Changes in Motoneurone and Motor Axon Properties Distal to the Lesion in Stroke

中风后，在中风水平以下的脊髓运动神经元会发生适应性变化，但人们对这些变化知之甚少。除了脊髓反射的夸大，远端的改变在很大程度上被临床医生忽视了。即使是脊髓反射被夸大的机制也仍然存在争议，部分原因是没有一个单一的过程可以解释它。使用最初为研究人类周围神经的生物物理特性而开发的新实验技术，该项目将量化运动神经元及其外周延伸运动轴突中发生的兴奋性变化，并将这些结果与相同患者的非瘫痪侧和健康匹配的受试者进行比较。随着时间的推移发生的变化将被记录在纵向研究中。这些发现将与患者的临床状态相关联，从而深入了解运动神经元属性的变化在多大程度上推动了痉挛等临床表现。此外，对照研究将进一步深入了解某些特定脊椎反射通路的传导障碍是否对痉挛有显著影响。该项目对于了解中枢神经系统损伤后神经结构的适应性变化(可塑性)的性质非常重要，并将揭示中风中发生的远程变化。这些研究不仅与了解目前的缺陷有关，而且还与了解并可能利用康复程序改变结果有关。

Following a stroke, adaptive changes occur in spinal cord motoneurones below the level of the stroke, but these are poorly understood. Apart from the exaggeration of spinal reflexes, distal changes have largely been neglected by clinicians. Even the mechanisms responsible for the exaggeration of spinal reflexes are still debated, in part because no single process can account for it. Using novel experimental techniques originally developed to study biophysical properties of human peripheral nerves, this project will quantify the changes in excitability that occur in motoneurones and their peripheral extension, the motor axon, and compare these with the findings on the non-paralysed side of the same patients and with healthy matched control subjects. The changes that occur over time will be documented in longitudinal studies. The findings will be correlated with the patient's clinical status, providing insight into the extent to which changes in motoneurone properties drive clinical manifestations such as spasticity. In addition, control studies will provide further insight into whether disturbed transmission in some specific spinal reflex pathways contributes significantly to spasticity. The project is important for understanding the nature of adaptive changes (plasticity) in neural structures following lesions in the central nervous system and will shed light on the remote changes that occur in stroke. The studies are relevant not only for understanding current deficits but also for understanding and perhaps altering outcomes using rehabilitation procedures.