Novel brain stimulation to enhance stroke recovery

新型脑刺激可促进中风康复

• 批准号: 6801828
• 负责人: ESTEBAN A FRIDMAN
• 金额: $ 5.4万
• 依托单位: INSTITUTE OF NEUROLOGICAL RESEARCH
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-30 至 2006-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6801828
• 关键词: South America; biomechanics; brain electronic stimulator; clinical research; clinical trials; electromyography; functional ability; human subject; human therapy evaluation; limb movement; longitudinal human study; medical rehabilitation related tag; motor cortex; neurophysiology; patient oriented research; physical therapy; rehabilitation; stroke; stroke therapy; transcranial magnetic stimulation

DESCRIPTION (provided by applicant) This proposal is concerned with recovery of motor function following brain damage after a cerebrovascular infarct. Though functional reorganization has been shown within the premotor cortex following recovery after stroke, we still known relative little about whether these changes can be enhanced during the neurorehabilitative period if special designed techniques, that stimulate the premotor cortex, are applied. Basic research studies have suggested an increase activity of the premotor cortex during conditional motor learning and during reaching and grasping an object. Therefore, we designed a conditional reaching and grasping motor training to indirectly stimulate this area of the brain in stroke patients during the recovery process. Moreover, increases of cortical activity and corticospinal excitability have followed trains of repetitive transcranial magnetic stimulation in humans. Thus, we designed a scheme of repetitive transcranial magnetic stimulation to directly stimulate the premotor cortex in stroke patients during the neurorehabilitative period. The aim of this proposal is to evaluate the efficacy of these two novel stimulation techniques, supported by neural basis, to enhance motor recovery after stroke. We designed two parallel independent prospective, single-blind, randomize, controlled trials in which we will objectively evaluate behavioral and kinematics changes during motor performance and correlate them with neurophysiological analysis. A voluntary reach-retrieval- delivery task that is an important component of the daily life will be used for the assessment. The proposed work promises to contribute important new insight into the field of therapeutic modalities that can be used to increase motor recovery after stroke. In addition, it will provide some insight into mechanisms underlying such recovery. Since stroke is the leading cause of motor disabilities this work has a clear clinical relevance.

描述（由申请人提供） 该建议与脑梗塞后脑损伤后的运动功能恢复有关。尽管中风后恢复后的恢复后的前皮层中已经显示了功能重组，但我们仍然对在神经居住期是否可以增强这些变化（如果特殊设计的技术）刺激前型皮层（刺激过前的皮层）的相对相对了解。基础研究表明，在条件运动学习期间以及触及和掌握物体期间，前皮层的活性增加。因此，我们设计了一个有条件的触及运动训练，以在恢复过程中间接刺激中风患者的大脑区域。此外，皮质活性和皮质脊髓兴奋性的增加遵循了人类重复的经颅磁刺激的列车。因此，我们设计了一种重复的经颅磁刺激方案，以直接刺激神经居住期的中风患者中的前皮层。 该提案的目的是评估这两种由神经基础支持的新型刺激技术的功效，以增强中风后运动的恢复。我们设计了两个平行的独立前瞻性，单盲，随机，对照试验，在运动性能过程中，我们将客观地评估行为和运动学变化，并将它们与神经生理学分析相关联。作为日常生活中重要组成部分的自愿触及回归交付任务将用于评估。 拟议的工作有望为治疗方式领域提供重要的新见解，这些洞察力可用于增加中风后运动恢复。此外，它将对这种恢复的基础机制提供一些洞察力。由于中风是运动障碍的主要原因，因此该工作具有明显的临床意义。

项目成果

Kinematic improvement following Botulinum Toxin-A injection in upper-limb spasticity due to stroke.

注射 A 型肉毒杆菌毒素治疗中风导致的上肢痉挛后运动改善。

• DOI: 10.1136/jnnp.2009.188052
• 发表时间: 2010
• 期刊: Journal of neurology, neurosurgery, and psychiatry
• 作者: Fridman,EstebanA;Crespo,Marcos;GomezArgüello,Santiago;Degue,Lorena;Villarreal,Mirta;Bohlhalter,Stephan;Wheaton,Lewis;Hallett,Mark
• 通讯作者: Hallett,Mark