Optimization of closed-loop taVNS for motor rehabilitation

运动康复闭环 taVNS 的优化

• 批准号: 10621747
• 负责人: Bashar W Badran
• 金额: $ 19.68万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-02 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10621747
• 关键词: Acceleration; Animal Model; Behavior Therapy; Brain; Centers of Research Excellence; Cervical; Ear; Electrodes; Enhancers; Human; Implant; Intervention; Left; Motor; Motor Cortex; Neuronal Plasticity; Pathologic; Persons; Rehabilitation therapy; Robotics; Stroke; Techniques; Tissues; Training; Translations; United States; Upper Extremity; Vagus nerve structure; brain tissue; functional disability; motor impairment; motor recovery; motor rehabilitation; neural; neuropsychiatry; post stroke; restoration; stroke recovery; stroke rehabilitation; vagus nerve stimulation; virtual reality

Nearly 800,000 people in the United States have a stroke annually, with motor impairments being the most common long-term functional disability. 85% of stroke cases result in reductions in upper limb function, and this has a severe negative impact on daily living. Motor recovery is achieved most commonly through professionally assisted motor rehabilitation training, and experimentally through various robotic, virtual reality, and brain stimulation techniques. Many of these rehabilitation techniques attempt to restore pathologically insufficient neural activity post-stroke to regain function, as the stroke induces damage to brain tissue and subsequent reorganization of cortical motor representations in surrounding undamaged tissue. Vagus nerve stimulation (VNS) can enhance motor rehabilitation by increasing neuroplasticity and accelerating the restoration of neural activity and function when paired in a temporally synchronized manner. VNS involves wrapping a cuff electrode around the left cervical bundle of the vagus nerve and has seen a reemergence in the past decade following several promising animal model findings demonstrating the ability to induce neuroplasticity in a target-dependent manner. In animal models, the temporal pairing of VNS bursts paired with motor rehabilitation can restore pathologically insufficient neural activity post-stroke. This intricate pairing of VNS and restorative behavioral intervention is known as “targeted plasticity” and is a promising approach to treatment of neuropsychiatric interventions, with potentially transformative potential in post stroke rehabilitation. Recently, a noninvasive alternative known as transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a promising alternative to conventionally implanted VNS. taVNS, however, targets the auricular branch of the vagus nerve, which innervates the human ear and activates the afferent and efferent vagal networks, allowing for a noninvasive, simple, and rapid translation of cervically implanted VNS findings. This proposal aims to develop noninvasive, closed- loop taVNS as an enhancer of neuroplasticity and accelerate upper limb motor restoration in post-stroke rehabilitation.

美国近80万人每年都有中风，运动影响是最常见的长期功能残疾。 85％的中风病例导致上肢功能降低，这对日常生活有严重的负面影响。运动恢复最常是通过专业辅助的运动康复训练来实现的，并通过各种机器人，虚拟现实和大脑刺激技术实验。这些康复技术中的许多试图试图恢复中风后神经元活性恢复到重复功能，因为中风会引起对脑组织的损害，并随后在未标记的组织中对皮质运动表达进行重组。迷走神经刺激（VNS）可以通过增加神经可塑性和加速度来增强运动康复，以暂时同步的方式配对时神经元活性和功能的恢复。 VNS涉及将袖带电极包裹在迷走神经的左颈束上，并且在过去的十年中看到了几个有望的动物模型发现，证明了以目标依赖性方式诱导神经塑性的能力。在动物模型中，与运动康复配对的VNS爆发的暂时配对可以在冲程后恢复病理上的神经活性活动不足。这种复杂的VN和恢复行为干预措施被称为“靶向可塑性”，是治疗神经精神干预措施的有前途的方法，在中风后康复中具有潜在的变革潜力。最近，一种被称为经肌迷走神经刺激（TAVN）的无创替代性已成为传统植入VNS的承诺替代品。然而，TAVN靶向迷走神经的耳部分支，该神经支配了人的耳朵并激活传入有效的迷走神经网络，从而可以对颈植入VNS发现的非侵入性，简单，快速地翻译。该建议旨在开发无创，闭环TAVN作为神经可塑性的增强子，并加速上肢运动后的上肢运动恢复 康复。