Neural correlates of whole-body motion perception during balance perturbations in stroke survivors and their relationship to balance function

中风幸存者平衡扰动期间全身运动感知的神经相关性及其与平衡功能的关系

基本信息

批准号：
10468014
负责人：
Jasmine Mirdamadi
金额：
$ 6.76万
依托单位：
EMORY UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-01 至 2023-06-30
项目状态：
已结题

项目摘要

PROJECT SUMMARY/ABSTRACT Both sensory and motor processing are impaired post-stroke, but frequently studied in isolation, with most rehabilitation focused on the motor system. Our current understanding of the perception of body position and movement (i.e. proprioception) is limited due to existing methodologies that are subjective, lack precision, and are often assessed in single joints of the upper limb during non-functional behaviors. My dissertation research used robotic methods to understand proprioceptive contributions to motor learning at a perceptual and neurophysiological level. Learning was associated with enhanced proprioceptive function and changes in sensorimotor neurophysiology. While these findings supported the value of using objective measures to quantify proprioception in the context of learning and identified underlying neural substrates, the neural mechanisms mediating proprioceptive contributions to functional behaviors, such as balance, is unknown. When balance is perturbed, the brain must integrate sensory input across multiple joints and limbs to perceive body position and plan the appropriate muscle response. Findings from our lab demonstrate that stroke survivors have altered cortical responses and muscle activation patterns in response to a perturbation, but it is unknown whether these abnormal responses are related to impairments in whole-body motion perception. Objective biomarkers, including structural integrity and cortical responses to balance perturbations, of balance function are necessary to identify individuals at risk for falls and to inform the development of targeted interventions that capitalize on an individual’s underlying brain-balance profile. Towards this long-term goal, we will pursue the following aims in chronic stroke survivors (N=20) and neurotypical older adults (N=20): 1) test whether worse whole-body motion perception is associated with worse balance function; 2) determine if cortical responses evoked during balance perturbations are modulating according to the difficulty of discriminating between balance perturbations; and 3) test whether measures of structural integrity in sensory pathways and cortical response latency are associated with balance function. To our knowledge, this is the first study using a multi-modal approach to identify brain-balance relationships underlying somatosensory perception during functional behaviors. If successful, such findings may contribute to a shift in existing rehabilitation interventions focused on the motor system towards integrative approaches that address sensory and perceptual contributions to movement. Given increased risk of falls with aging that is further increased post-stroke, developing structural and functional biomarkers of somatosensory perception and balance function is necessary to identify individuals at risk for falls, and to advance development of effective, evidence-based rehabilitation interventions.

项目概要/摘要中风后感觉和运动处理都会受损，但经常单独研究，大多数我们目前对身体位置和感知的理解是康复的重点。由于现有的方法是主观的、缺乏精确性和我的论文研究中经常对上肢的单个关节进行评估。使用机器人方法来理解本体感受对运动学习的贡献学习与本体感觉功能的增强和变化有关。虽然这些发现支持使用客观测量来进行感觉运动神经生理学的价值。量化学习背景下的本体感觉并确定潜在的神经基质调节本体感觉对功能行为（例如平衡）的贡献的机制尚不清楚。当平衡受到干扰时，大脑必须整合多个关节和四肢的感觉输入来感知我们实验室的研究结果证明了中风的身体姿势和计划适当的肌肉反应。幸存者改变了皮质反应和肌肉激活模式以应对扰动，但这是尚不清楚这些异常反应是否与全身运动感知障碍有关。平衡的客观生物标志物，包括结构完整性和皮质对平衡扰动的反应识别有跌倒风险的个人并为制定有针对性的预防措施提供信息是必要的为了实现这一长期目标，我们利用个人潜在的大脑平衡状况进行干预。将在慢性中风幸存者 (N=20) 和神经典型老年人 (N=20) 中追求以下目标： 1) 测试 2）确定较差的全身运动感知是否与较差的平衡功能相关；平衡扰动期间引起的皮质反应根据平衡的难度进行调节区分平衡扰动；3) 测试测量感官结构完整性是否良好据我们所知，这是第一个与平衡功能相关的通路和皮质反应潜伏期。使用多模式方法来识别大脑平衡体感潜在关系的研究如果成功的话，这些发现可能有助于改变现有的行为。康复干预措施侧重于运动系统，采取解决感觉问题的综合方法鉴于随着年龄的增长，跌倒的风险进一步增加。中风后，开发体感知觉和平衡功能的结构和功能生物标志物有必要识别有跌倒风险的个人，并促进有效、基于证据的发展康复干预。

项目成果

期刊论文数量（4）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

State-dependent interhemispheric inhibition reveals individual differences in motor behavior in chronic stroke.

状态依赖性半球间抑制揭示了慢性中风运动行为的个体差异。

DOI：
10.1016/j.clinph.2023.02.177
发表时间：
2023
期刊：
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
影响因子：
0
作者：
Mirdamadi,JasmineL;Xu,Jing;Arevalo-Alas,KarlaM;Kam,LianaK;Borich,MichaelR
通讯作者：
Borich,MichaelR

Distinct cortical correlates of perception and motor function in balance control.

平衡控制中感知和运动功能的独特皮质关联。