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

• 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
• 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
• 来源: https://reporter.nih.gov/project-details/10468014
• 关键词: Address; Advanced Development; Affect; Afferent Pathways; Aging; Attenuated; Behavior; Biological Markers; Body Image; Brain; Clinical; Clinical assessments; Collaborations; Data; Development; Discrimination; Elderly; Electroencephalography; Environment; Equilibrium; Fright; Gait speed; Goals; Impairment; Individual; Intervention; Joints; Judgment; Lateral; Learning; Limb structure; Measures; Mediating; Methodology; Methods; Motion; Motion Perception; Motor; Motor output; Movement; Muscle; Musculoskeletal Equilibrium; Paresis; Participant; Pathway interactions; Pattern; Perception; Posture; Process; Proprioception; Quality of life; Rehabilitation therapy; Research; Response Latencies; Robotics; Sensorimotor functions; Sensory; Side; Signal Transduction; Stroke; Structure-Activity Relationship; Surface; System; Testing; Upper Extremity; Work; base; body position; chronic stroke; cognitive load; disability; equilibration disorder; evidence base; fall risk; falls; improved; motor control; motor deficit; motor learning; motor recovery; multimodality; neural correlate; neuroimaging; neuromechanism; neuromuscular system; neurophysiology; post stroke; relating to nervous system; response; sensory input; somatosensory; stem; stroke rehabilitation; stroke survivor; white matter

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.

项目摘要/摘要 感觉和运动处理后触摸后都受损，但经常孤立地研究，大多数 康复专注于运动系统。我们目前对身体位置感知的理解和 由于现有的主观方法，缺乏精度和 在非功能行为时，通常会在上肢的单个关节中评估。我的论文研究 使用机器人方法来了解感知和 神经生理水平。学习与增强的本体感受功能和变化有关 感觉运动神经生理学。尽管这些发现支持使用客观测量的价值 在学习和确定基本神经基质的背景下量化本体感受 介导对功能行为（例如平衡）的本体感受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才能感知 身体位置并计划适当的肌肉反应。我们实验室的发现证明了中风 幸存者响应扰动而改变了皮质反应和肌肉激活模式，但这是 未知这些异常反应是否与全身运动感知中的损伤有关。 客观生物标志物，包括结构完整性和平衡扰动的皮质反应 需要功能来确定有跌倒风险的人并告知目标的发展 利用个人基本的大脑平衡概况的干预措施。达到这个长期目标，我们 将在慢性中风存活（n = 20）和神经型老年人（n = 20）中追求以下目标 较差的全身运动感知是否与较差的平衡功能有关； 2）确定是否 在平衡扰动期间诱发的皮质反应正在根据难度调节 区分平衡扰动； 3）测试感官中结构完整性的度量是否 途径和皮质反应潜伏期与平衡功能有关。据我们所知，这是第一个 使用多模式方法的研究来识别体感的脑平衡关系 功能行为期间的感知。如果成功，此类发现可能会导致现有的转变 康复干预措施集中在运动系统上，朝向感官的综合方法 和对运动的感知贡献。鉴于随着衰老的衰老风险增加而进一步增加 中风后，发展体感​​感知和平衡功能的结构和功能性生物标志物 确定有跌倒风险的人是必要的，并提高有效的，基于证据的人 康复干预措施。

项目成果

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
• 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。

• DOI: 10.1101/2023.08.22.554282
• 发表时间: 2023
• 期刊: bioRxiv : the preprint server for biology
• 作者: Mirdamadi,JasmineL;Ting,LenaH;Borich,MichaelR
• 通讯作者: Borich,MichaelR