Functional connectivity associated with motor recovery after internal capsule lesions

与内囊损伤后运动恢复相关的功能连接

• 批准号: 10612393
• 负责人: Shashank Amit Anand
• 金额: $ 4.77万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10612393
• 关键词: Acute; Address; Adult; Affect; Animals; Area; Behavioral; Bilateral; Biology; Blood; Blood Vessels; Brain; Cause of Death; Chronic; Chronic Phase; Clinical; Collection; Corticospinal Tracts; Coupled; Defect; Devices; Diffusion; Electrodes; Endothelin-1; Face; Feedback; Fiber; Functional Magnetic Resonance Imaging; Generations; Goals; Health; Human; Image; Implant; Industry; Infarction; Injury; Internal Capsule; Intervention; Learning; Lesion; Limb structure; Macaca; Macaca mulatta; Measurement; Measures; Mediating; Medical; Modeling; Motor; Motor Cortex; Orthotic Devices; Outcome; Oxygen; Paresis; Patients; Performance; Phase; Physiology; Primates; Quality of life; Recommendation; Recovery; Recovery of Function; Rehabilitation device; Rehabilitation therapy; Residual state; Rest; Scanning; Signal Transduction; Stroke; Survivors; System; Technology; Testing; arm; blood oxygen level dependent; brain computer interface; brain remodeling; chronic stroke; clinical predictors; clinically relevant; clinically significant; disability; efficacy validation; functional outcomes; graph theory; gray matter; haptic feedback; improved; injured; insight; motor function improvement; motor function recovery; motor impairment; motor recovery; nonhuman primate; novel; post stroke; rehabilitation strategy; response; restoration; robotic device; stroke recovery; stroke rehabilitation; stroke survivor; stroke therapy; tool; white matter

Project Summary Stroke survivors face significant long-term health consequences, with rehabilitation being essential to improve their recovery and quality of life. Currently, patients who do not restore motor function after 3-6 months are unlikely to show further recovery. Lesions with white matter tract involvement typically correlate with worse outcomes. For example, corticospinal tract lesions (CST) lesions produce worse motor deficiencies and portend poor functional recovery. Brain-computer interface mediated stroke rehabilitation (BCI-SR) can be a powerful rehabilitation tool. In BCI-SR, a patient learns to modulate localized brain activity that is recorded by electrodes. This can be used to control an orthosis to move the paretic limb. Most BCI systems utilize signals from affected hemisphere, attempting to drive plasticity in injured cortex. However, residual brain function after stroke limits BCI-SR efficacy, making ipsilesional BCI difficult to use in patients with the worst injuries. In humans, contralesional BCI-SR devices have used the uninjured hemisphere to drive further rehabilitation after the traditional plateau in motor function recovery. Clinical predictions of functional outcome after stroke are imprecise. Resting state functional connectivity (rsFC) measures the correlation of blood oxygen level-depending (BOLD) fluctuations at rest across the brain, providing a powerful tool to study brain network remodeling after stroke. However, human studies investigating brain remodeling after a stroke typically include patients with diverse lesions and do not have access to baseline measurements that allow rsFC comparison pre- and post-stroke. Animal studies could address both issues by enabling the generation of replicable, homogenous, and specific infarcts and by allowing collection of baseline measurements prior to infarct generation. There is also an absence of adequate animal studies characterizing rsFC changes associated with BCI rehabilitation strategies. Our project goal is to further characterize rsFC changes associated with CST lesions and test a BCI-mediated rehabilitation strategy after motor recovery plateaus. We will generate uniform lesions in the CST of six Rhesus macaques and after three months of natural recovery, drive contralesional BCI-SR. In each primate, we will collect resting-state functional MRI at baseline before lesioning, after CST lesioning, and during contralesional BCI-SR. We will then identify acute and chronic changes in rsFC that correspond with CST lesioning, innate recovery, and brain-computer-interface mediated rehabilitation. Through these approaches, we seek to validate the efficacy of a novel stroke rehabilitation strategy while providing insight into recovery-associated changes in rsFC.

项目摘要 中风幸存者面临着重大的长期健康后果，康复是改善的关键 他们的康复和生活质量。目前，3-6个月后仍未恢复运动功能的患者为 不太可能出现进一步的复苏。白质束受累的病变通常与病情恶化相关 结果。例如，皮质脊髓束损伤(CST)损伤会导致更严重的运动缺陷和预兆 功能恢复不佳。脑机接口介导的卒中康复(BCI-SR)可以是一种强大的 康复工具。在BCI-SR中，患者学习调节电极记录的局部大脑活动。 这可以用来控制矫形器来移动瘫痪的肢体。大多数BCI系统使用受影响的信号 大脑半球，试图推动受损皮质的可塑性。然而，中风后残留的脑功能受到限制 BCI-SR的有效性，使自发性BCI难以在最严重的创伤患者中使用。在人类身上， 对比性的BCI-SR设备已经利用未受伤的大脑半球来驱动进一步的康复 传统的运动功能恢复平台期。 对中风后功能结果的临床预测是不准确的。静息状态功能连通性(RsFC) 测量整个大脑静息时血氧水平依赖(BOLD)波动的相关性，提供 研究中风后脑网络重塑的有力工具。然而，研究大脑的人体研究 中风后的重塑通常包括具有不同病变的患者，并且无法获得基线 允许卒中前后rsFC比较的测量。动物研究可以通过以下方式解决这两个问题 能够产生可复制的、同种的和特定的梗死，并允许收集基线 脑梗塞发生前的测量结果。也缺乏充分的动物研究来表征 与脑梗死康复策略相关的rsFC变化。 我们的项目目标是进一步表征与CST病变相关的rsFC变化，并测试BCI介导的 运动恢复高原后的康复策略。我们将在6只恒河猴的CST产生均匀的病变 猕猴和自然恢复三个月后，驱动对照的BCI-SR。在每一种灵长类中，我们都会 在病变前、病变后和对照期间收集静息状态的功能磁共振成像 BCI-SR。然后，我们将确定rsFC中与cst病变相对应的急性和慢性变化。 康复和脑-机接口介导的康复。通过这些方法，我们试图验证 一种新的卒中康复策略的有效性，同时提供对康复相关变化的洞察 Rsfc。