Deep brain stimulation for visuomotor function in Parkinson's disease

深部脑刺激对帕金森病视觉运动功能的影响

• 批准号: 10655565
• 负责人: Aasef G Shaikh
• 金额: --
• 依托单位: LOUIS STOKES CLEVELAND VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10655565
• 关键词: Affect; American; Anatomy; Area; Atlases; Bilateral; Biophysics; Bradykinesia; Brain; Clinical; Computer Simulation; Data; Deep Brain Stimulation; Degenerative Disorder; Depth Perception; Diplopia; Distal; Dorsal; Electrodes; Equipment; Eye; Eye Abnormalities; Eye Movements; Functional disorder; Goals; Hypokinesia; Image; Impairment; Interdisciplinary Study; Knowledge; Left; Location; Magnetic Resonance Imaging; Maps; Measures; Mental Depression; Modeling; Motor; Movement; Movement Disorder Society Unified Parkinson' s Disease Rating Scale; Nature; Nerve Degeneration; Operative Surgical Procedures; Parkinson Disease; Patients; Pharmacotherapy; Positioning Attribute; Quality of life; Questionnaires; Research; Resolution; STN stimulation; Social Impacts; Therapeutic; Tissues; Tremor; Veterans; Vision; Visual System; Visual impairment; electric field; excessive anxiety; experimental study; gaze; improved; insight; military veteran; motor deficit; motor impairment; motor symptom; multidisciplinary; novel; orbit muscle; preservation; programs; progressive neurodegeneration; treatment response; visual motor; visual tracking; way finding

The sufferers of a prevalent condition called Parkinson's disease have tremors, rigidity, and slow movements. In addition to its effects on body movements, Parkinson's disease affects many other brain functions. Visual impairments are common in Parkinson's patients who have difficulties holding their eyes steady at a given location, seamlessly look around and read, and refocus their eyes from one image to the other placed at different depths. About two thirds of Parkinson's disease patients have problems coordinating two eyes' movements necessary to refocusing at different depths, i.e., abnormal vergence causing disabling double vision and abnormal depth perception. Most treatment options available to Parkinson's disease patients are limited to their effects on tremor, rigidity, and slowness – their impact on visual function is poorly understood. Orbital muscle surgeries are not ideal treatments given the brain's continually changing state due to the disease's degenerative nature. Presently available strategies of deep brain stimulation have variable effects on eye movements and vergence function. Our research program aims to identify the best possible therapeutic approach using deep brain stimulation to improve vergence eye movements in Parkinson's disease while continuing to offer its other benefits. Our multidisciplinary program has two aspects. One part of the study will examine the effects of deep brain stimulation on vergence abnormalities affecting their ability to focus at various depths. Using state-of-the-art, high-resolution, research-grade ophthalmic equipment, we will examine how deep brain stimulation can improve the patients' ability to refocus and treat vergence abnormalities affecting depth perception. Once we identify these favorable changes, we will correlate them with the stimulated anatomical location within the same patient's brain. To do so, we will combine novel computer simulations of deep brain stimulation-induced electrical field overlaid upon the patient's magnetic resonance images. The knowledge gained will allow us to find the most beneficial stimulation locations to improve vision while offering improvement in tremors, rigidity, and slow movements.

帕金森氏症的患者有震颤、僵硬和迟缓的症状 动静。除了对身体运动的影响外，帕金森氏症还会影响许多其他大脑 功能。视觉障碍在帕金森氏症患者中很常见，他们的眼睛很难保持稳定 在给定的位置，无缝地环视和阅读，并将眼睛从一个图像重新聚焦到另一个放置的图像 在不同的深度。大约三分之二的帕金森氏症患者的双眼协调有问题。 在不同深度重新聚焦所需的动作，即异常的会聚导致双眼失明 以及不正常的深度知觉。帕金森氏症患者可用的大多数治疗方案仅限于 它们对震颤、僵硬和迟缓的影响--它们对视觉功能的影响还知之甚少。轨道 肌肉手术并不是理想的治疗方法，因为由于这种疾病，大脑的状态不断变化 退化的本性。目前可用的脑深部刺激策略对眼睛有不同的影响 运动收敛功能。我们的研究计划旨在找出最好的治疗方法 深部脑刺激改善帕金森病患者眼球运动的探讨 继续提供它的其他好处。我们的多学科项目有两个方面。研究的一部分将 观察脑深部刺激对聚焦异常的影响，从而影响他们的注意力集中能力。 深度。使用最先进的、高分辨率、研究级的眼科设备，我们将检查 脑刺激可提高患者重新聚焦和治疗影响深度的聚焦异常的能力 感知力。一旦我们确定了这些有利的变化，我们将把它们与受刺激的解剖学联系起来。 在同一个病人的大脑中的位置。要做到这一点，我们将结合对大脑深层的新的计算机模拟 刺激诱导的电场叠加在患者的磁共振图像上。《知识》 Gain将允许我们找到最有益的刺激位置来改善视力，同时提供改善 在颤动、僵硬和缓慢的运动中。