Sensorimotor integration underlying hand control in Carpal Tunnel Syndrome

腕管综合症中手部控制的感觉运动整合

• 批准号: 7911721
• 负责人: MARCO SANTELLO
• 金额: $ 18.76万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-30 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7911721
• 关键词: Address; Adult; Affect; Age; Behavior; Carpal Tunnel Syndrome; Clinical; Complex; Data; Digit structure; Disease; Drops; Ensure; Feedback; Fingers; Freedom; Friction; Gender; Hand; Hand functions; Impairment; Individual; Knowledge; Lateral; Lead; Learning; Left; Location; Manuals; Maps; Measures; Medial; Memory; Modeling; Motor; Muscle; Musculoskeletal Diseases; Nerve; Nerve compression syndrome; Neurologic; Neuromuscular Diseases; Neuropathy; Neurosciences; Outcome; Patient Self-Report; Patients; Performance; Population; Process; Property; Public Health; Quality of life; Randomized; Relative (related person); Research; Research Proposals; Ring Finger Domain; Role; Sensory; Severities; Spatial Distribution; Surface; Syndrome; Tactile; Testing; Texture; Thumb structure; United States; Visual; Weight; clinical application; design; grasp; improved; indexing; insight; lifetime risk; median nerve; motor control; motor deficit; pressure; public health relevance; receptor; response; sensory feedback; skeletal disorder; somatosensory

DESCRIPTION (provided by applicant): Effective control of object grasping and manipulation relies on the ability to adjust forces of individual digits to the properties of the object being grasped such as its weight, center of mass or texture. These adjustments rely on (a) detecting object properties through sensory feedback derived primarily from receptors in the fingertips and hand muscles and (b) integrating this feedback with activation of hand muscles appropriate for grasping and manipulation. However, the fine tuning of hand muscle activity to object properties can be disrupted by a number of neurological and musculo-skeletal diseases such as Carpal Tunnel Syndrome (CTS). This compresion neuropathy of the median nerve is one of the most common and debilitating diseases affecting hand function. CTS results in self-reported loss of manual dexterity (e.g., difficulties with fine manipulation, dropping objects, etc.) which is due to somatosensory deficits in the thumb, index, middle and lateral half of the ring finger, and, in severe cases, motor deficits in the thumb. As whole- hand grasping require sensing object properties from all digits to accurately adjust their forces, the study of CTS offers a unique opportunity to improve our understanding the mechanisms underlying sensorimotor integration during whole-hand grasping and manipulation. This primary objective will be pursued by using CTS as a research model to address these important questions of sensorimotor control of grasping. An additional secondary objective is to use the results of the proposed research to improve our understanding of the extent to which increasing impairment in nerve function affects sensorimotor transformations necessary for learning and executing specific aspects of skilled object manipulation. We will pursue two Specific Aims: (1) to quantify the extent to which patients with CTS are able to coordinate all digit forces and contact points when altering object properties (center of mass, weight and texture) and their predictability during five-digit grasping; and (2) to determine the extent to which patients with CTS are able to coordinate digit forces as a function of the number of digits (two, three, four, and five) involved in the grasp. In both Aims, multi-dimensional measures of grasp control from patients with mild and moderately severe CTS will be compared with those obtained from age- and gender-matched healthy controls. PUBLIC HEALTH RELEVANCE. The objectives of the proposed research are relevant to public health as they address a debilitating neuromuscular disease of the hand, Carpal Tunnel Syndrome (CTS), that affects the quality of life in 6 to 14 million adults in the United States. We propose to use CTS as a model to improve our understanding of the mechanisms underlying sensorimotor integration responsible for skilled object manipulation. The knowledge gained through our proposed research will provide significant insight into how electrodiagnostic measures of nerve function relate to specific aspects of grasp control, thus improving the interpretability and applications of these clinical measures.

描述（由申请人提供）：物体抓取和操纵的有效控制依赖于根据被抓取物体的特性（例如其重量、质心或纹理）调整单个手指的力的能力。这些调节依赖于（a）通过主要来自指尖和手部肌肉中的感受器的感觉反馈来检测物体属性，以及（B）将该反馈与适于抓握和操纵的手部肌肉的激活相结合。然而，手部肌肉活动对物体属性的微调可能会被许多神经和肌肉骨骼疾病（如腕管综合征（CTS））所破坏。这种正中神经的压迫性神经病是影响手功能的最常见和使人衰弱的疾病之一。CTS导致自我报告的手部灵活性丧失（例如，精细操作困难、掉落物体等）这是由于拇指、食指、无名指的中间和外侧的躯体感觉缺陷，并且在严重的情况下，拇指的运动缺陷。由于全手抓握需要从所有手指感知物体属性以准确调整其力，因此CTS的研究提供了一个独特的机会，以提高我们对全手抓握和操纵过程中感觉运动整合机制的理解。这一主要目标将通过使用CTS作为研究模型来解决这些重要的问题的感觉运动控制的把握。另一个次要目标是使用拟议的研究结果，以提高我们的理解，在何种程度上增加神经功能损伤影响必要的学习和执行熟练的对象操作的特定方面的感觉运动转换。我们将追求两个具体目标：（1）量化CTS患者在改变物体属性时能够协调所有手指力和接触点的程度（质心，重量和纹理）和他们的预测在五个数字的把握;以及（2）确定CTS患者能够协调手指力量的程度作为手指数量的函数（二、三、四、五）参与抓。在这两个目的中，将轻度和中重度CTS患者的抓握控制多维指标与年龄和性别匹配的健康对照进行比较。公共卫生相关性。 拟议研究的目标与公共卫生有关，因为它们解决了一种使人衰弱的手部神经肌肉疾病，腕管综合征（CTS），这种疾病影响了美国600万至1400万成年人的生活质量。我们建议使用CTS作为一个模型，以提高我们对负责熟练的对象操作的感觉运动整合的机制的理解。通过我们提出的研究所获得的知识将提供重要的洞察神经功能的电诊断措施与具体方面的把握控制，从而提高这些临床措施的可解释性和应用。