Cortical Preparation for Postural Responses in Parkinson's Disease

描述（由申请人提供）：帕金森病（PD）是一种慢性进行性疾病，通常影响65岁以上的人群，这是美国人口的一部分，正在迅速扩大。这项建议的广泛目标是了解健康个体对姿势扰动的反应的准备皮质机制，以及这种准备活动如何在PD成人中受损。更具体地说，脑电图（EEG）将用于测量偶然性负变（CNV），即在提示自愿运动之前发生的EEG振幅的缓慢负移。CNV测量准备皮层活动，并反映“中央集”和预期的反应准备。先前的研究表明，PD影响“中枢设置”和姿势反应，但没有测量相应的皮质活动。这个建议的假设是，准备皮质活动代表“中央设置”的预期缩放的姿势反应和PD影响这个“中央设置”。第一个目的是比较准备皮质电位之前，可预测的和不可预测的幅度的姿势扰动在健康的个人，测试的假设，即预期的皮质活动的作用是规模的姿势反应的预期幅度的扰动。据建议，健康的成年参与者将显示更大的幅度CNVs在他们的EEG之前，可预测的幅度扰动比不可预测的扰动。还假设在大的、可预测的扰动之前将存在比在需要较小姿势响应的小的、可预测的扰动之前更大幅度的CNV。第二个目的是比较准备皮质电位之前，可预测和不可预测的幅度的姿势扰动成人PD年龄匹配，健康的人。与健康成人相比，PD成人表现出受损的预期缩放行为。该假设是，与健康对照相比，患有PD的成人将显示较小的振幅CNV。第三个目的是比较“想大”，注意提示策略，影响准备皮层电位和可预测的姿势反应的大小。假设在接受姿势扰动之前，指导患有PD的成年人“想得大”将增加CNV的幅度和姿势反应的大小。这些研究将通过更好地了解1）皮质准备与姿势控制的“中枢集”相关，2）PD影响“中枢集”和CNV功能，3）提示改变PD中的CNV功能和姿势反应，支持重点康复方法，以改善帕金森病成人患者的姿势控制并减少福尔斯。 公共卫生相关性：在美国，据估计，每年诊断出60，000例帕金森病（PD）新病例，加入目前患有PD的100万美国人。虽然药物有助于PD的许多症状，但它们不能阻止疾病进展，并且对与PD相关的姿势，平衡和步态问题无益。更好地了解PD如何影响对预期姿势扰动的反应的能力，才能为PD成人制定有效的康复干预措施。

DESCRIPTION (provided by applicant): Parkinson's disease (PD) is a chronic, progressive disease usually affecting people over the age of 65, a segment of the United States population that is rapidly expanding. The broad goal of this proposal is to understand the preparatory cortical mechanisms that underlie response to postural perturbation in healthy individuals and how this preparatory activity is impaired in adults with PD. More specifically, electroencephalography (EEG) will be used to measure contingent negative variation (CNV), a slow, negative shift in EEG amplitude that occurs prior to cued voluntary movements. The CNV measures preparatory cortical activity and reflects 'central set' and anticipatory preparation of responses. Previous studies have shown that PD affects 'central set' and postural responses, but have not measured corresponding cortical activity. The hypothesis of this proposal is that preparatory cortical activity represents 'central set' for anticipatory scaling of postural responses and that PD affects this 'central set'. The first aim is to compare preparatory cortical potentials prior to predictable and unpredictable magnitudes of postural perturbations in healthy individuals, testing the hypothesis that the role of anticipatory cortical activity is to scale postural responses for the anticipated magnitude of perturbations. It is proposed that healthy adult participants will show larger amplitude CNVs in their EEG prior to predictable magnitude perturbations than to unpredictable perturbations. It is also hypothesized that there will be larger amplitude CNVs before large, predictable perturbations than before small, predictable perturbations requiring a smaller postural response. The second aim is to compare preparatory cortical potentials prior to predictable and unpredictable magnitudes of postural perturbations in adults with PD to age-matched, healthy individuals. Adults with PD show impaired anticipatory scaling behaviorally, as compared to healthy adults. The hypothesis is that adults with PD will show smaller amplitude CNV as compared to healthy controls. The third aim is to compare how "Think Big", an attentional cuing strategy, affects preparatory cortical potentials and the size of predictable postural responses. It is hypothesized that instructing adults with PD to "think big" prior to receiving a postural perturbation will increase both the amplitude of the CNV and the size of the postural response. These studies will support focused rehabilitation approaches to improve postural control and decrease falls in adults with Parkinson's disease by providing a better understanding of how 1) cortical preparation is related to 'central set' for postural control, 2) PD affects 'central set' and CNV function and 3) cuing alters CNV function and postural responses in PD. PUBLIC HEALTH RELEVANCE: In the United States, it is estimated that 60,000 new cases of Parkinson's disease (PD) are diagnosed each year, joining the 1 million Americans who currently have PD. Although medications help with many symptoms of PD, they do not stop disease progression and are not beneficial for posture, balance and gait problems associated with PD. A better understanding of how PD affects the ability to prepare responses for anticipated postural perturbations is needed before effective rehabilitation interventions can be developed for adults with PD.