Individual-specific engagement of cortical resources for standing balance control in aging and post stroke

个体特定的皮质资源参与衰老和中风后的站立平衡控制

• 批准号: 10391863
• 负责人: Michael Robert Borich
• 金额: $ 61.07万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-15 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10391863
• 关键词: Address; Affect; Age; Aging; Anatomy; Attention; Behavior; Behavioral; Biological Markers; Biomechanics; Brain; Brain imaging; Clinical; Clinical assessments; Cognitive; Data; Disease; Early Diagnosis; Elderly; Electrodes; Electroencephalography; Electrophysiology (science); Equilibrium; Fall prevention; Gait; Goals; Health; Human; Impairment; Individual; Intervention; Kinetics; Lateral; Leg; Lesion; Link; Longevity; Measures; Mediating; Methods; Motor; Muscle; Musculoskeletal Diseases; Neurologic; Neuromechanics; Orthopedics; Paresis; Performance; Phase; Prevention strategy; Publishing; Quality of life; Resources; Risk Factors; Scientific Advances and Accomplishments; Sensory; Signal Transduction; Stroke; Surface; Testing; Translations; Walking; balance recovery; base; cognitive task; density; equilibration disorder; fall risk; functional MRI scan; improved; individual variation; innovation; leg paresis; nervous system disorder; neuromechanism; neurophysiology; novel; personalized approach; personalized intervention; personalized strategies; post stroke; precision medicine; prognostic tool; prospective; response; stroke rehabilitation; stroke survivor; young adult

Project Summary Our long-term goal is to identify neural mechanisms of healthy and impaired balance to guide mechanistically- based predictors, assessments, and interventions for addressing balance and gait impairments common in aging and neurological disorders. It is well-known clinically that engagement of cortical resources in balance control is an indicator of fall risk in older adults including stroke survivors, as inferred by the degradation of balance and/or gait performance when a concurrent cognitive task shifts attention away from balance control. A scientific barrier to improving prognostic tools, preventive strategies, and interventions for balance impairments is that we lack an understanding of how and when cortical resources are engaged in balance control, particularly with balance task difficulty. An innovation of our proposal is to identify direct, mechanistic measures of cortical activity during reactive balance. We will combine MPI Ting’s expertise in the neuromechanics of reactive balance control and MPI Borich’s expertise in human electrophysiology to identify relationships between brain activity and motor function to improve stroke rehabilitation. Our objective is to identify cortical activity signatures that distinguish individual-, task-, and group-level differences in the engagement of cortical resources for balance control amongst young adults (Aim 1), older adults (Aim 2), and older adults with unilateral lesions due to stroke (Aim 3). We will measure electroencephalographic (EEG), electromyographic (EMG), and biomechanical signals during reactive balance recovery to support-surface translations. We propose to use both clinically feasible electrode-based analysis approaches, as well as mechanistically-important anatomically-informed functional analyses using high-density EEG in combination with structural and functional MRI scans. We hypothesize that cortical activity signatures during balance control increase in an individual-, age-, and disease-specific manner as balance task difficulty increases. Within groups, we predict individual variability in cortical activity to be explained by balance challenge, i.e., balance task difficulty normalized to step threshold, a measure of balance function. However, between groups, we predict cortical activity signatures and their relation to balance challenge will differ. Our Aims are motivated by our preliminary data that show 1) increases in N1 and beta power over leg sensorimotor regions with balance task difficulty depend on balance function in young and older adults 2) opposite relationships between sensorimotor functional connectivity and balance task difficulty in younger vs. older adults; 3) distinct aspects of balance function associated with sensorimotor vs. prefrontal-motor connectivity in older adults; and 4) sensorimotor functional connectivity in stroke survivors associated with walking function. If successful, we will identify neurophysiological indicators of balance health that will be broadly applicable across the lifespan, and across neurological and orthopedic balance disorders to significantly advance the scientific framework to enable precision-medicine strategies for personalized, mechanistic assessments and interventions to improve quality of life those with poor balance health.

项目概要 我们的长期目标是确定健康和受损平衡的神经机制，以机械地指导- 基于预测因子、评估和干预措施，以解决衰老过程中常见的平衡和步态障碍 和神经系统疾病。临床上众所周知，皮质资源参与平衡控制 是老年人（包括中风幸存者）跌倒风险的指标，通过平衡能力下降来推断 当并发认知任务将注意力从平衡控制转移开时，会影响步态和/或步态表现。一个科学的 改善平衡障碍的预后工具、预防策略和干预措施的障碍是我们 缺乏对皮质资源如何以及何时参与平衡控制的了解，尤其是 平衡任务难度。我们提案的一个创新是确定皮质的直接、机械测量 反应性平衡期间的活动。我们将结合 MPI Ting 在反应性神经力学方面的专业知识 平衡控制和 MPI Borich 在人体电生理学方面的专业知识可识别大脑之间的关系 活动和运动功能，以改善中风康复。我们的目标是识别皮质活动特征 区分个人、任务和群体层面在皮质资源平衡方面的差异 年轻人（目标 1）、老年人（目标 2）和因中风导致单侧病变的老年人的控制 （目标 3）。我们将测量脑电图 (EEG)、肌电图 (EMG) 和生物力学信号 在反应平衡恢复至支撑表面平移期间。我们建议同时使用临床上可行的 基于电极的分析方法，以及机械上重要的解剖学功能 使用高密度脑电图结合结构和功能 MRI 扫描进行分析。我们假设 平衡控制期间的皮质活动特征以个体、年龄和疾病特异性的方式增加 随着平衡任务难度的增加。在群体内，我们预测皮质活动的个体差异是 通过平衡挑战来解释，即平衡任务难度标准化为步骤阈值，平衡的衡量标准 功能。然而，在各组之间，我们预测皮质活动特征及其与平衡挑战的关系 会有所不同。我们的目标源于我们的初步数据，这些数据显示 1) N1 和 beta 功率的增加 平衡任务困难的腿部感觉运动区域取决于年轻人和老年人的平衡功能 2) 年轻人与老年人的感觉运动功能连接性和平衡任务难度之间存在相反的关系。 老年人； 3）与感觉运动和前额运动相关的平衡功能的不同方面 老年人的连通性； 4) 中风幸存者的感觉运动功能连接 行走功能。如果成功，我们将确定平衡健康的神经生理学指标，这些指标将广泛应用于 适用于整个生命周期，以及神经和骨科平衡障碍，以显着 推进科学框架，以实现个性化、机械化的精准医疗策略 评估和干预措施，以改善平衡健康状况不佳者的生活质量。