Physiological Analysis Of Involuntary Movements

这个项目的目标是了解不同的不自主运动障碍的潜在生理机制。我们使用的工具包括临床神经生理学方法，如脑电图，肌电图，经颅磁刺激和神经成像与正电子发射断层扫描和功能磁共振成像。该科目前正在进行的项目包括震颤和抽搐的研究。我们正在使用生理学的方法来确定心因性震颤的诊断标准。一个看起来很有希望的测试是测量一个肢体震颤的频谱，同时要求患者在另一个肢体以指定的频率进行运动。我们也在收集与心因性运动相关的肌肉募集、感觉调节和皮质活动（使用EEG）模式的信息。分析表明，准备皮层活动（运动前电位测量）是类似于之前的自愿运动。刺激反应的模式被发现是高度可变的和不一致的患者有刺激敏感性肌阵挛。在观察到Lafora体病患者通过生酮饮食得到显著改善后，我们目前正在对更多患者进行对照研究。我们已经完成了一项对原发性震颤患者的磁共振波谱研究，该研究显示小脑中N-乙酰天冬氨酸的损失，增加了小脑是该疾病中受损结构的证据。

The goal of this project is to understand the underlying physiological mechanisms of different involuntary movement disorders. The tools we use include clinical neurophysiological methods such as electroencephalography, electromyography, and transcranial magnetic stimulation and neuroimaging with positron emission tomography and functional magnetic resonance imaging. Currently active projects in the Section include studies of tremor and tic. We are using physiological methods to see if criteria can be defined to make the diagnosis of psychogenic tremor. One test that looks promising is measuring the frequency spectrum of the tremor in one extremity while asking the patient to make movements with specified frequencies in the opposite extremity. We are also collecting information regarding patterns of muscle recruitment, sensory modulation and cortical activity (using EEG) associated with psychogenic movements. Analysis reveals that the preparatory cortical activity (measured by pre-movement potentials) is similar to that preceding voluntary movements. The pattern of stimulus-response was found to be highly variable and inconsistent in patients who had stimulus sensitive myoclonus. Following the observation that a patient with Lafora Body Disease was markedly improved with a ketogenic diet, we are currently engaged in a controlled study of more patients. We have completed a study of magnetic resonance spectroscopy in patients with essential tremor that shows a loss of N-acetyl-aspartate in the cerebellum, increasing evidence that the cerebellum is the damaged structure in the disorder.