The Proactive and Reactive Neuromechanics of Instability in Aging and Dementia with Lewy Bodies

衰老和路易体痴呆中不稳定的主动和反应神经力学

• 批准号: 10749539
• 负责人: Emily Kathryn Eichenlaub
• 金额: $ 3.95万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2024
• 资助国家: 美国
• 起止时间: 2024-01-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10749539
• 关键词: Acceleration; Address; Affect; Age; Aging; Agreement; Alzheimer' s Disease; Area; Basic Science; Characteristics; Clinic; Clinical; Communities; Complex; Cross-Sectional Studies; Dementia; Dementia with Lewy Bodies; Development; Diagnostic; Elderly; Electromyography; Enrollment; Equilibrium; Equipment; Equity; Exhibits; Fellowship; Financial cost; Goals; Heart; Impaired cognition; Impairment; Incidence; Injury; Laboratories; Length; Link; Measurement; Measures; Monitor; Motion; Motor; Muscle; Neuromechanics; Outcome; Persons; Population; Prevalence; Probability; Public Health; Quality of life; Reaction Time; Rehabilitation therapy; Research; Research Ethics; Research Personnel; Self-Help Devices; Technical Expertise; Translations; Ultrasonography; Universities; Walking; Work; age effect; age-related muscle loss; aging population; career; clinical translation; cohort; design; efficacy evaluation; equilibration disorder; evidence base; executive function; fall risk; falls; high risk; improved; in vivo; innovation; insight; muscle strength; negative affect; novel; personalized intervention; pre-doctoral; predictive modeling; recruit; response; sex; technological innovation; ultrasound; walking stability; wearable sensor technology; young adult

PROJECT SUMMARY Our rapidly aging population remains at an exceptionally high risk of debilitating falls. This is especially concerning given the compounding effects of dementia. In particular, Dementia with Lewy Bodies (DLB) is uniquely associated with an increased prevalence of falls. Developing an improved mechanistic framework to understand balance impairment due to age aging and DLB to mitigate falls risk is at the heart of this proposal. The neuromechanics of standing and walking balance control, and thus the origins of balance impairment due to aging and DLB, are incredibly complex. Proactive responses precede the onset of a balance challenge via feedforward control to prepare the body to accommodate instability. Conversely, reactive responses follow the onset of a balance challenge and are compensatory, requiring rapid corrections to mitigate instability. The overarching scientific premise of this fellowship proposal is that aging negatively affects reactive balance responses, while the compounding effects of age and cognitive decline negatively affect proactive balance responses in people with DLB, thus increasing vulnerability to real-world balance challenges that can precipitate falls. This cross- sectional fellowship study will enroll 25 young adults, 25 older adults with clinically probable DLB, and 25 age- and sex- matched older adults. I will strategically combine quantitative motion capture, electromyography, dynamic in vivo ultrasound imaging, and wearable sensors with an innovative suite of standing and walking perturbation paradigms designed to emulate real-world balance challenges. Aim 1 will determine the effects of age and LBD on whole-body vulnerability to anticipated and unanticipated balance challenges during standing and walking. Aim 2 will characterize the local muscle neuromechanical determinants of reactive and proactive balance responses across these cohorts. Finally, with community- based translation as the ultimate goal of my scientific and professional development, Aim 3 will quantify the viability of wearable sensors to monitor and detect between-group differences in vulnerability to perturbations. This study will be the first to objectively quantify between-group differences in multi-scale characteristics of proactive and reactive balance responses using laboratory-based and wearable-sensor based outcomes designed to move my discoveries from the laboratory to the clinic and the community. This area of mechanistic and hypothesis-driven research has been severely understudied, but has significant and immediate potential to inform novel advances in diagnostics, rehabilitation, mobile monitoring, and wearable assistive technologies to mitigate falls.

项目摘要 我们迅速衰老的人口仍然处于使人衰弱的高风险。这尤其令人担忧 痴呆症的复合作用。特别是，有路易体的痴呆症（DLB）与 跌倒的患病率增加。开发改进的机械框架，以了解由于 年龄衰老和DLB减轻跌倒风险是该提议的核心。站立和步行平衡的神经力学 控制，因此由于老化和DLB引起的平衡损伤的起源非常复杂。主动反应 在通过前进发粉控制挑战的开始之前，要准备身体以适应不稳定性。 相反，反应性响应遵循平衡挑战的发作，是补偿性的，需要快速校正 减轻不稳定。该奖学金提案的总体科学前提是老化会对反应性产生负面影响 平衡反应，而年龄和认知下降的复合影响会对主动的平衡反应产生负面影响 在患有DLB的人中，增加了对现实世界的平衡挑战的脆弱性。这个交叉 分区奖学金研究将招募25名年轻人，25名临床可能DLB的老年人以及25岁的年龄和性别 - 匹配的老年人。我将战略性地结合定量运动捕获，肌电图，动态体内动态 超声成像和可穿戴传感器，具有创新的站立和行走扰动范式设计的套件 模仿现实世界的平衡挑战。 AIM 1将确定年龄和LBD对全身脆弱性的影响 站立和步行期间的预期和意外平衡挑战。 AIM 2将描述当地肌肉 这些队列中反应性和主动平衡反应的神经力学决定因素。最后，有了社区 - 基于我的科学和专业发展的最终目标，AIM 3将量化 可穿戴的传感器以监视和检测扰动脆弱性的组间差异。这项研究将是 首先要客观地量化主动和反应平衡多尺度特征的组间差异 使用基于实验室和可穿戴传感器的结果的响应，旨在从实验室转移我的发现 去诊所和社区。机械和假设驱动的研究领域已被严重研究， 但具有巨大而直接的潜力，可以为诊断，康复，移动监控和 可穿戴辅助技术减轻跌倒。