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Pathophysiology of Involuntary Movements and Volitional Disorders

不自主运动和意志障碍的病理生理学

基本信息

批准号：
7735255
负责人：
MARK A HALLETT
金额：
$ 107.34万
依托单位：
NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
依托单位国家：
美国
项目类别：
财政年份：
资助国家：
美国
起止时间：
至
项目状态：
未结题

项目摘要

The pathophysiology of psychogenic movement disorders (PMD) is very poorly understood. These disorders are common in the population, diagnosis is difficult and treatment typically ineffective. We are studying the mechanisms underlying these disorders using cognitive tasks, neurophysiological testing, psychiatric measures, and functional imaging. One functional imaging study is an fMRI comparison of patients with tremor, and preliminary results show abnormal activation in dorsolateral prefrontal cortex. We also want to look for abnormal activations related to tasks that probe functions such as emotional expression and movement inhibition. We will also investigate these patients for their sense of agency during fMRI studies, similar to the way we have studied normal subjects. Another major problem is the differentiation of conversion from malingering. There are no clinical methods available for this important distinction. We will be attempting to do this with fMRI. Using the Libet clock method of timing of subjective experience, it is possible to determine the time of the sense of willing a movement. It is possible that patients with distorted sense of volition will have abnormal timing of the sense of willing with respect to the timing of the movement itself. Initial studies in this regard are being undertaken in schizophrenia and for the tics in Tourette Syndrome. The origin of tics is generally unknown, and we have been approaching physiology in several ways. Tourette syndrome patients report "premonitory urge" and other sensory abnormalities associated with the presence of tics. We have been studying tic genesis with functional neuroimaging and EEG, and intend a series of studies looking at the physiology of the sensory urge. For many years, we have been collecting families with essential tremor looking for possible genetic abnormalities, and in several families found an area suggestive of genetic linkage on chromosome 6 and 11. This work is being done in conjunction with Dr. Lev Goldfarb.

人们对心因性运动障碍（PMD）的病理生理学知之甚少。这些疾病在人群中很常见，诊断困难且治疗通常无效。我们正在利用认知任务、神经生理学测试、精神病学测量和功能成像来研究这些疾病的机制。一项功能成像研究是对震颤患者进行功能磁共振成像比较，初步结果显示背外侧前额皮质异常激活。我们还想寻找与探测情绪表达和运动抑制等功能的任务相关的异常激活。我们还将在功能磁共振成像研究中调查这些患者的代理感，类似于我们研究正常受试者的方式。另一个主要问题是区分皈依与诈病。没有临床方法可用于这一重要区别。我们将尝试通过功能磁共振成像来做到这一点。利用主观经验计时的利贝特时钟方法，可以确定愿意运动的感觉的时间。意志力扭曲的患者可能会出现意志力相对于运动本身时间安排的异常。这方面的初步研究正在针对精神分裂症和抽动秽语综合征的抽动进行。抽动的起源通常是未知的，我们一直在通过多种方式研究生理学。抽动秽语综合症患者报告有“先兆冲动”和其他与抽动相关的感觉异常。我们一直在通过功能性神经影像学和脑电图研究抽动的起源，并打算进行一系列研究来观察感觉冲动的生理学。多年来，我们一直在收集患有特发性震颤的家庭，寻找可能的遗传异常，并在几个家庭中发现了暗示 6 号和 11 号染色体上存在遗传连锁的区域。这项工作是与 Lev Goldfarb 博士合作完成的。

项目成果

期刊论文数量（26）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

How does botulinum toxin work?

肉毒杆菌毒素如何发挥作用？

DOI：
发表时间：
2000
期刊：
Annals of neurology
影响因子：
11.2
作者：
Hallett,M
通讯作者：
Hallett,M

Neurophysiology of tics.

抽动症的神经生理学。

DOI：
发表时间：
2001
期刊：
Advances in neurology
影响因子：
0
作者：
Hallett,M
通讯作者：
Hallett,M

Psychogenic palatal tremor.

心因性腭震颤。

DOI：
10.1002/mds.20731
发表时间：
2006
期刊：
Movement disorders : official journal of the Movement Disorder Society
影响因子：
0
作者：
PirioRichardson,Sarah;Mari,Zoltan;Matsuhashi,Masao;Hallett,Mark
通讯作者：
Hallett,Mark

Modulation of symptomatic palatal tremor by magnetic stimulation of the motor cortex.

通过运动皮层的磁刺激调节症状性腭震。

DOI：
10.1016/s1388-2457(00)00301-1
发表时间：
2000
期刊：
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
影响因子：
0
作者：
Chen,JT;Yu,HY;Wu,ZA;Kao,KP;Hallett,M;Liao,KK
通讯作者：
Liao,KK

The Unified Myoclonus Rating Scale.