Cortical Plasticity after Hemispherectomy

大脑半球切除术后的皮质可塑性

• 批准号: 6964960
• 负责人: GARY W. MATHERN
• 金额: $ 18.49万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-08-15 至 2007-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6964960
• 关键词: adolescence (12-20); age difference; brain injury; cingulate gyrus; clinical research; developmental neurobiology; disease /disorder onset; exercise; functional ability; functional magnetic resonance imaging; gait; hemispherectomy; human subject; human therapy evaluation; middle childhood (6-11); motor cortex; muscle strength; neural plasticity; patient oriented research; postoperative state; preschool child (1-5); prognosis; psychomotor function; quality of life; rehabilitation; sensory cortex; young adult human (21-34)

DESCRIPTION (provided by applicant): In post-hemispherectomy children for seizure control, this proposal will examine motor and gait functions pre- and post- Body Weight Support Treadmill (BWST) training, and correlate changes from BWST training with functional MRI (fMRI) cortical activation from voluntary ankle movements. Our goals are to understand functional plasticity in the developing human brain by determining if age at injury/surgery, from specific pathologies, predicts baseline motor/gait functions and response to BWST training that can be used to design rehabilitation programs, using fMRI, that improve quality-of-life (QOL) for brain injured children. We hypothesize that injury/surgery from birth to 2 years maintains the developmental regulated ipsilateral corticospinal tract (ICS) that innervates ipsilateral muscles from primary motor/sensory (M1S1) cortex. By comparison, later injury/surgery, where the ICS tract has partially developmental regressed, will result in poorer functional recovery, especially for distal ankle/foot functions affecting walking. Based on Preliminary Data obtained from a Pilot Study we propose to determine if: 1) Age at injury/surgery related to pathology predicts motor and gait deficits pre- and post-hemispherectomy for proximal and distal muscles of the upper and lower limbs; 2) BWST training improves motor function and walking measures, if the changes are better in children with an early age at lesion/surgery, and if training induced walking and motor improvements are associated with better QOL measures; and 3) post-BWST gains of motor and walking function correlate with and increase in fMRI activation of M1S1 and cingulate cortex with ipsilateral and contralateral foot dorsiflexion consistent with cortical plasticity involving preservation of the ICS tract. The results of this research will have a conceptual impact regarding concepts of cortical plasticity in the developing human brain: and has practical application for neurorehabilitation in children post-hemispherectomy and for those with other forms of early developmental cerebral injury, such as trauma, hemorrhage, and tumors.

描述（由申请人提供）：在肺炎后切除术儿童进行癫痫发作的儿童中，该提案将检查运动前和步态功能，体重和后体重支持跑步机（BWST）训练，并将BWST训练与功能性MRI（FMRI）的变化相关联（FMRI）的皮质激活。我们的目标是通过确定受伤/手术时的年龄是否从特定的病理学来预测基线运动/步态/步态功能以及对BWST训练的反应，该功能是否可以使用fMRI来设计康复计划，从而改善大脑受伤儿童的生活质量（QOL）。我们假设从出生到2年的损伤/手术维持了发育调节的同侧皮质脊髓束（ICS），该皮层（ICS）从原发性运动/感觉（M1S1）皮质中支配了同侧肌肉。相比之下，后来的伤害/手术（ICS道部分发育后，会导致功能恢复较差，尤其是针对影响步行的远端踝关节功能。根据从试点研究获得的初步数据，我们建议确定：1）与病理学相关的损伤/手术年龄预测运动前和静脉后切除术前后近端和下肢近端肌肉的缺陷； 2）BWST训练可以改善运动功能和步行措施，如果病变/手术年龄较早的儿童的变化更好，并且如果训练引起的步行和运动改善与更好的QOL措施有关； 3）BWST的运动后增长和步行功能与M1S1的fMRI激活相关，并增加了与涉及ICS段的皮质可塑性一致的同侧和对侧足背面的扣带回皮层。这项研究的结果将对发展中大脑的皮质可塑性的概念产生概念上的影响：在眼膜后切除术后儿童以及患有其他形式的早期发育性大脑损伤的人，例如创伤，出血和肿瘤。