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.

项目总结/摘要 脑性瘫痪（CP）是由围产期脑损伤引起的，是最普遍和最昂贵的儿科疾病之一。 神经系统疾病在美国患有CP的人经常经历终身的移动性挑战。 用于克服这些挑战的现代治疗方法更加强调 CP青少年如何计划腿部运动、执行运动动作和整合感觉的神经学基础 信息.尽管有这种神经科学的方法，这些新的疗法仍然受到大量的限制。 关于异常感觉运动皮层活动和/或脊髓如何具体影响 年轻人患脑瘫的步态 我们的超现代脑磁图（MEG）脑成像结果显示， 在CP青年患者不典型的腿部运动和感觉过程中发挥重要作用。 此外，我们的高分辨率MRI管道已经表明，脊髓组织的结构完整性是 在患有CP的个体中受损。从这些实验中，我们可以推断， 脊髓完整性可能会影响CP青少年进行前馈预测和/或在线预测的能力。 在步态期间对他们的腿部运动学进行校正。然而，这一猜测尚未完全成立， MEG/MRI记录环境的物理限制。为了继续前进，我们将使用我们广泛的MEG 开发新的脑电图（EEG）方法的基础工作，具有科学的严谨性， 灵活性，以精确量化实时步态期间的感觉运动皮层活动。此外，我们将利用 尖端的神经生理学测试，同时量化脊髓神经元间的动力学是如何 在步态中调制。本研究的目的是：（1）建立多模式MEG-EEG神经成像代理， 在患有CP的年轻人中观察到的异常感觉运动皮层振荡已知会影响 运动缺陷，（2）量化感觉运动EEG皮层振荡和脊髓神经元间动力学 青年CP在步态，和（3）破译，如果改变感觉运动皮层振荡和脊髓 脊髓神经元间动力学是更好的预测活动性缺陷，在青年CP相对于 最常用的临床指标。为了实现这些目标，青年与CP和神经典型控制将 进行一系列的实验，这些实验将同时使用MEG-EEG神经成像， 步态，以及步态期间脊髓神经元间动力学的评估。此外，与会者将 接受一系列临床评估（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将为设计和 测试创新的治疗方案，这些方案针对的是限制神经功能的特定神经生理缺陷， 患有CP的青年的流动性。