Investigating subthreshold vestibular stimulation as a strategy for rehabilitation in individuals with bilateral vestibular hypofunction
研究阈下前庭刺激作为双侧前庭功能减退患者的康复策略
基本信息
- 批准号:10571440
- 负责人:
- 金额:$ 10万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-01-01 至 2023-12-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAdultAgeAnimal ModelAutomobile DrivingBalance trainingBehaviorBilateralClinical TrialsCuesDataDevelopment PlansDiagnosisDiseaseDizzinessDoctor of PhilosophyEarEquilibriumEsthesiaExposure toFaceFunctional disorderFutureGoalsHead MovementsHealthHealth ExpendituresHourIndividualInstitutionInterventionKnowledgeLeadLearningLesionMeasuresMentorsMentorshipMethodsMonitorMotionMovementNatureNervous SystemNeuronal PlasticityNeuronsOhioOutcomePathologyPatient Self-ReportPatientsPerformancePersonal SatisfactionPhaseProtocols documentationQuality of lifeRehabilitation therapyResearchResearch Project GrantsRotationSamplingScientistSecondary toSensorySeriesStimulusSymptomsSystemTechniquesTrainingTranslationsUniversitiesVestibular Function TestsVestibular lossVisionWorkcareercareer developmentclinical developmentdesensitizationdesignenvironmental changefall riskfallsgazehealth related quality of lifeimprovedimproved outcomeinnovationneuralneurophysiologynovelnovel strategiesrecruitrehabilitation sciencerehabilitation strategyresponsesensory stimulusskillsvestibulo-ocular reflex
项目摘要
1 Project Summary/Abstract
2 In individuals with bilateral vestibular hypofunction (BVH), vestibular responses to self-motion cues are reduced
3 bilaterally, often without a defined cause. The persistent state of desensitization yields symptoms of bouncing or
4 unstable vision, dizziness, imbalance, and falls; collectively, these symptoms lead to a substantial reduction in
5 quality of life. However, despite the sizeable impact of BVH on quality of life, health care expenditures, and falls,
6 interventions tailored to the specific needs of patients with BVH, as opposed to patients with unilateral lesions,
7 have yet to be developed. The objective of this proposal is to investigate a novel strategy for improving vestibular
8 function in individuals with BVH. The nervous system possesses a robust capacity to regulate neural activity in
9 the face of changing environmental or internal conditions. When exposed to a weak sensory stimulus (e.g., slow
10 movements of the head), a specific type of neural plasticity, “homeostatic plasticity”, has been shown to increase
11 the responsiveness of the involved neurons to subsequent motion stimuli. In this project, we aim to determine if
12 such mechanisms, prompted by periods of subthreshold (i.e., low amplitude) motion, may serve as a potential
13 strategy for driving plasticity in the lesioned vestibular system. Specifically, in individuals diagnosed with BVH
14 we will (1) measure changes in sensitivity to self-motion cues immediately following a subthreshold motion
15 stimulus (Aim 1), (2) characterize changes in vestibular function after repeated exposure to a subthreshold
16 motion stimulus (Aim 2), and (3) determine if the addition of a subthreshold motion “primer” can improve the
17 outcomes of vestibulo-ocular reflex (VOR) adaptation (Aim 3A) and balance training (Aim 3B). We hypothesize
18 that the use of a subthreshold stimulus, secondary to its capacity to drive plastic changes in the vestibular
19 system, will lead to an increased sensitivity to self-motion cues, as well as positive changes in vestibular function
20 (e.g., gaze stability, balance), in patients with BVH. In accordance with the topic of the proposed research project,
21 my long-term career goal is to establish a research lab that focuses on developing innovative treatments for
22 vestibular dysfunction. To achieve this goal, the proposed career development plan focuses on acquiring the
23 skills and knowledge required to design, implement, monitor, and analyze the results of clinical trials in the
24 rehabilitation sciences; more specifically, this includes (1) gaining a better understanding of the
25 neurophysiological principles underlying vestibular plasticity/learning, (2) learning state-of-the-art techniques for
26 analyzing the behavior of the VOR, and (3) learning current methods for adapting the gain of the VOR. The
27 mentored phase of the training plan will take place at Ohio State University in the lab of Dr. Daniel Merfeld, PhD.
28 Consistent with the translational nature of the project, the mentorship team will consist of clinician-scientists and
29 basic vestibular scientists, both at Ohio State (Daniel Merfeld, PhD & Kevin Kerber, MD) and at external
30 institutions (Michael Schubert, PT, PhD, and Soroush Sadeghi Ghandehari, MD, PhD).
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1项目摘要/摘要
2在双侧前庭功能减退(BVH)的个体中,前庭对自我运动提示的反应减弱
3双边的,通常没有明确的原因。持续的脱敏状态会导致弹跳或
4视力不稳定、头晕、不平衡和摔倒;这些症状加在一起,导致
5生活质量。然而,尽管BVH对生活质量、医疗保健支出和跌倒有相当大的影响,
6针对BVH患者的特定需要而不是单侧病变的患者的干预措施,
7个尚未开发。这项建议的目的是研究一种改善前庭功能的新策略
8 BVH患者的功能。神经系统具有强大的调节神经活动的能力
9面对不断变化的环境或内部条件。当暴露于弱感觉刺激(例如,慢
头部的10个动作),一种特定类型的神经可塑性,“内稳态可塑性”,已被证明增加
11受累神经元对随后的运动刺激的反应性。在这个项目中,我们的目标是确定
12这种由亚阈值(即,低幅度)运动周期推动的机制可以作为潜在的
13前庭系统损伤的可塑性驱动策略。具体地说,在被诊断为BVH的个人中
我们将(1)测量在亚阈值运动后立即对自我运动线索的敏感度的变化
15刺激(目标1),(2)表征重复暴露于亚阈值后前庭功能的变化
16个运动刺激(目标2),以及(3)确定添加一个亚阈值运动“启动剂”是否可以改善
17例前庭-眼反射(VOR)适应(目标3A)和平衡训练(目标3B)的结果。我们假设
18使用亚阈值刺激,次要于其驱动前庭可塑性变化的能力
19系统,将导致对自我运动提示的敏感性增加,以及前庭功能的积极变化
20(例如凝视稳定性、平衡性),在BVH患者中。根据拟议研究项目的主题,
我的长期职业目标是建立一个研究实验室,专注于开发创新的治疗方法
前庭功能障碍22例。为了实现这一目标,拟议的职业发展计划侧重于获得
23设计、实施、监控和分析临床试验结果所需的技能和知识
24康复科学;更具体地说,这包括(1)更好地了解
25前庭可塑性/学习的神经生理学原理,(2)学习最先进的技术
26分析VOR的行为,以及(3)学习当前适应VOR增益的方法。这个
27培训计划的指导阶段将在俄亥俄州立大学的丹尼尔·默菲尔德博士的实验室进行。
28与项目的翻译性质一致,导师小组将由临床医生-科学家和
29名前庭基础科学家,包括俄亥俄州立大学(Daniel Merfeld,博士和Kevin Kerber,医学博士)和外部
30个机构(Michael Schubert,PT,PhD和Soroush Sadeghi Gamdehari,MD,PhD)。
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项目成果
期刊论文数量(0)
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