Neurophysiology of Motor Disorders in Spastic Diplegia

描述(由申请者提供)：这个职业过渡奖的目标是获得脑瘫运动障碍的临床和神经生理学方面的研究培训。NINDS人体运动控制科的Mark Hallett博士将担任这一培训奖项的主要导师。脑性瘫痪是由于大脑发育中的静止性损伤而导致的一组非进行性运动障碍的综合征。生长和发育的过程使脑瘫的运动综合征进一步复杂化，导致临床情况发生变化。痉挛偏瘫儿童的镜像运动在10岁以下的患手中表现突出，但在这个年龄段之后更加对称，不那么明显。研究人员推测，这些变化是由膝盖骨成熟引起的。了解发育对脑性瘫痪运动表现的影响，对于在生命的各个阶段制定有效的康复策略至关重要。许多脑瘫儿童成年后为社会做出了重大贡献，但这些成就只有通过有效的治疗干预来克服身体和教育障碍才可能实现。对治疗策略的研究可以减少实施不适当或不可逆转干预的可能性。对这类患者进行研究的一个主要障碍是难以区分运动综合征。神经生理学可以帮助区分特定的高渗模式及其对儿童功能障碍的影响。本奖项提出的研究重点是利用神经生理学方法加强我们对痉挛双瘫运动障碍的了解，并探索发育对这些障碍的影响。在运动控制生理学训练的同时，一组研究探索了痉挛双瘫运动综合征的更基本的生理学方面。这些研究将评估患有双重人格的儿童，目的是澄清这些运动障碍的生理性质及其与患者功能状态的关系。第二组研究考察了不同年龄段的痉挛双瘫儿童的运动技能，目的是确定膝盖骨发育对脑瘫运动综合征的影响。

DESCRIPTION (provided by applicant): The goal of this Career Transition Award is to acquire research training in clinical and neurophysiologic dimensions of motor disorders in cerebral palsy. Dr Mark Hallett of the Human Motor Control Section, NINDS, will act as the principal mentor for this training award. Cerebral palsy is a group of syndromes with non-progressive motor impairment resulting from a static injury to the developing brain. The processes of growth and development further complicate the motor syndromes of cerebral palsy leading to a changing clinical picture. Mirror movements in children with spastic hemiplegia are prominent in the affected hand under 10 years of age, but are more symmetric and less noticeable after this age. Investigators speculate that callosal maturation is responsible for these changes. Understanding the affect of development on motor manifestations of cerebral palsy is critical to develop effective rehabilitative strategies at each stage of life. Many children with cerebral palsy make significant contributions to society as adults, but these achievements are possible only by overcoming physical and educational impediments with effective therapeutic interventions. Research into therapeutic strategies can decrease the possibility of performing inappropriate or irreversible interventions. A major obstacle to research in this group of patients is difficulty in distinguishing between motor syndromes. Neurophysiology can help to distinguish between the specific hypertonic patterns and their contribution to the child's functional disability. The focus of the research proposed in this award is to use neurophysiologic methods to enhance our understanding of the motor disabilities of spastic diplegia and to explore the affect of development on these disorders. One set of studies, coinciding with training in the physiology of motor control, explores the more basic physiologic aspects of motor syndromes in spastic diplegia. These studies will assess diplegic children with the goal of clarifying the physiologic nature of these motor disorders and their relationship to functional status of the patients. A second set of studies examines motor skills in spastic diplegia children at different ages with the goal of defining the affect of callosal development on the motor syndromes of cerebral palsy.