Neurophysiology of Motor Disorders in Spastic Diplegia

描述（由申请人提供）：本职业过渡奖的目标是获得脑瘫运动障碍临床和神经生理学方面的研究培训。nih人体运动控制科的Mark Hallett博士将担任该培训奖的主要导师。脑瘫是一组非进行性运动障碍综合征，由发育中的大脑受到静态损伤引起。生长发育的过程进一步使脑瘫运动综合征复杂化，导致临床表现的变化。痉挛性偏瘫患儿的镜像运动在10岁以下的患手中很突出，但在这个年龄之后更对称，不那么明显。研究者推测胼胝体成熟是造成这些变化的原因。了解发育对脑瘫运动表现的影响对于在生命的每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对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措施克服身体和教育障碍才能实现。对治疗策略的研究可以减少进行不适当或不可逆干预的可能性。在这组患者中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残疾的贡献。该奖项提出的研究重点是使用神经生理学方法来提高我们对痉挛性双瘫运动障碍的理解，并探索发育对这些疾病的影响。一组与运动控制生理学训练相一致的研究，探讨了痉挛性双瘫中运动综合征的更基本的生理学方面。这些研究将评估双瘫儿童，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的痉挛性双瘫儿童的运动技能，目的是确定胼胝体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.