Translating basic knowledge about motor control to applications for motor recovery after CNS lesions

由成人发作的中枢神经系统损伤（帕金森病（PD）或中风）引起的感觉运动障碍包括肌张力障碍（僵硬、痉挛）和运动缺陷。特别是，运动的协调性也受到前庭系统病变的影响。我们来自麦吉尔大学和蒙特利尔大学的合作研究人员团队将研究如何根据运动动作的基本中枢控制机制的知识来改善这些缺陷的治疗。我们将集中讨论运动控制障碍的三个中心特征：（a）在双关节臂系统中，牵张反射阈值的中枢调节缺陷可能是PD和卒中中不同臂关节的肌肉无力、僵硬、痉挛和运动不协调的基础;（B）通常用于达到相同运动目标的补偿机制的缺陷（“运动等效性”），而不考虑患有PD、中风和前庭缺陷的患者中参与运动动作的身体节段的数量;（c）在PD和中风的痉挛期间预期、预测控制的缺陷。基于手臂运动缺陷的这些中心方面的实验分析（共4个实验），我们将详细说明3个诊断测试，评估这些神经系统患者的中枢牵张反射阈值调节以及补偿和预测控制。我们计划将这些测试用于临床。研究将在CRIR（康复跨学科研究中心）附属的两所大学和4家医院进行。我们团队的物理治疗师和CRIR医生将协助这些项目。我们的学员，包括3名博士生，将利用我们的多学科方法来运动控制，并学习如何将基础研究的结果应用于康复。

Sensorimotor disturbances resulting from adult-onset central nervous system damage (Parkinson's Disease (PD) or stroke) include disorders in muscle tone (rigidity, spasticity) and movement deficits. In particular, coordination of movement is also affected by lesions of the vestibular system. Our team of collaborating researchers from McGill and University of Montreal will investigate how treatment of these deficits may be improved based on the knowledge of basic central control mechanisms underlying motor actions. We will focus on three central characteristics of disordered motor control: (a) Deficits in central regulation of stretch-reflex thresholds in the double-joint arm system that may underlie muscle weakness, rigidity, spasticity and incoordination of motions of different arm joints in PD and stroke; (b) Deficits in compensatory mechanisms normally used to reach the same motor goal ("motor equivalency") regardless of the number of body segments involved in the motor action in patients with PD, stroke and vestibulo-deficiency; (c) Deficits in anticipatory, predictive control during prehension in PD and stroke. Based on the experimental analysis of these central aspects of arm movement deficits (4 experiments in total), we will elaborate 3 diagnostic tests that evaluate the central stretch reflex threshold regulation as well as compensatory and predictive control in these neurological patients. We plan to adapt the tests for clinical use. Research will be carried out at two Universities and at 4 hospitals affiliated with the CRIR (Center for Interdisciplinary Research in Rehabilitation). Physiotherapists from our group and CRIR physicians will assist in the projects. Our trainees, including 3 PhD students, will take advantage of our multidisciplinary approach to motor control and learn how the results of fundamental studies can be applied to rehabilitation.