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

成人起病的中枢神经系统损伤(帕金森氏病或中风)引起的感觉运动障碍包括肌肉张力障碍(僵硬、痉挛)和运动障碍。特别是，前庭系统的损伤也会影响运动的协调性。我们来自McGill和蒙特利尔大学的合作研究团队将基于对基本中枢控制机制的了解，研究如何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)双关节手臂系统中伸展反射阈值的中枢调节缺陷，可能是帕金森病和中风患者肌肉无力、僵硬、痉挛和不同手臂关节运动协调不协调的原因；(B)帕金森病和中风患者无论参与运动动作的身体节段数如何，通常用于实现相同运动目标的代偿机制存在缺陷；(C)帕金森病和中风患者在抓握过程中预见性和预测性控制存在缺陷。基于对手臂运动缺陷的这些中枢方面的实验分析(共4个实验)，我们将详细阐述3种诊断测试，以评估这些神经科患者的中枢拉伸反射阈值调节以及补偿和预测控制。我们计划将这些测试调整为临床使用。研究将在两所大学和CRIR(康复跨学科研究中心)附属的4家医院进行。我们小组的物理治疗师和CRIR医生将协助这些项目。我们的学员，包括3名博士生，将利用我们多学科的运动控制方法，学习如何将基础研究的成果应用于康复。

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.