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）：有多个并行环路将基底神经节与各种运动和认知回路连接起来。丘脑底核 (STN) 的高频刺激和多巴胺能药物可显着改善帕金森病的运动症状。然而，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。长期目标是确定 STN 刺激和药物对帕金森病患者术后六个月和长期运动控制选定方面的影响。核心假设是，STN 刺激和药物治疗对主要涉及运动通路的帕金森病症状的作用相似。 STN 刺激和药物治疗可能对任务产生不同的影响，包括涉及运动控制认知方面的途径。目标 1 将确定 STN 刺激和药物对次要任务期间震颤和僵硬的影响，从而增加任务的认知复杂性。假设是，当使用次要认知任务时，STN 刺激的效果会降低。目标 2 将确定 STN 刺激和药物治疗对言语的影响。假设 STN 刺激会导致言语清晰度恶化，因为涉及多个基底神经节通路。目标 3 确定 STN 刺激和药物对内部引导肢体力控制的影响。假设是在 STN 刺激的情况下，由于前扣带皮层的激活减少，肘部力量会被高估。目标 4 将确定 STN 刺激和药物治疗对运动迟缓和震颤的长期影响。假设 STN 刺激和药物治疗仍将通过类似的机制发挥作用，但绝对益处将因疾病进展而减少。这些实验将客观量化 STN 刺激和药物治疗对震颤、强直、运动迟缓、言语和记忆引导力控制的功效。量化不同认知需求的运动任务将增加我们对 STN 刺激的积极和消极后果的理解。