Behavioral and Neural Correlates of Post-Stroke Fatigue

中风后疲劳的行为和神经相关性

• 批准号: 10725951
• 负责人: Hui-Ting Goh
• 金额: $ 37.29万
• 依托单位: TEXAS WOMAN'S UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-10 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10725951
• 关键词: Adopted; Anodes; Behavior assessment; Behavioral; Brain; Brain imaging; Brain region; Clinical; Clinical Trials; Clinical assessments; Complex; Complication; Development; Education; Experimental Designs; Fatigue; Fostering; Functional Magnetic Resonance Imaging; Future; Goals; Imaging Techniques; Individual; Intervention; Investigation; Knowledge; Measures; Mediating; Motor; Motor Cortex; Neuromodulator; Outcome; Participant; Pathologic; Perception; Phase; Population; Proxy; Quality of life; Randomized; Recovery; Rehabilitation therapy; Reporting; Research; Research Personnel; Rest; Severities; Stroke; Students; TAP1 gene; Texas; Thalamic structure; Therapeutic Effect; Transcranial magnetic stimulation; Woman; Work; clinical efficacy; clinically significant; cohort; design; disabling symptom; efficacy evaluation; evidence base; experience; follow-up; innovation; insight; multimodality; negative affect; neural; neural correlate; neuromechanism; neurophysiology; noninvasive brain stimulation; novel; patient response; post intervention; post stroke; randomized, clinical trials; stroke survivor; theories; therapy development; transcranial direct current stimulation; university student

PROJECT SUMMARY Up to 85% stroke survivors experience post-stroke fatigue (PSF) defined as intensified perceived effort during activities. PSF is a significant barrier to full participation in rehabilitation and negatively affects quality of life after stroke. Despite its well-known impacts, there are very few targeted interventions for PSF largely due to unclear underlying mechanisms. A few brain stimulation studies have suggested a relationship between primary motor cortex (M1) excitability and PSF. Recent clinical trials using anodal transcranial direct current stimulation (tDCS) to modulate brain excitability reported mixed clinical efficacy in reducing PSF with unclear mechanisms of action. The proposed research will address the gaps in our knowledge by determining the behavioral and neural correlates of PSF using an experimental design and multimodal approach. Thirty-two individuals with significant fatigue due stroke will be randomly assigned to receive five consecutive sessions of anodal or sham tDCS. Before and after intervention, participants will complete clinical and behavioral assessments of PSF, brain excitability assessment using transcranial magnetic stimulation, and brain connectivity assessment using resting state functional MRI. In aim 1, we will determine if upregulating M1 excitability via tDCS will reduce PSF assessed by clinical and behavioral markers. Aim 2 will utilize brain stimulation and brain imaging techniques to probe the neurophysiological effect of tDCS on PSF. Aim 3 will explore the correlation between behavioral changes and neurophysiological changes to provide further insights into the neural correlates of PSF. Our long-term goal is to develop evidence based, theory-driven interventions to manage PSF. The proposed study is innovative in that it investigates a relative novel intervention to mitigate PSF and adopts a multimodal approach to examine the underlying mechanisms. The comprehensive research will guide the development of treatment targeted the underlying mechanisms of PSF. In addition to its scientific and clinical significances, the proposed research will achieve its educational goals by fostering a group of student researchers and promoting rigorous research cultures within our institute.

项目概要 高达 85% 的中风幸存者会经历中风后疲劳 (PSF)，定义为“加剧” 活动期间感知到的努力。 PSF 是全面参与康复的重大障碍 并对中风后的生活质量产生负面影响。尽管其影响众所周知，但仍有很多 PSF 的针对性干预措施很少，主要是由于潜在机制尚不明确。几个脑子 刺激研究表明初级运动皮层 (M1) 兴奋性之间存在关系 和PSF。最近的临床试验使用阳极经颅直流电刺激 (tDCS) 调节大脑兴奋性 在降低 PSF 方面的临床疗效不一，但尚不清楚 行动机制。拟议的研究将通过以下方式解决我们的知识差距 使用实验设计确定 PSF 的行为和神经相关性 多式联运方法。将随机抽取 32 名因中风而出现明显疲劳的个体 分配接受连续五次阳极或假 tDCS 治疗。之前和之后 干预后，参与者将完成 PSF、大脑的临床和行为评估 使用经颅磁刺激和大脑连接评估兴奋性 使用静息态功能 MRI 进行评估。在目标 1 中，我们将确定是否上调 M1 通过 tDCS 的兴奋性将减少临床和行为标记评估的 PSF。目标2将 利用脑刺激和脑成像技术来探讨神经生理学效应 PSF 上的 tDCS。目标 3 将探讨行为变化与 神经生理学变化，以进一步了解 PSF 的神经相关性。我们的 长期目标是开发基于证据、理论驱动的干预措施来管理 PSF。这 拟议的研究具有创新性，因为它研究了一种相对新颖的干预措施来减轻 PSF 并采用多模式方法来研究潜在机制。全面的 研究将指导针对 PSF 潜在机制的治疗方法的开发。 除了其科学和临床意义外，拟议的研究还将实现其 通过培养一批学生研究人员和促进严谨的研究来实现教育目标 我们研究所内的文化。