PREVENTION OF NEUROMOTOR DEFICITS WITH CHELATION THERAPY

描述（改编自申请人的摘要）：以前的研究 表明琥珀酰亚胺是铅软组织螯合剂;因此， 神经行为健康的好处是可以预期的。 但大部分 已发表的研究将注意力集中在琥珀酰亚胺的能力上， 降低血铅水平而不评估其对神经行为的影响 健康 拟议的横断面研究旨在评估罚款 运动和粗大运动能力以及姿势平衡和步态， 200名儿童[来自辛辛那提铅治疗临床中心， 儿童（TLC）]目前正在随机双盲研究中 临床试验旨在评估铅螯合作用的影响， 药物琥珀酰亚胺。 在拟议的研究中，我们将评估姿势平衡 和步态以及精细和粗大运动发育后，TLC儿童有 完成他们的琥珀酰亚胺或安慰剂计划和TLC随访期。 将进行姿势平衡和步态以及精细和粗大运动评估。 我们已经使用了13年以上的既定技术， 年的辛辛那提铅计划项目（LPP）队列。 姿势 将使用基于微处理器的测力平台评估平衡和步态 系统沿着测试协议，该协议间接评估 与姿势平衡相关的各种生理系统。 精细运动 和大运动评估将使用综合 Bruininks-Oserestsky运动能力测试（BOTMP）测试组合。 的 琥珀酰的TLC临床试验主要集中在全球措施， 认知发展 运动发育的总体评估和 不强调精细运动球、姿势平衡和运动。 因此，本研究将为我们理解 螯合疗法和其他措施对发育的好处， 铅在所考虑的暴露范围内。 我们的出版 辛辛那提LPP队列中拟定运动发育的结果 测量仪器（BOTMP），姿势平衡测试和运动测试 表明这些测量技术是灵敏， 认知测量相对不受社会经济辅助因素的影响。 因此，该项目对于进一步了解 琥珀对姿势平衡发育方面的临床益处， 运动结果和精细和粗运动功能的发展， 社会经济弱势群体的中枢神经系统。

DESCRIPTION (adapted from the applicant's abstract): Previous studies have shown that succimer is a soft tissue chelator of lead; therefore, potential neurobehavioral health benefits may be expected. However, most of the published studies focused their attention toward succimer's ability to reduce blood lead level without evaluating its impact on neurobehavioral health. The proposed cross-sectional study is designed to evaluate the fine motor and gross motor proficiency as well as postural balance and gait in 200 children [from the Cincinnati Clinical Center for Treatment of Lead in Children (TLC)] who are currently active in a randomized double blind clinical trial designed to assess the effects of lead chelation using the drug succimer. In the proposed study, we will be assessing postural balance and gait and fine and gross motor development after the TLC children have completed their succimer or placebo program and the TLC follow-up period. The postural balance and gait and fine and gross motor assessments will be carried out with established techniques which have been used by us over 13 years on the Cincinnati Lead Program Project (LPP) cohort. The postural balance and gait will be assessed with a microprocessor-based force platform system along with a test protocol which indirectly assesses the roles of various physiological systems relevant for postural balance. The fine motor and gross motor assessments will be carried out using the comprehensive Bruininks-Oserestsky Test of Motor Proficiency (BOTMP) test battery. The TLC clinical trial of succimer is focused mainly on global measures of cognitive development. Assessments of motor development in the gross and fine motor spheres, postural balance and locomotion are not emphasized. Thus, this study will make a unique contribution to our understanding of the developmental benefits of chelation therapy and other measures to reduce lead in the range of exposures that are being considered. Our published findings from Cincinnati LPP cohort with the proposed motor development measurement instrument (BOTMP), postural balance test and locomotion test indicate that these measurement techniques are sensitive and, compared to cognitive measures are relatively uninfluenced by socioeconomic cofactors. Thus, the project has significance for furthering out understanding of the clinical benefits of succimer on developmental aspects of postural balance, locomotional outcomes and fine and gross motor functions in the developing central nervous system in socioeconomically disadvantaged populations.