Physiological Analysis Of Voluntary Movement

随意运动的生理分析

• 批准号: 7143847
• 负责人: MARK A HALLETT
• 金额: --
• 依托单位: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7143847
• 关键词: Parkinson' s disease; apraxias; body movement; cerebellar ataxia /dyskinesia; clinical trials; computer simulation; dystonia; electroencephalography; electrostimulus; eyelid disorder; family genetics; functional magnetic resonance imaging; gamma aminobutyrate; hemiplegia; human subject; human therapy evaluation; nervous system disorder therapy; neuromuscular disorder; neuropathology; neurophysiology; patient oriented research; positron emission tomography; reflex; stroke; torticollis; transcranial magnetic stimulation; tremor

The goal of this project is to learn more about the control of movement in normal humans and in patients with voluntary movement disorders such as Parkinson's disease, dystonia, cerebellar ataxia, and hemiplegia from stroke. The tools we use include clinical neurophysiological methods such as electroencephalography, electromyography, and transcranial magnetic stimulation (TMS) and neuroimaging with positron emission tomography and functional magnetic resonance imaging (fMRI). Currently active projects in the Section include studies of normal physiology, the pathophysiology and treatment of dystonia, the bradykinesia in Parkinson?s disease, and recovery from hemiplegia. We are trying to determine EEG methods to predict in real time when someone is going to move and whether they will move their right or left hand. We have optimized features and classification methods for the prediction. Our real-time study demonstrated that we can reliably predict human movement intention before movement occurs. We are now attempting to reduce missed-predictions and explore methods to predict laterality of movement intention. The work should be relevant for use with a brain-computer interface. Simple movements have been studied for many years, but most movements humans make are more complex. We have been studying complex praxis movements with both EEG and fMRI. fMRI shows a pattern of parietal and premotor activity, more in the left hemisphere regardless of the hand used for making the movement. Coherence analysis with EEG has shown that parietal and premotor areas are coherent during preparation and execution of movement, inferring event related functional connectivity. Using event-related fMRI we assessed hemispheric lateralization of transitive (tool-related) and intransitive (communicative) praxis movements in normal people and patients with ideomotor apraxia. The findings of this study point to left hemispheric organization of normal praxis movements. Preliminary findings from two patients with IMA suggest that impaired praxis movements are associated with an altered pattern of lateralization, particularly if the disorder is more severe. We have been doing many studies of dystonia largely in patients with focal hand dystonia. We have devoted considerable time in pursuing the hypothesis that there is a deficient surround inhibition with voluntary movement in dystonic patients. We have demonstrated this with TMS. We are now pursuing the mechanism of surround inhibition studying different types of known inhibitory processes. We are also using EEG methods to see if this will help reveal surround inhibition mechanisms. In another effort to identify EEG evidence of deficient intracortical inhibition in focal hand dystonia, we recorded scalp somatosensory evoked potentials from median nerve electric stimulation to quantify high frequency oscillations, which may reflect the activity of inhibitory interneurons in the cortex. We have been studying the electrophysiological correlate of the deficit in somesthetic discrimination in focal hand dystonia. We are also studying the blink reflex in patients with blepharospasm and torticollis. In this study, we are evaluating the R3 component of the blink reflex and comparing it with first degree unaffected relatives and control subjects. We are interested to see if there is a possible neurophysiological marker in the unaffected first degree relatives. We are currently exploring the genetics of movement disorders with several different populations of patients. We have evaluated approximately 250 patients with focal dystonia (blepharospasm, torticollis, writer's cramp, Meige's Syndrome and spasmodic dysphonia). This collection includes families where focal dystonia is present, as well as, sporadic cases. In addition, we are also looking into the genetics of essential tremor through a large family (40 people) with multiple members affected. Both studies are aimed at identifying the gene or genes responsible for the specific movement disorder. In the area of Parkinson's Disease, we are evaluating the efficacy of various types of non-invasive brain stimulation. High frequency repetitive TMS lead to improvement in the speed of gait and hand movements in patients with Parkinson?s Disease in a placebo controlled trial. We are now studying transcranial direct current stimulation. We are also studying postural instability and its changes with aging, given the importance of falls in the elderly. We are pursuing the hypothesis that neural detectors of unstable postures deteriorate with aging. We have evidence for these neural detectors with both EEG and fMRI studies. Along this line of research of postural stability, we are also evaluating the role of vision in postural control using virtual reality (VR). In studies of hemiplegia, we are studying the physiology of diaschisis. We have confirmed the feasibility of a magnetic resonance spectroscopy technique for analysis of GABA and are applying this now to patients with subcortical stroke. We are also assessing the safety of using high frequency repetitive TMS in patients with stroke, hoping that this will be a useful adjunct to physical therapy.

这个项目的目标是了解更多关于正常人和随意运动障碍患者的运动控制，如帕金森病，肌张力障碍，小脑共济失调和中风偏瘫。我们使用的工具包括临床神经生理学方法，如脑电图，肌电图，经颅磁刺激（TMS）和神经成像与正电子发射断层扫描和功能磁共振成像（fMRI）。目前活跃的研究项目包括正常生理学、病理生理学和肌张力障碍的治疗、帕金森氏症的运动迟缓？的疾病，并从偏瘫恢复。 我们正试图确定脑电图方法来预测真实的时间，当有人要移动，以及他们是否会移动他们的右手或左手。我们优化了预测的特征和分类方法。我们的实时研究表明，我们可以可靠地预测运动发生之前的人的运动意图。我们现在正试图减少误预测，并探索方法来预测偏侧运动意图。这项工作应该与脑机接口有关。 简单的动作已经研究了很多年，但人类的大多数动作都更复杂。我们一直在研究复杂的praxis运动与脑电图和功能磁共振成像。功能磁共振成像显示顶叶和运动前区活动的模式，更多的是在左半球，而不考虑用哪只手来做运动。EEG的相干性分析表明，顶叶和运动前区在运动的准备和执行过程中是相干的，推断出与事件相关的功能连接。使用事件相关功能磁共振成像，我们评估了正常人和意念失用症患者的传递性（工具相关）和不传递性（交流）实践运动的半球侧化。这项研究的结果表明，正常的实践运动的左半球组织。两名IMA患者的初步研究结果表明，受损的实践运动与偏侧化模式的改变有关，特别是如果疾病更严重。 我们已经做了很多肌张力障碍的研究，主要是在局灶性手肌张力障碍患者。我们花了相当多的时间在追求的假设，有一个缺陷的周围抑制与自主运动的张力障碍患者。我们已经用TMS证明了这一点。我们现在正在研究不同类型的已知抑制过程的环绕抑制机制。我们也在使用脑电图的方法，看看这是否有助于揭示周围的抑制机制。在另一项努力，以确定缺乏皮质内抑制局灶性手肌张力障碍的EEG证据，我们记录了头皮体感诱发电位从正中神经电刺激，以量化高频振荡，这可能反映了抑制性中间神经元在皮层的活动。我们一直在研究局灶性手肌张力障碍患者躯体感觉辨别障碍的电生理相关性。我们也在研究眼睑痉挛和斜颈患者的眨眼反射。在这项研究中，我们评估了眨眼反射的R3成分，并将其与一级未受影响的亲属和对照组进行比较。我们有兴趣看看是否有一个可能的神经生理学标记在未受影响的一级亲属。 我们目前正在探索运动障碍的遗传学与几个不同的患者群体。我们已经评估了大约250名患有局灶性肌张力障碍（眼睑痉挛、斜颈、书写痉挛、Meige综合征和痉挛性发音障碍）的患者。该集合包括存在局灶性肌张力障碍的家庭，以及散发病例。此外，我们还通过一个有多名成员受影响的大家庭（40人）研究原发性震颤的遗传学。这两项研究的目的都是确定导致特定运动障碍的基因。 在帕金森病领域，我们正在评估各种类型的非侵入性脑刺激的疗效。高频重复经颅磁刺激可改善帕金森病患者的步态和手部运动速度？在安慰剂对照试验中的疾病。我们现在正在研究经颅直流电刺激。 鉴于老年人福尔斯跌倒的重要性，我们也在研究姿势不稳定及其随年龄的变化。我们正在追求的假设是，不稳定姿势的神经探测器随着年龄的增长而退化。我们有证据证明这些神经探测器与脑电图和功能磁共振成像研究。沿着姿势稳定性的研究路线，我们还使用虚拟现实（VR）评估视觉在姿势控制中的作用。 在对偏瘫的研究中，我们研究的是神经联系不能的生理学。我们已经证实了磁共振波谱技术分析GABA的可行性，并将其应用于皮质下卒中患者。我们也正在评估中风患者使用高频重复经颅磁刺激的安全性，希望这将是一个有用的辅助物理治疗。