Neural Adaptation to Strabismus Surgery

描述（由申请人提供）：虽然手术矫正通常是斜视的首选治疗方法，但结果可能存在问题。据报道，20-40%的斜视矫正手术以某种方式失败，因此需要再次手术。我们认为，斜视手术有时会失败的原因之一是，治疗后的适应性过程可能会抵消手术的影响，使眼睛恢复到以前的错位状态。这些适应性过程可能局限于肌肉本身（肌肉重塑），也可能涉及神经过程（中枢神经系统重塑）。该项目的目标是更好地了解斜视矫正手术后的神经适应性变化，这反过来又可能为治疗失败或成功的原因提供额外的见解。我们实验室的研究表明，在破坏双眼视觉的条件下特别饲养的幼猴再现了具有大水平错位、A/V模式、分离水平偏差（DHD）和分离垂直偏差（DVD）的感觉性斜视综合征。我们的策略，这个项目是第一个特点的神经驱动水平眼外肌（内侧和外侧直）的斜视猴记录从运动神经元的眼神经和外展神经核。此后，我们将使用与人类患者相似的切除或后退手术技术治疗这些动物的斜视。治疗后，我们将记录来自相同运动核团的神经反应。术前和术后人群神经驱动水平眼外肌的比较将提供关于大脑如何适应肌肉增强或减弱过程的数据。在最后的目标，我们将记录从细胞在眼上区，以检查是否神经适应手术治疗后有其起源的聚散回路。完成我们的研究将有利于理解和治疗发展形式的斜视。

DESCRIPTION (provided by applicant): Although surgical correction is often the preferred treatment method for strabismus, there can be problems with the outcome. By some accounts, 20-40% of strabismus correction surgeries fail in one way or another and therefore re-operation is required. We suggest that a reason strabismus surgery sometimes fails is that there are adaptive processes that follow the treatment that may work to negate the effects of surgery and revert the eyes to a previous state of misalignment. These adaptive processes might be localized to muscle itself (muscle remodeling) or might involve neural processes (central nervous system remodeling). The goal of this project is to develop a better understanding of the neural adaptive changes that follow strabismus correction surgery which in turn may provide additional insight into reasons for failure or success following treatment. Studies from our laboratory have shown that specially rearing infant monkeys under conditions that disrupted binocular vision reproduced a sensory strabismus syndrome with large horizontal misalignment, A/V patterns, Dissociated Horizontal Deviation (DHD) and Dissociated Vertical Deviation (DVD). Our strategy for this project is first to characterize the neural drive to horizontal extraocular muscles (medial and lateral recti) of the strabismic monkeys by recording from motoneurons in the oculomotor and abducens nuclei. Thereafter, we will treat the strabismus in these animals using similar resection or recession surgery techniques to those used in human patients. Following treatment, we will record neural responses from the same motor nuclei. Comparison of the pre- and post-surgery population neural drive to horizontal extraocular muscles will provide data on how the brain adapts to a muscle strengthening or weakening procedure. In the final aim, we will record from cells in the supraoculomotor area to examine whether the neural adaptation that follows surgical treatments has its origin in vergence circuits. Completion of our studies will be of benefit to the understanding and treatment of developmental forms of strabismus.