Physiological Analysis Of Voluntary Movement

该项目的目标是更多地了解正常人和自主运动障碍患者的运动控制，如帕金森病，小脑共济失调，中风偏瘫和肌张力障碍。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（TMS）和神经成像与正电子发射断层扫描和功能磁共振成像（fMRI）。目前活跃的研究项目包括正常生理学、病理生理学和肌张力障碍的治疗、帕金森氏症的运动迟缓？的疾病，并从偏瘫恢复。 功能磁共振成像（fMRI）被用来调查正常老化和帕金森？的疾病对自动运动。受试者被要求练习连续的手指运动任务，直到他们可以自动执行这些任务。结果表明，经过大量的训练，大多数老年健康受试者都能实现自动化，但帕金森病患者的自动化难度更大，只能自动完成简单的任务。在类似的运动中，老年人的大脑各部分的活动比年轻人多，帕金森病患者的大脑各部分的活动比老年人多。鉴于老年人福尔斯跌倒的重要性，我们也在研究姿势不稳定及其随年龄的变化。我们正在追求的假设是，不稳定姿势的神经探测器随着年龄的增长而退化。我们有证据证明这些神经探测器与脑电图和功能磁共振成像研究。 在另一项研究中，我们试图确定使用EEG来预测某人何时移动以及他们是移动右手还是左手的真实的方法。通过离线研究，我们确定了两个半球的主要运动区的功率变化的因素，可以预测运动意图和区分左手运动和右手运动。我们现在正试图在真实的时间内执行这一点。 简单的动作已经研究了很多年，但人类的大多数动作都更复杂。我们现在正在用脑电图和功能磁共振成像研究复杂的运动。功能磁共振成像显示顶叶和运动前区活动的模式，更多的是在左半球，而不考虑用哪只手来做运动。EEG的相干性分析表明，顶叶和运动前区在运动的准备和执行过程中是相干的，推断出与事件相关的功能连接。 我们已经做了很多肌张力障碍的研究，主要是在局灶性手肌张力障碍患者。我们已经完成了一项调查？把戏？病人用它来减轻他们的肌张力障碍，为对技巧机制的生理学研究做准备。我们使用基于体素的形态测量来证明这些患者双侧的周围皮质的手部代表性中灰质的稳健增加。我们花了相当多的时间在追求的假设，有一个缺陷的周围抑制与自主运动的张力障碍患者。我们已经用经颅磁刺激（TMS）证明了这一点。我们现在正在研究不同类型的已知抑制过程的环绕抑制机制。我们也在使用脑电图的方法，看看这是否有助于揭示周围的抑制机制。 在帕金森地区？的疾病，我们正在评估高频率重复经颅磁刺激的疗效，以改善帕金森病患者的步态和手部运动的速度？在安慰剂对照试验中的疾病。初步分析显示，患者在每周两次持续4周的重复治疗过程中似乎有所改善。 我们已经制定了任务，以确定在正常成熟的健康儿童的运动皮层生理学的特点，以了解异常运动皮层生理脑瘫儿童。我们已经在儿童和成人中进行了EEG研究，在双手和单手手指轻敲，以确定成熟的运动任务期间，大脑半球间和内的连贯性，以及运动任务期间的脑-肌肉耦合。我们还开发了运动学习研究，以确定成熟的双手和单手程序学习，和TMS研究，以确定成熟的刺激反应曲线。

The goal of this project is to learn more about the control of movement in normal humans and in patients with voluntary movement disorders such as Parkinson's disease, cerebellar ataxia, hemiplegia from stroke and dystonia. The tools we use include clinical neurophysiological methods such as electroencephalography, electromyography, and transcranial magnetic stimulation (TMS) and neuroimaging with positron emission tomography and functional magnetic resonance imaging (fMRI). Currently active projects in the Section include studies of normal physiology, the pathophysiology and treatment of dystonia, the bradykinesia in Parkinson?s disease, and recovery from hemiplegia. Functional magnetic resonance imaging (fMRI) was used to investigate the influence of normal aging and Parkinson?s disease on automatic movements. Subjects were asked to practice sequential finger movement tasks until they could perform them automatically. Our results showed that after extensive training, most aged healthy subjects can achieve automaticity, but Parkinson patients have more difficulty and can only perform simple tasks automatically. There is more activity in various parts of brain in old compared to young subjects and in Parkinson patients compared with old subjects during similar movements. We are also studying postural instability and its changes with aging, given the importance of falls in the elderly. We are pursuing the hypothesis that neural detectors of unstable postures deteriorate with aging. We have evidence for these neural detectors with both EEG and fMRI studies. In another study, we are trying to determine methods using EEG to predict in real time when someone is going to move and whether they will move their right or left hand. From offline studies, we determined factors of the power changes on the two hemispheric primary motor areas that can predict movement intention and classify left hand movement from right hand movement. We are now attempting to implement this in real time. Simple movements have been studied for many years, but most movements humans make are more complex. We are now studying complex praxis movements with both EEG and fMRI. fMRI shows a pattern of parietal and premotor activity, more in the left hemisphere regardless of the hand used for making the movement. Coherence analysis with EEG has shown that parietal and premotor areas are coherent during preparation and execution of movement, inferring event related functional connectivity. We have been doing many studies of dystonia largely in patients with focal hand dystonia. We have completed a survey of ?tricks? that patients use to reduce their dystonia in preparation for physiological studies of the mechanism of tricks. We used voxel-based morphometry to demonstrate a robust increase in grey matter in the hand representation of perirolandic cortices, bilaterally, in these patients. We have devoted considerable time in pursuing the hypothesis that there is a deficient surround inhibition with voluntary movement in dystonic patients. We have demonstrated this with transcranial magnetic stimulation (TMS). We are now pursuing the mechanism of surround inhibition studying different types of known inhibitory processes. We are also using EEG methods to see if this will help reveal surround inhibition mechanisms. In the area of Parkinson?s Disease, we are evaluating the efficacy of high frequency repetitive TMS to improve the speed of gait and hand movements in patients with Parkinson?s Disease in a placebo controlled trial. Preliminary analysis shows that patients appear to improve over the course of repeated treatments given twice weekly for 4 weeks. We have developed tasks to ascertain characteristics of motor cortex physiology in healthy children during normal maturation in order to understand anomalous motor cortex physiology in children with cerebral palsy. We have performed EEG studies in children and adults during bimanual and unimanual finger tapping to determine maturation of inter- and intra-hemispheric coherence during motor tasks, and brain-muscle coupling during motor tasks. We have also developed motor learning studies to determine maturation of bimanual and unimanual procedural learning, and TMS studies to determine maturation of stimulus response curves.