Cortical Plasticity after Hemispherectomy

大脑半球切除术后的皮质可塑性

基本信息

批准号：
7140373
负责人：
GARY W. MATHERN
金额：
$ 16.03万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-08-15 至 2008-07-31
项目状态：
已结题

项目摘要

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）：对于用于控制癫痫发作的大脑半球切除术后儿童，本提案将检查体重支持跑步机 (BWST) 训练前后的运动和步态功能，并将 BWST 训练的变化与功能性 MRI (fMRI) 相关联随意踝关节运动引起的皮质激活。我们的目标是通过确定受伤/手术时的年龄（根据特定的病理学）是否可以预测基线运动/步态功能和对 BWST 训练的反应来了解发育中的人类大脑的功能可塑性，这些功能可用于设计康复计划，使用功能磁共振成像，改善脑损伤儿童的生活质量（QOL）。我们假设从出生到 2 岁的损伤/手术维持了发育调节的同侧皮质脊髓束 (ICS)，其支配初级运动/感觉 (M1S1) 皮层的同侧肌肉。相比之下，后期受伤/手术时，ICS 束部分发育退化，将导致功能恢复较差，尤其是影响行走的远端踝/足功能。根据从试点研究中获得的初步数据，我们建议确定：1）与病理学相关的受伤/手术时的年龄可以预测上肢和下肢近端和远端肌肉在半球切除术前后的运动和步态缺陷； 2) BWST 训练可以改善运动功能和步行测量，如果病变/手术时年龄较小的儿童的变化更好，并且训练引起的步行和运动改善与更好的生活质量测量相关； 3) BWST 后运动和行走功能的增强与 M1S1 和扣带皮层的 fMRI 激活相关并增加，同侧和对侧足背屈与涉及 ICS 束的皮质可塑性一致。这项研究的结果将对人类大脑发育中的皮质可塑性概念产生概念性影响：并且对于大脑半球切除后儿童的神经康复以及患有其他形式的早期发育性脑损伤（例如创伤、出血、和肿瘤。