复研究或临床康复中没有涉及，因为 对作为这种协调基础的机制缺乏了解，以及这种机制如何 受到中风的影响。这项提案将研究眼手协调的神经解剖学基础。 以及大脑中动脉中风对这些网络的影响。预计结果将提供一个 为更好地理解眼手协调在功能缺陷和功能恢复中的作用奠定基础 中风后。这种先进的理解应该为一系列翻译研究提供基础，这些研究将 导致新的临床评估和干预措施以解决中风患者的眼-手协调缺陷 幸存者。这一知识反过来可能解决目前运动恢复和功能恢复之间的差距 患有眼手协调失调(EHDC)的中风幸存者的康复。我们的主要假设是 大脑中动脉卒中可通过损害特定的额顶回路而导致EHC的缺陷，并且 这些回路的变化可以预测中风后的功能恢复。我们将解决这些假设 通过以下两个目标。在目标1中，我们将确定EHDC对运动恢复和 在大脑中动脉卒中中的作用。假设：大脑中动脉卒中会产生EHC缺陷，干扰上肢功能 康复和功能独立。目标2：确定额顶顶神经网络的微结构变化 MCA卒中患者运动功能恢复与EHDC的关系。假说：大脑中动脉卒中的微结构完整性将 与不协调(错时)有关。这项提案的发现将详细说明功能神经解剖学 潜在的眼-手协调，以及该系统中病变对功能的影响 性能。这一知识基础将提供一条翻译研究路线，以确定 眼手协调对功能缺陷和功能性卒中恢复的贡献。