Physiological Analysis Of Involuntary Movements

这个项目的目标是了解不同非自愿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(EEG)、脑磁图(MEG)、肌电(EMG)和经颅磁刺激(TMS)，以及正电子发射断层扫描(PET)和功能磁共振成像(FMRI)的神经成像。该科目前正在进行的项目包括抽搐、心因性运动障碍、震颤和不宁腿综合症的研究。 我们一直在用几种方法来研究抽搐的生理学。抽动症患者报告“先兆性冲动”和其他与抽搐相关的感觉异常。利用脑磁图，我们研究了三叉神经体感诱发反应，以探讨感觉习惯性降低和网络异常的可能性，这可能是感觉症状参与抽动的原因。我们的初步结果表明，患者可能不习惯于正常的重复感觉。我们也一直在调查冲动的本质。我们对18名健康志愿者进行了fMRI研究，观察了天真的受试者看到演员打哈欠时的冲动，以及其他控制动作。激活的区域主要在腹内侧额叶皮质。 心因性运动障碍(PMD)的病理生理学还知之甚少。我们正在使用认知任务、神经生理学测试、精神病学测量和功能成像来研究这些障碍的潜在机制。功能成像研究是对震颤患者的功能磁共振成像比较，初步结果显示前额叶背外侧皮质异常激活。 需要新的治疗方法来治疗特发性震颤。一种很有希望的试剂是1-辛醇，我们正在继续开发它。我们目前正在研究S这种药物的药代动力学特征，并在ET患者的剂量递增和交叉研究中比较两种不同剂型的疗效。除了表征1-辛醇的药代动力学外，我们还在一项针对特发性震颤患者的双盲安慰剂对照试验中测试其疗效。我们还收集了有特发性震颤的家系，寻找可能的基因异常，在几个家庭中发现了6号和11号染色体上的遗传连锁区域。 我们完成了一项关于不宁腿综合征(RLS)的研究，使用带有眨眼反射的听觉和触觉预脉冲。初步结果显示，与对照组相比，患者在触觉预脉冲期间的抑制程度降低。这一发现表明RLS患者的脊髓回路存在异常。

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 (EEG), magnetoencephalography (MEG), electromyography (EMG), and transcranial magnetic stimulation (TMS) and neuroimaging with positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). Currently active projects in the Section include studies of tic, psychogenic movement disorders, tremor and restless legs syndrome. We have been approaching the physiology of tics in several ways. Tourette syndrome patients report "premonitory urge" and other sensory abnormalities associated with the presence of tics. Using MEG, we investigated trigeminal somatosensory evoked responses in order to investigate possibilities of decreased habituation to sensation and network abnormalities which may account for the involvement of sensory symptoms in tics. Our preliminary results suggest that patients may not habituate normally to repetitive sensations. We have also been investigating the nature of urge. We performed an fMRI study in 18 healthy volunteers looking at the urge when naive subjects viewed an actor yawning, along with other control actions. The main area of activation was in the ventromedial prefrontal cortex. The pathophysiology of psychogenic movement disorders (PMD) is very poorly understood. We are studying the mechanisms underlying these disorders using cognitive tasks, neurophysiological testing, psychiatric measures, and functional imaging. The functional imaging study is an fMRI comparison of patients with tremor, and preliminary results show abnormal activation in dorsolateral prefrontal cortex. New treatments are needed for essential tremor. One promising agent is 1-octanol which we continue to develop. We are currently working to characterize this drug?s pharmacokinetics and comparing the efficacy of two different formulations in a dose escalation and cross-over study in patients with ET. In addition to characterizing the pharmacokinetics of 1-octanol, we are testing its efficacy in a double-blind placebo-controlled trial in patients with essential tremor. We are also collecting families with essential tremor looking for possible genetic abnormalities, and in several families found an area suggestive of genetic linkage on chromosome 6 and 11. We completed a study on restless legs syndrome (RLS) using an auditory and tactile prepulse with the blink reflex. Preliminary results show that there is decreased inhibition during a tactile prepulse in patients compared to controls. This finding suggests an abnormality in the spinal cord circuitry of RLS patients.