Plasticity of Audiovisual Movement Representations: Implications for Limb Apraxia

描述（由申请人提供）：Brenda Hanna-Pladdy博士是堪萨斯大学医学中心（KUMC）兰登老龄化中心和精神病学部门的临床神经心理学家和助理教授。本提案旨在促进候选人脑卒中恢复机制和fMRI技能的科学发展，使其成为一名独立的临床科学家。KUMC的Landon老化中心和Hoglund脑成像中心将为候选人提供理想的环境，以研究中风后辅助熟练运动和失用症恢复的神经机制。本研究计划的长期目标是探索实践系统中运动表征的多感官性质，以确定康复目标。意指运动失用症（IMA）是左半球中风后常见的一种熟练的运动障碍，可能导致日常环境中的重大残疾。与主要导师（Nudo博士）的合作将使候选人通过扩展候选人在中风恢复和神经可塑性方面的科学背景，并提高她的研究和资助技能，为独立学术生涯的发展奠定基础。联合导师将在功能磁共振成像技术和中风的病变症状映射（Savage博士）以及熟练运动障碍的神经解剖学和临床方面（Haaland博士）提供指导。该研究将利用与事件相关的功能磁共振成像（fMRI）研究，旨在区分在听觉、视觉和多感官提示的情况下，与检索熟悉工具/物体（没有实际运动）的时空特征有关的区域。这些激活模式将与测量LH中风患者（有或没有失用症）和正常对照的运动轨迹质量的行为范式相关联，以确定在视觉线索（即多感官线索）之外添加听觉运动线索是否可以更好地获得运动表征。目的如下：(i)表征感觉线索如何促进物体动作特征的检索，（ii）阐明实践的神经基础和运动表征的多感官性质，以及（iii）评估LH中风后视听运动表征的功能适应。该数据将阐明失用症的功能和解剖学基础，并有助于确定卒中后肢体失用症康复的适当感觉线索。

DESCRIPTION (provided by applicant): Dr. Brenda Hanna-Pladdy is a clinical neuropsychologist and Assistant Professor in the Landon Center on Aging and Department of Psychiatry at the University of Kansas Medical Center (KUMC). The purpose of this proposal is to foster the scientific development in stroke recovery mechanisms and fMRI skills of the candidate, so that she may become an independent clinical scientist. The Landon Center on Aging and the Hoglund Brain Imaging Center at KUMC will provide the candidate with the ideal setting to investigate the neural mechanisms subserving skilled movements and the recovery of apraxia following stroke. The long-term objective of this research plan is to explore the multisensory nature of movement representations in the praxis system in order to identify rehabilitation targets. Ideomotor apraxia (IMA) is a skilled movement disorder that is common after left hemisphere (LH) stroke, and may contribute to significant disability in the everyday environment. The collaboration with the primary mentor (Dr. Nudo) will allow the candidate to obtain the foundation for the development of an independent academic career by expanding the candidate's scientific background in stroke recovery and neuroplasticity, and promoting her research and grantsmanship skills. The co-mentors will provide mentorship in fMRI techniques and lesion-symptom mapping in stroke (Dr. Savage), and neuroanatomical and clinical aspects of skilled movement disorders (Dr. Haaland). The proposed study will utilize an event-related fMRI study designed to distinguish regions involved in retrieving the spatiotemporal features of familiar tools/objects (without actual movement) when elicited by auditory, visual and multisensory cues. These activation patterns will be correlated to a behavioral paradigm measuring the quality of movement trajectories in LH stroke patients (with and without apraxia) and normal controls to determine if the addition of auditory motion cues to visual cues (i.e., multisensory cues) may provide better access to movement representations. The aims are the following (i) to characterize how sensory cues facilitate the retrieval of object action features, (ii) to elucidate the neural substrates of praxis and the multisensory nature of movement representations, and (iii) to evaluate functional adaptation in audiovisual movement representations following LH stroke. This data will elucidate the functional and anatomical basis for apraxia, and help identify appropriate sensory cues for rehabilitation of limb apraxia following stroke. PUBLIC HEALTH RELEVANCE: This research will have broad impact on public health, as stroke is a leading cause of long-term disability, and leaves many of its victims unable to function independently in the environment without assistance leading to substantial social and fiscal costs. IMA is a disorder common after LH stroke that directly affects effective manipulation of objects in the environment, and has demonstrated impact on independence. Thus, development of a rehabilitation program for IMA will significantly improve functional independence and quality of life for stroke survivors.