Joint Discoordination in Parkinson's Disease

描述(申请人提供)：证据表明，帕金森氏病(PD)患者在复杂的动作表现上尤其受损，这些动作需要几个关节的协调。研究这些损伤具有相当重要的实际意义，因为日常生活中进行的动作(伸手、抓握、指向、举起等)基本上是多关节的，缺乏协调是这种疾病最令人虚弱的方面之一。许多研究假设，多关节运动中的损伤是由于患者同时控制几个关节的困难造成的。我们实验室获得的数据表明，帕金森病多关节运动变形的原因是不同的。我们认为帕金森病患者在调节交互扭矩方面存在困难。这些力矩可以被认为是外周生物力学对肢体控制施加的约束的影响。健康的老年人在正常的运动速度下克服了这些限制。我们的数据表明，帕金森病患者在中速甚至低速运动时无法处理生物力学约束。本建议的目的是(1)证明不能适当地调节交互扭矩是帕金森病患者多关节运动中断的主要原因，(2)确定交互扭矩如何影响患者在多关节运动中对单个关节的控制，以及(3)检查患者无法协调调节关节交互扭矩所需的肌肉扭矩的可信原因。我们的实验利用了不同的手臂运动，它们操纵关节协调模式，强调交互力矩在控制关节运动中的不同作用。我们实验中获得的数据将为了解基底节功能障碍提供重要的科学和临床贡献。

DESCRIPTION (provided by applicant): Evidence indicates that Parkinson's Disease (PD) patients are particularly impaired in the performance of complex movements that require coordination of several joints. Studying these impairments is of considerable practical importance, because movements performed in everyday life (reaching, grasping, pointing, lifting, etc) are essentially multi-joint and the lack of coordination is one of the most debilitating aspects of the disease. Many studies have hypothesized that impairments in multi-joint movements arise from difficulties patients have in controlling several joints simultaneously. Data obtained in our lab suggest that the reason for multi-joint movement distortions in PD is different. We argue that PD patients have difficulties in the regulation of interactive torques. These torques may be considered as the effect of constraints imposed by peripheral biomechanics on control of the limbs. Healthy older adults overcome these constraints at normal movement speeds. Our data suggest that PD patients are unable to deal with the biomechanical constraints during movements of moderate and even low speeds. The purpose of the present proposal is (1) to demonstrate that the inability to properly regulate interactive torques is the major cause of multi-joint movement disruptions in PD, (2) to establish how interactive torques affect control at individual joints in multi-joint movements of the patients, and (3) to examine plausible reasons for the inability of patients to coordinate muscle torques necessary to modulate interactive torques at the joints. Our experiments utilize various arm movements, which manipulate joint coordination patterns stressing different roles of interactive torques in the control of joint movements. The data obtained in our experiments will provide important scientific and clinical contributions into knowledge of basal ganglia dysfunctions.