STN Stimulation - Neural Control of Movement and Posture

STN 刺激 - 运动和姿势的神经控制

• 批准号: 7114429
• 负责人: Daniel M. Corcos
• 金额: $ 32.09万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-30 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7114429
• 关键词: Parkinson' s disease; basal ganglia; body movement; central nervous system stimulants; clinical research; electrodes; electroencephalography; electromyography; gait; human subject; human therapy evaluation; implant; magnetic resonance imaging; medical implant science; neuromuscular disorder; neurophysiology; neuroregulation; neurosurgery; outcomes research; performance; posture; statistics /biometry; thalamic nuclei

DESCRIPTION (provided by applicant): There are multiple parallel loops that connect the basal ganglia with various motor and cognitive circuits. High frequency stimulation of the subthalamic nucleus (STN) and dopaminergic medication dramatically improves the motor symptoms of Parkinson's disease. However, recent evidence suggests that STN stimulation can also have negative effects on speech and aspects of cognition. The long-range goal is to determine the effect of STN stimulation and medication on selected aspects of motor control in patients with Parkinson's disease six months following surgery and over the long term. The central hypothesis is that STN stimulation and medication act similarly for signs of Parkinson's disease that primarily involves motor pathways. STN stimulation and medication can have differential effects for tasks that include pathways involved in cognitive aspects of motor control. Aim 1 will determine the effects of STN stimulation and medication on tremor and rigidity during secondary tasks that increase the cognitive complexity of the task. The hypothesis is that STN stimulation will be less effective when a secondary cognitive task is used. Aim 2 will determine the effects of STN stimulation and medication on speech. The hypothesis is that STN stimulation will cause deterioration in speech intelligibility since multiple basal ganglia pathways are involved. Aim 3 determines the effects of STN stimulation and medication on internally guided limb force control. The hypothesis is that elbow force will be overestimated in the presence of STN stimulation because of a reduction in the activation of the anterior cingulate cortex. Aim 4 will determine the long-term effects of STN stimulation and medication on bradykinesia and tremor. The hypothesis is that STN stimulation and medication will still act through similar mechanisms, but that the absolute benefit will be reduced due to disease progression. These experiments will objectively quantify the efficacy of STN stimulation and medication for tremor, rigidity, bradykinesia, speech, and memory guided force control. Quantifying motor tasks that differ in their cognitive requirements will increase our understanding of both the positive and negative consequences of STN stimulation.

描述（由申请人提供）：有多个平行环将基底神经节与各种电动机和认知电路连接起来。丘脑下核（STN）和多巴胺能药物的高频刺激可显着改善帕金森氏病的运动症状。但是，最近的证据表明，STN刺激也会对言语和认知方面产生负面影响。远程目标是确定帕金森氏病在手术后六个月和长期长期来确定帕金森氏病患者的运动控制方面的影响。中心假设是，STN刺激和药物对主要涉及电动途径的帕金森氏病的迹象也相似。 STN刺激和药物可能对包括参与运动控制认知方面的途径的任务产生不同的影响。 AIM 1将确定STN刺激和药物对次级任务中震颤和刚性的影响，从而增加了任务的认知复杂性。假设是，当使用次级认知任务时，STN刺激将降低。 AIM 2将确定STN刺激和药物对语音的影响。假设是，由于涉及多个基底神经节途径，因此STN刺激会导致语音清晰度的恶化。 AIM 3决定了STN刺激和药物对内部引导肢体控制的影响。假设是，由于降低了前扣带回皮层的激活，肘部力将在存在性STN刺激的情况下被高估。 AIM 4将确定STN刺激和药物对Bradykinesia和Tremor的长期影响。假设是STN刺激和药物仍将通过类似的机制起作用，但是由于疾病进展，绝对益处将降低。这些实验将客观地量化STN刺激和药物对震颤，刚性，胸肌，语音和记忆力指导力控制的功效。量化其认知要求不同的运动任务将增加我们对STN刺激的正面和负面后果的理解。