Dynamic Imaging of Cerebral Palsy Gait

脑瘫步态的动态成像

• 批准号: 10586427
• 负责人: Max J Kurz
• 金额: $ 61.64万
• 依托单位: FATHER FLANAGAN'S BOYS' HOME
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-20 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10586427
• 关键词: Address; Adolescence; Adult; Affect; Biological Markers; Brain imaging; Cerebral Palsy; Childhood; Clinical; Clinical assessments; Complement; Cortical Cord; Corticospinal Tracts; Coupled; Development; Direct Costs; Economic Burden; Elements; Environment; Equation; Equilibrium; Esthesia; Exhibits; Foundations; Functional disorder; Gait; Image; Individual; Interneurons; Knowledge; Leg; Magnetic Resonance Imaging; Magnetoencephalography; Methods; Modeling; Modernization; Motor; Movement; Muscle; Musculoskeletal System; Nervous system structure; Neurologic; Neurosciences; Participant; Perinatal Brain Injury; Peripheral; Persons; Play; Population; Protocols documentation; Proxy; Resolution; Role; Seminal; Sensory; Sensory Process; Series; Societies; Somatosensory Cortex; Specificity; Spinal Cord; Techniques; Testing; Therapeutic; Therapeutic Intervention; Time; Tissues; United States; Work; Youth; cost; design; experience; experimental study; flexibility; foot; gray matter; improved; indexing; innovation; kinematics; multimodal neuroimaging; multimodality; neuroimaging; neurophysiology; novel; novel therapeutics; relating to nervous system; somatosensory; spasticity; therapeutic target; white matter

PROJECT SUMMARY/ABSTRACT Cerebral palsy (CP) results from a perinatal brain injury and is one of the most prevalent and costly pediatric neurologic conditions in the United States. Individuals with CP frequently experience lifelong mobility challenges. The modern treatment approaches being used to overcome these challenges place greater emphasis on the neurological basis for how youth with CP plan their leg movements, execute motor actions, and integrate sensory information. Despite this neuroscience-informed approach, these new therapies are still limited by substantial knowledge gaps regarding how the aberrant sensorimotor cortical activity and/or spinal cord specifically affects the gait of youth with CP. Our ultramodern magnetoencephalographic (MEG) brain imaging results have revealed that cortical aberrations play a substantial role in the uncharacteristic leg motor actions and sensory processes seen in youth with CP. Furthermore, our high-resolution MRI pipelines have shown that the structural integrity of spinal cord tissue is compromised in individuals with CP. From these experiments, we have inferred that the altered cortical dynamics and spinal cord integrity likely impacts the ability of youth with CP to make feed-forward predictions and/or online corrections to their leg kinematics during gait. However, this conjecture has yet to be fully established due to physical limitations of the MEG/MRI recording environments. To move forward, we will use our extensive MEG foundational work to develop new electroencephalographic (EEG) methods that have the scientific rigor and flexibility to precisely quantify the sensorimotor cortical activity during real-time gait. Furthermore, we will utilize cutting-edge neurophysiological tests to concurrently quantify how the spinal cord interneuronal dynamics are modulated during gait. The Aims of this study will: (1) establish multimodal MEG-EEG neuroimaging proxies of the aberrant sensorimotor cortical oscillations seen in youth with CP that are known to impact the extent of the mobility deficits, (2) quantify the sensorimotor EEG cortical oscillations and spinal cord interneuronal dynamics of youth with CP during gait, and (3) decipher if alterations in the sensorimotor cortical oscillations and spinal cord interneuronal dynamics are better predictors of the mobility deficits seen in youth with CP relative to the most commonly used clinical metrics. To achieve these Aims, youth with CP and neurotypical controls will undergo a series of experiments that will use simultaneous MEG-EEG neuroimaging, EEG neuroimaging during gait, and assessments of the spinal cord interneuronal dynamics during gait. Furthermore, the participants will undergo a battery of clinical assessments (e.g., balance, spasticity, selective control, strength and sensation). We foresee that the body of new knowledge gained through this project will set-the-stage for the design and testing of innovative therapeutic protocols that target the specific neurophysiological deficits that are limiting the mobility of youth with CP.

项目摘要/摘要 脑瘫（CP）是由围产期脑损伤引起的，是最普遍，最昂贵的小儿之一 美国的神经系统状况。患有CP的人经常遇到终身行动能力挑战。 用于克服这些挑战的现代治疗方法更加重视 与CP青年如何计划腿部运动，执行运动动作并整合感官的神经依据 信息。尽管采用这种神经科学知识的方法，但这些新疗法仍然受到大量限制 知识差距关于异常感觉运动性皮质活性和/或脊髓如何特异性影响 CP青年步态。 我们的超现代磁脑电图（MEG）脑成像结果表明皮质畸变 在CP年轻人中看到的非特色腿运动动作和感官过程中发挥了重要作用。 此外，我们的高分辨率MRI管道表明，脊髓组织的结构完整性为 在患有CP的个体中受到妥协。从这些实验中，我们可以推断出改变的皮质动力学 脊髓完整性可能会影响CP青年做出前馈预测和/或在线的能力 步态过程中其腿部运动学的校正。但是，由于 MEG/MRI记录环境的物理限制。为了前进，我们将使用广泛的MEG 开发具有科学严谨和的新脑电图（EEG）方法的基础工作 在实时步态过程中精确量化感觉运动皮质活性的灵活性。此外，我们将使用 尖端的神经生理测试同时量化脊髓间神经元动力学的方式 在步态期间调节。这项研究的目的是：（1）建立多模式MEG-EEG神经影像学代理 在CP青年中看到的异常感觉运动振荡，已知会影响 迁移率缺陷，（2）量化感觉运动EEG皮质振荡和脊髓间神经元动力学 步态期间患有CP的青年，以及（3）解密，如果感觉运动振荡和脊柱的改变 绳索中神经元动力学是更好地预测CP年轻人的活动性缺陷 最常用的临床指标。为了实现这些目标，具有CP和神经型控制的青年将 进行一系列实验，这些实验将同时使用MEG-EEG神经影像学，在 步态和步态过程中脊髓间神经元动力学的评估。此外，参与者将 进行一系列临床评估（例如，平衡，痉挛，选择性控制，力量和感觉）。 我们预见，通过该项目获得的新知识的身体将为设计和 测试针对特定神经生理缺陷的创新治疗方案，这些方案限制了 CP青年的流动性。