Modulation of interhemispheric interactions and arm activity after stroke

中风后半球间相互作用和手臂活动的调节

• 批准号: 9301660
• 负责人: Michael Dimyan
• 金额: $ 18.4万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9301660
• 关键词: Address; Age; Aging; Area; Automobile Driving; BRAIN initiative; Behavioral; Brain; Chronic; Clinical; Clinical Investigator; Data; Development; Disabled Persons; Dorsal; Enrollment; Foundations; Functional Imaging; Functional Magnetic Resonance Imaging; Goals; Grant; Human; Image; Imaging Techniques; Impairment; Intervention; Investigation; Ipsilateral; Isometric Exercise; Left; Maryland; Measures; Mentored Patient-Oriented Research Career Development Award; Mentors; Mission; Modeling; Motor; Movement; Multimodal Imaging; Muscle; Neurology; Neurorehabilitation; Output; Participant; Patients; Physiologic pulse; Physiological; Physiology; Preparation; Public Health; Quality of life; Recovery; Rehabilitation therapy; Relaxation; Research; Research Proposals; Role; Stroke; Techniques; Therapeutic Intervention; Time; Training; Transcranial magnetic stimulation; United States National Institutes of Health; Universities; Wrist; arm; arm function; arm movement; arm paresis; base; career development; chronic stroke; design; disability; disability burden; effective therapy; experimental study; healthy volunteer; hemiparesis; improved; innovation; medical schools; metabolic imaging; millisecond; mind control; motor control; multimodality; nervous system disorder; neural circuit; neurophysiology; neuroregulation; post stroke; professor; public health relevance; relating to nervous system; signal processing; stroke hemiparesis; stroke rehabilitation; stroke survivor; targeted treatment; therapy design

DESCRIPTION (provided by applicant): This K23 application is submitted by Michael A. Dimyan, MD, Assistant Professor of Neurology at the University Of Maryland School Of Medicine. My long-term goal is to become an independent clinical investigator focusing on the neural substrates of arm motor control as a basis for developing interventions to improve neurorehabilitation after stroke. This K23 award will allow me to pursue advanced training in arm motor control and their neurophysiological substrates. I will train in the technique of concurrent multimodal neurophysiology and imaging. This training will be applied to investigating the dynamic modulation of interhemispheric inhibition throughout the time-course of arm activity, with a goal of identifying targets for intervention to enhance arm rehabilitation after stroke. I will be mentored by a team of experts in clinical neurorehabilitation, arm motor control, neurophysiology and multi-modal imaging including Dr. George Wittenberg, Dr. Jill Whitall, Dr. Rao Gullapalli and Dr. Peter Gorman. Even after comprehensive rehabilitation, 30% of stroke survivors are left with arm weakness. Chronic hemiparesis is significant because 50% of the reduction in quality of life for stroke survivors is due to arm weakness. Current treatments of hemiparesis are based on different models of how the two arms interact after stroke. However, these models are limited by an incomplete understanding of interhemispheric competition. In particular, we do not know how interactions between the two arms are dynamically modulated during arm activity. I will pursue this problem by 1) defining normal interhemispheric interactions between the two arms during unilateral arm activity 2) discovering how aging and stroke impair those dynamics and 3) determining how other brain areas influence the interaction between the two arms. This will be done by studying neurophysiological measures of corticospinal and interhemispheric interactions in hemiparetic patients and healthy controls performing an arm activity. I will also use multimodal neurophysiological and imaging techniques to examine brain network interactions and their influence on corticospinal activity. The proposed research is innovative conceptually in its elaboration and addition to the model of interhemispheric interactions during movement and after stroke. The results of this research may significantly contribute to our understanding of the interaction between the two arms. This is important because it will allow us to design therapies that take advantage of those interactions. The impact of this proposal is that it will allow us to design interventions that taret specific neurophysiological impairments at specific time-points during movement to enhance rehabilitation after stroke. This research proposal addresses the NIH missions to reduce the burden of neurological disorders and enhance the quality of life of people with disabilities. This proposal also addresses the goals of the NIH BRAIN initiative to develop a dynamic picture of the human brain describing how neural circuits interact in time and space.

描述（由申请人提供）：此 K23 申请由马里兰大学医学院神经病学助理教授 Michael A. Dimyan 医学博士提交。我的长期目标是成为一名独立的临床研究者，专注于手臂运动控制的神经基础，作为开发干预措施以改善中风后神经康复的基础。这个 K23 奖项将使我能够继续进行手臂运动控制及其神经生理学基础方面的高级培训。我将接受并发多模式神经生理学和成像技术的培训。该训练将用于研究大脑半球间抑制在整个手臂活动过程中的动态调节，目的是确定干预目标，以增强中风后手臂的康复。我将得到临床神经康复、手臂运动控制、神经生理学和多模态成像领域专家团队的指导，其中包括 George Wittenberg 博士、Jill Whitall 博士、Rao Gullapalli 博士和 Peter Gorman 博士。 即使经过全面康复，30% 的中风幸存者仍会出现手臂无力的情况。慢性偏瘫非常严重，因为中风幸存者生活质量下降的 50% 是由于手臂无力所致。目前的治疗方法 偏瘫的研究基于中风后两臂相互作用的不同模型。然而，这些模型由于对半球间竞争的不完全理解而受到限制。特别是，我们不知道在手臂活动期间如何动态调节两个手臂之间的相互作用。我将通过以下方式解决这个问题：1）定义单侧手臂活动期间两臂之间正常的半球间相互作用；2）发现衰老和中风如何损害这些动态；3）确定其他大脑区域如何影响两臂之间的相互作用。这将通过研究偏瘫患者和进行手臂活动的健康对照的皮质脊髓和半球间相互作用的神经生理学测量来完成。我还将使用多模式神经生理学和成像技术来检查大脑网络相互作用及其对皮质脊髓活动的影响。拟议的研究在概念上具有创新性，它对运动期间和中风后的半球间相互作用模型进行了阐述和补充。这项研究的结果可能会极大地有助于我们理解两个手臂之间的相互作用。这很重要，因为它将使我们能够设计利用这些相互作用的疗法。该提案的影响在于，它将允许我们设计针对运动过程中特定时间点的特定神经生理学损伤的干预措施，以增强中风后的康复。该研究提案旨在解决 NIH 减轻神经系统疾病负担和提高残疾人生活质量的使命。该提案还解决了 NIH BRAIN 计划的目标，即开发人类大脑的动态图像，描述神经回路如何在时间和空间中相互作用。