Functional connectivity associated with motor recovery after internal capsule lesions

与内囊损伤后运动恢复相关的功能连接

基本信息

批准号：
10464388
负责人：
Shashank Amit Anand
金额：
$ 4.68万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-05-01 至 2024-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10464388
关键词：
Acute Address Adult Affect Animals Area Behavioral Bilateral Biology Blood Blood Vessels Brain Cause of Death Chronic Chronic Phase Clinical Collection Corticospinal Tracts Coupled Defect Devices Diffusion Electrodes Endothelin-1 Face Feedback Fiber Functional Magnetic Resonance Imaging Generations Goals Health Human Image Implant Industry Infarction Injury Internal Capsule Intervention Learning Lesion Limb structure Macaca Macaca mulatta Measurement Measures Mediating Medical Modeling Motor Motor Cortex Orthotic Devices Outcome Oxygen Paresis Patients Performance Phase Physiology Primates Quality of life Recovery Recovery of Function Rehabilitation device Rehabilitation therapy Residual state Rest Scanning Seeds Signal Transduction Stroke Survivors System Technology Testing arm base blood oxygen level dependent brain computer interface brain remodeling chronic stroke clinically relevant clinically significant efficacy validation functional outcomes graph theory gray matter haptic feedback improved injured insight motor function improvement motor function recovery motor impairment motor recovery nonhuman primate novel post stroke rehabilitation strategy response restoration robotic device stroke recovery stroke rehabilitation stroke survivor stroke therapy tool white matter

项目摘要

Project Summary Stroke survivors face significant long-term health consequences, with rehabilitation being essential to improve their recovery and quality of life. Currently, patients who do not restore motor function after 3-6 months are unlikely to show further recovery. Lesions with white matter tract involvement typically correlate with worse outcomes. For example, corticospinal tract lesions (CST) lesions produce worse motor deficiencies and portend poor functional recovery. Brain-computer interface mediated stroke rehabilitation (BCI-SR) can be a powerful rehabilitation tool. In BCI-SR, a patient learns to modulate localized brain activity that is recorded by electrodes. This can be used to control an orthosis to move the paretic limb. Most BCI systems utilize signals from affected hemisphere, attempting to drive plasticity in injured cortex. However, residual brain function after stroke limits BCI-SR efficacy, making ipsilesional BCI difficult to use in patients with the worst injuries. In humans, contralesional BCI-SR devices have used the uninjured hemisphere to drive further rehabilitation after the traditional plateau in motor function recovery. Clinical predictions of functional outcome after stroke are imprecise. Resting state functional connectivity (rsFC) measures the correlation of blood oxygen level-depending (BOLD) fluctuations at rest across the brain, providing a powerful tool to study brain network remodeling after stroke. However, human studies investigating brain remodeling after a stroke typically include patients with diverse lesions and do not have access to baseline measurements that allow rsFC comparison pre- and post-stroke. Animal studies could address both issues by enabling the generation of replicable, homogenous, and specific infarcts and by allowing collection of baseline measurements prior to infarct generation. There is also an absence of adequate animal studies characterizing rsFC changes associated with BCI rehabilitation strategies. Our project goal is to further characterize rsFC changes associated with CST lesions and test a BCI-mediated rehabilitation strategy after motor recovery plateaus. We will generate uniform lesions in the CST of six Rhesus macaques and after three months of natural recovery, drive contralesional BCI-SR. In each primate, we will collect resting-state functional MRI at baseline before lesioning, after CST lesioning, and during contralesional BCI-SR. We will then identify acute and chronic changes in rsFC that correspond with CST lesioning, innate recovery, and brain-computer-interface mediated rehabilitation. Through these approaches, we seek to validate the efficacy of a novel stroke rehabilitation strategy while providing insight into recovery-associated changes in rsFC.

项目概要中风幸存者面临严重的长期健康后果，康复对于改善健康状况至关重要他们的康复和生活质量。目前，3-6个月后运动功能未恢复的患者不太可能显示出进一步的复苏。累及白质束的病变通常与更糟糕的情况相关结果。例如，皮质脊髓束病变 (CST) 病变会导致更严重的运动缺陷并预示功能恢复不佳。脑机接口介导的中风康复（BCI-SR）可以成为一种强大的方法康复工具。在 BCI-SR 中，患者学习调节电极记录的局部大脑活动。这可用于控制矫形器来移动偏瘫肢体。大多数 BCI 系统利用受影响的信号半球，试图驱动受伤皮层的可塑性。然而，中风后的残余脑功能受到限制 BCI-SR 的功效使得同侧 BCI 难以用于损伤最严重的患者。在人类中，对侧 BCI-SR 设备使用未受伤的半球来推动术后的进一步康复运动功能恢复的传统平台期。中风后功能结果的临床预测是不精确的。静息态功能连接 (rsFC) 测量大脑休息时血氧水平依赖性 (BOLD) 波动的相关性，提供研究中风后大脑网络重塑的强大工具。然而，人类研究调查大脑中风后的重塑通常包括具有不同病变且无法获得基线的患者允许 rsFC 比较中风前后的测量。动物研究可以通过以下方式解决这两个问题能够生成可复制的、同质的和特定的梗塞，并允许收集基线梗塞发生前的测量。还缺乏足够的动物研究来表征 rsFC 的变化与 BCI 康复策略相关。我们的项目目标是进一步表征与 CST 病变相关的 rsFC 变化，并测试 BCI 介导的运动恢复平台期后的康复策略。我们将在六只恒河猴的 CST 中产生均匀的病变猕猴自然恢复三个月后，驱动对侧BCI-SR。在每一种灵长类动物中，我们都会在病变前、CST 病变后和对侧病变期间收集基线的静息态功能 MRI BCI-SR。然后，我们将识别与 CST 病变相对应的 rsFC 的急性和慢性变化，先天性恢复和脑机接口介导的康复。通过这些方法，我们试图验证一种新的中风康复策略的功效，同时提供与恢复相关的变化的见解 rsFC。