Non-invasive Cerebellar Stimulation to Improve Locomotion

无创小脑刺激改善运动

• 批准号: 7572332
• 负责人: Pablo Ariel Celnik
• 金额: $ 25.98万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-01-15 至 2010-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7572332
• 关键词: Address; Behavior; Behavior assessment; Behavioral; Brain; Brain Part; Cerebellum; Cerebrum; Coupling; Double-Blind Method; Ensure; Environment; Gait; Gait abnormality; Goals; Hand; Impairment; Individual; Intervention; Investigation; Knowledge; Laboratories; Learning; Leg; Lesion; Life; Locomotion; Locomotor adaptation; Methods; Motion; Motor; Movement; Neuraxis; Neurologic; Painless; Pathway interactions; Patients; Pattern; Performance; Physiological; Physiology; Process; Public Health; Recovery; Rehabilitation therapy; Research; Simulate; Specificity; Speed; Stroke; Structure; Survivors; Technology; Testing; Therapeutic Intervention; Training; Transcranial magnetic stimulation; Walking; Work; design; flexibility; improved; interest; locomotor tasks; motor learning; novel; novel therapeutic intervention; public health relevance; relating to nervous system; research study; sound; theories; visual memory

DESCRIPTION (provided by applicant): Stroke patients with locomotor impairment and gait abnormalities require interventions to enhance the beneficial effects of physical training. The cerebellum is important for making walking smooth, accurate, and adaptable. We have shown that individuals with cerebral damage retain their ability to use some cerebellum dependent learning mechanisms to temporarily improve walking, suggesting that these mechanisms could be useful in rehabilitating gait impairment. Specifically, training stroke patients with gait asymmetries on a split belt treadmill resulted in after-effects that induce a more symmetric locomotor pattern. This effect is promising, since it shows that these individuals still have the neural flexibility to change their gait pattern. However, this beneficial effect is short-lived with return to baseline abnormalities. Transcranial direct current stimulation (tDCS), a form of non-invasive non-painful stimulation, can modulate corticomotor excitability and enhance motor performance and learning of hand motor tasks when applied over the sensorimotor cortex. However, whether tDCS can enhance locomotor function when applied over the cerebellum in healthy and stroke patients is unknown. Here, we proposed to test the hypothesis that cerebellar tDCS will enhance locomotor adaptation in healthy and stroke patients with cerebral damage. In a parallel double blind design, aim 1 will determine in healthy individuals the effects of cerebellar tDCS (anodal, cathodal or sham) on (a) locomotor adaptation using motion analysis, and (b) corticospinal excitability changes using transcranial magnetic stimulation (TMS). Aim 2, will use a similar design, to study behavioral changes resulting from cerebellar tDCS in stroke patients with gait abnormalities due to cerebral damage. This investigation will use two powerful and complimentary technologies to clarify the potential use and underlying mechanisms of a new scientifically sound strategy to enhance locomotor function after stroke. There is no universally accepted treatment to enhance training effects after stroke. In this setting, cerebellar tDCS could evolve into an economical and easily implemented strategy to help address a significan public health burden, gait impairment after stroke. PUBLIC HEALTH RELEVANCE: This proposal will investigate the behavioral and physiological effects of applying transcranial direct current stimulation (tDCS), a form of non-invasive non-painful stimulation, to the cerebellum. The goal is to enhance cerebellar function, which would result in an improvement in locomotor learning. We will test this intervention in healthy individuals and stroke patients with gait impairment. If successful, tDCS could become an easy and inexpensive therapeutic intervention to enhance locomotor training in stroke patients and other neurological conditions.

描述（由申请人提供）：伴有运动障碍和步态异常的脑卒中患者需要干预以增强体能训练的有益效果。小脑对于使行走平稳、准确和适应性强很重要。我们已经证明，脑损伤的个体保留了使用小脑依赖学习机制暂时改善行走的能力，这表明这些机制可能对康复步态障碍有用。具体来说，在分离式带跑步机上训练步态不对称的中风患者会导致更对称的运动模式。这种效果是有希望的，因为它表明这些人仍然有神经灵活性来改变他们的步态模式。然而，随着基线异常的恢复，这种有益效果是短暂的。经颅直流电刺激（tDCS）是一种非侵入性、无痛性的刺激，可以调节皮质运动兴奋性，增强手部运动任务的运动表现和学习能力。然而，tDCS是否能增强健康人和脑卒中患者小脑的运动功能尚不清楚。在此，我们提出验证小脑tDCS会增强健康和脑损伤脑卒中患者的运动适应的假设。在平行双盲设计中，目的1将在健康个体中确定小脑tDCS（阳极、阴极或假性）对(a)运动分析的运动适应和(b)经颅磁刺激（TMS）皮质脊髓兴奋性变化的影响。Aim 2将使用类似的设计，研究脑损伤导致步态异常的脑卒中患者小脑tDCS引起的行为改变。这项研究将使用两种强大的互补技术来阐明一种新的科学合理策略的潜在用途和潜在机制，以增强中风后的运动功能。目前还没有普遍接受的治疗方法来增强中风后的训练效果。在这种情况下，小脑tDCS可以发展成为一种经济且易于实施的策略，以帮助解决卒中后重大的公共卫生负担-步态障碍。公共卫生相关性：本提案将研究应用经颅直流电刺激（tDCS）对小脑的行为和生理影响，tDCS是一种非侵入性非疼痛性刺激。目的是增强小脑功能，从而改善运动学习。我们将在健康个体和有步态障碍的中风患者中测试这种干预措施。如果成功，tDCS将成为一种简单而廉价的治疗干预手段，用于加强中风患者和其他神经系统疾病患者的运动训练。