Effect of Contralateral Leg on Motor Output Post Stroke

描述（由申请人提供）：本指导研究科学家发展奖的目的是为候选人在医学康复研究领域的长期成功职业生涯做好准备。候选人将得到一名高级科学家的主要资助，该科学家将为候选人提供一段时间的集中训练，内容包括运动皮质神经生理学，中风后运动皮质可塑性，以及使用经颅磁刺激作为测量皮质兴奋性的研究工具。本研究的目的是确定卒中后半瘫患者的双侧腿部控制机制；具体来说，确定一条腿的感觉运动状态对另一条腿的运动行为的影响。将进行三项研究以确定：1)运动皮质损伤是否会导致双侧踝关节周期性运动的特异性缺陷，而不是单侧？2)同侧皮质脊髓通路在多大程度上促进运动皮质卒中患者单侧和双侧周期性踝关节运动？3)运动皮层的损伤是否会损害双侧腿部对行走过程中新的单侧扰动的运动反应？为了回答这些问题，我们将记录由运动皮质中风引起的半瘫患者以及年龄和性别匹配的健康对照者在进行脚踝运动任务和行走时的三维运动运动学和肌电图。结果将有助于解释运动皮层和皮质-脊髓通路的具体功能，并将为开发新的康复技术以恢复脑卒中后半瘫患者的正常运动功能提供基础。该计划提供的指导将有助于指导候选人成为一名独立的研究者，并为候选人的长期研究目标提供重大进展，即理解人类运动中的肢间协调和神经损伤后运动功能恢复的机制。相关性：这项研究将对公共卫生产生广泛的影响，因为中风是导致长期残疾的主要原因，并使许多患者在没有帮助的情况下无法行走（AHA 2005）。这些研究的发现有望帮助开发针对中风康复和步态恢复的新疗法。

DESCRIPTION (provided by applicant): The purpose of this Mentored Research Scientist Development Award is to prepare the candidate for a successful long-term career in medical rehabilitative research. The candidate will receive primary sponsorship from a senior-level scientist who will provide the candidate with a period of intensive, focused training in the areas of motor cortical neurophysiology, motor cortical plasticity following stroke, and the use of transcranial magnetic stimulation as a research tool to measure cortical excitability. The purpose of the research proposed here is to determine mechanisms of bilateral leg control in individuals with post stroke hemi paresis; specifically, to determine the effects of the sensorimotor state of one leg on the motor behavior of the opposite leg. Three studies will be undertaken to determine: 1) does damage to the motor cortex cause specific deficits in bilateral more than unilateral cyclical ankle movements? 2) to what extent do ipsilateral uncrossed corticospinal pathways contribute to unilateral and bilateral cyclical ankle movements in individuals with motor cortical stroke? and 3) does damage to the motor cortex impair bilateral leg motor responses to a novel unilateral perturbation during walking? To answer these questions, 3-D movement kinematics and electromyography will be recorded from subjects with hemi paresis caused by motor cortical stroke and healthy age- and gender-matched control subjects performing ankle movement tasks and walking. Results will help explain the specific function of the motor cortex and corticospinal pathway and will provide a basis for the development of novel rehabilitation techniques to recover normal locomotor's function in individuals with post-stroke hemi paresis. The mentorship provided in this plan will help direct the candidate toward independence as an investigator and lend significant progress toward the candidate's long-term research goal of understanding interlimb coordination during human locomotion and mechanisms for recovery of locomotor's function following neurological damage. RELEVANCE: This research will have broad impact on public health, as stroke is a leading cause of long-term disability and leaves many of its victims unable to walk without assistance (AHA 2005). Findings from these studies are expected to help lead to the development of new treatments aimed at stroke rehabilitation generally and gait recovery specifically.