Driving Cortical Plasticity for Rehabilitation of Reaching After Stroke.

驱动皮质可塑性以实现中风后的康复。

• 批准号: 8460511
• 负责人: GEORGE F. WITTENBERG
• 金额: $ 28.84万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-06-20 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8460511
• 关键词: Affect; Area; Automobile Driving; Brain; Clinical; Corticospinal Tracts; Coupled; Cues; Data; Dorsal; Effectiveness; Environment; Future; Goals; Hybrids; Individual; Knowledge; Lead; Life; Location; Magnetism; Measures; Methods; Modeling; Motor; Motor Cortex; Movement; Multi-Institutional Clinical Trial; Muscle; Neuronal Plasticity; Neurons; Neurorehabilitation; Neurosciences; Patients; Population; Recovery; Rehabilitation therapy; Research; Resources; Robot; Robotics; Speed; Staging; Stereotyping; Stimulus; Stroke; Survivors; Synapses; Techniques; Testing; Time; Training; Transcranial magnetic stimulation; Upper Extremity; Visual; Work; arm; base; chronic stroke; design; disability; experience; functional outcomes; improved; limb movement; magnetic field; motor function improvement; post stroke; research clinical testing; stroke rehabilitation; volunteer

DESCRIPTION (provided by applicant): Stroke is one of the most common causes of disability and there is tremendous room for improvement in rehabilitation techniques. While neural plasticity likely supports much natural and practice-related recovery, such naturally occurring mechanisms for plasticity could be potentially enhanced to improved functional outcomes. We propose a hybrid approach to combining transcranial magnetic stimulation, long seen as an adjunctive method in neurorehabilitation, with upper extremity robotic therapy, another promising method. Our preliminary data shows the potential of brain stimulation to measure and induce plasticity in the motor cortex. We plan to: 1. Determine parameters of stimulation timing that enhance plasticity in normal volunteers; 2. Determine parameters of stimulation location that enhance plasticity in normal volunteers; and 3. Determine feasibility and pilot data regarding effectiveness in chronic stroke patients. The resulting methods will be applicable to a wide range of motor disability found in stroke survivors and a wide range of methods that combine motor practice with other stimuli, whether natural (such as visual cuing) or artificial (such as magnetic stimulation.) When we have accomplished these aims, we will have established methods that can be used in a larger, multi-site clinical trial of combined stimulation and upper extremity robotic rehabilitation, and will also have uncovered valuable basic mechanisms regarding the induction of motor cortical plasticity through a precisely timed combination of stimulation and repetitive practice of movement in both normal and stroke affected populations. The data obtained by completing these aims will greatly impact future design of stroke rehabilitation paradigms.

描述（由申请人提供）：中风是最常见的残疾原因之一，康复技术有巨大的改进空间。虽然神经可塑性可能支持许多自然和实践相关的恢复，但这种自然发生的可塑性机制可能会得到增强，以改善功能结果。我们提出了一种混合的方法，结合经颅磁刺激，长期以来被视为神经康复的一种预防性方法，上肢机器人治疗，另一种有前途的方法。我们的初步数据显示了脑刺激测量和诱导运动皮层可塑性的潜力。我们计划：1.确定参数的刺激时间，提高可塑性在正常志愿者; 2。确定增强正常志愿者可塑性的刺激位置参数;以及3.确定慢性卒中患者有效性的可行性和试点数据。由此产生的方法将适用于中风幸存者中发现的各种运动障碍，以及将联合收割机运动练习与其他刺激结合的各种方法，无论是自然的（如视觉提示）还是人工的（如磁刺激）。当我们实现这些目标时，我们将建立可用于组合刺激和上肢机器人康复的更大，多站点临床试验的方法，并且还将揭示关于通过在正常和中风受影响人群中精确定时的刺激和重复运动练习的组合来诱导运动皮层可塑性的有价值的基本机制。通过完成这些目标获得的数据将极大地影响未来的中风康复模式的设计。