Dynamic Imaging of Cerebral Palsy Gait

项目摘要/摘要 脑性瘫痪(CP)是围产期脑损伤的结果，是最常见和最昂贵的儿科疾病之一 美国的神经学状况。患有慢性阻塞性肺病的患者经常面临终身移动性挑战。 用来克服这些挑战的现代治疗方法更加强调 患有脑性瘫痪的青少年如何规划腿部运动、执行运动动作和整合感觉的神经学基础 信息。尽管采用了神经科学的方法，但这些新疗法仍然受到实质性的限制。 关于异常感觉运动皮质活动和/或脊髓如何具体影响的知识空白 患有慢性胰腺炎的年轻人的步态。 我们的超现代脑磁图(MEG)脑成像结果显示，皮质像差 在患有CP的青年患者中，在不典型的腿部运动动作和感觉过程中扮演着重要的角色。 此外，我们的高分辨率核磁共振管道显示，脊髓组织的结构完整性是 在患有CP的个体中受到损害。从这些实验中，我们推断，改变后的大脑皮层动力学 脊髓的完整性可能会影响患有CP的青少年做出前馈预测和/或在线预测的能力 在步态中纠正他们的腿部运动学。然而，这一猜想尚未完全得到证实，因为 脑磁图/磁共振成像记录环境的物理限制。为了继续前进，我们将使用我们广泛的MEG 开发新的脑电(EEG)方法的基础工作 灵活地精确量化实时步态中的感觉运动皮质活动。此外，我们将利用 尖端神经生理学测试，同时量化脊髓神经元间动力学如何 在步态过程中被调制。本研究的目的是：(1)建立多模式脑电-脑电成像指标 已知的影响慢性阻塞性肺疾病程度的异常感觉运动皮质振荡 运动障碍，(2)量化感觉运动脑电皮质振荡和脊髓神经元间动力学 步态中患有脑性瘫痪的青年，以及(3)破译感觉运动皮质振荡和脊髓是否发生变化 脊髓神经元间动力学可以更好地预测青少年脑性瘫痪患者的活动能力缺陷 最常用的临床指标。为了实现这些目标，患有CP和神经典型控制组的青少年将 进行一系列实验，将使用同步的脑电神经成像，脑电神经成像在 步态，以及步态过程中脊髓神经元间动力学的评估。此外，参与者将 接受一系列的临床评估(如平衡、痉挛、选择性控制、力量和感觉)。 我们预计，通过这个项目获得的新知识将为设计和 测试针对特定神经生理缺陷的创新治疗方案，这些缺陷限制了 患有脑性瘫痪的青年的流动性。

PROJECT SUMMARY/ABSTRACT Cerebral palsy (CP) results from a perinatal brain injury and is one of the most prevalent and costly pediatric neurologic conditions in the United States. Individuals with CP frequently experience lifelong mobility challenges. The modern treatment approaches being used to overcome these challenges place greater emphasis on the neurological basis for how youth with CP plan their leg movements, execute motor actions, and integrate sensory information. Despite this neuroscience-informed approach, these new therapies are still limited by substantial knowledge gaps regarding how the aberrant sensorimotor cortical activity and/or spinal cord specifically affects the gait of youth with CP. Our ultramodern magnetoencephalographic (MEG) brain imaging results have revealed that cortical aberrations play a substantial role in the uncharacteristic leg motor actions and sensory processes seen in youth with CP. Furthermore, our high-resolution MRI pipelines have shown that the structural integrity of spinal cord tissue is compromised in individuals with CP. From these experiments, we have inferred that the altered cortical dynamics and spinal cord integrity likely impacts the ability of youth with CP to make feed-forward predictions and/or online corrections to their leg kinematics during gait. However, this conjecture has yet to be fully established due to physical limitations of the MEG/MRI recording environments. To move forward, we will use our extensive MEG foundational work to develop new electroencephalographic (EEG) methods that have the scientific rigor and flexibility to precisely quantify the sensorimotor cortical activity during real-time gait. Furthermore, we will utilize cutting-edge neurophysiological tests to concurrently quantify how the spinal cord interneuronal dynamics are modulated during gait. The Aims of this study will: (1) establish multimodal MEG-EEG neuroimaging proxies of the aberrant sensorimotor cortical oscillations seen in youth with CP that are known to impact the extent of the mobility deficits, (2) quantify the sensorimotor EEG cortical oscillations and spinal cord interneuronal dynamics of youth with CP during gait, and (3) decipher if alterations in the sensorimotor cortical oscillations and spinal cord interneuronal dynamics are better predictors of the mobility deficits seen in youth with CP relative to the most commonly used clinical metrics. To achieve these Aims, youth with CP and neurotypical controls will undergo a series of experiments that will use simultaneous MEG-EEG neuroimaging, EEG neuroimaging during gait, and assessments of the spinal cord interneuronal dynamics during gait. Furthermore, the participants will undergo a battery of clinical assessments (e.g., balance, spasticity, selective control, strength and sensation). We foresee that the body of new knowledge gained through this project will set-the-stage for the design and testing of innovative therapeutic protocols that target the specific neurophysiological deficits that are limiting the mobility of youth with CP.