Mechanisms of Motor Receovery after Subtotal Brain Injury

脑部次全损伤后运动恢复的机制

• 批准号: 7017020
• 负责人: ROBERT J MORECRAFT
• 金额: $ 32.12万
• 依托单位: UNIVERSITY OF SOUTH DAKOTA
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-02-15 至 2009-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7017020
• 关键词: Macaca mulatta; arm; behavior test; brain injury; disease /disorder model; experimental brain lesion; functional ability; limb movement; longitudinal animal study; neural plasticity; psychomotor function; pyramidal tracts; stroke

DESCRIPTION (provided by applicant): Stroke is the leading cause of functional disability affecting greater than 780,000 people a year in the United States. The negative personal, social and economic impacts of this disease are staggering. In clinical practice, it is a common observation that variable levels of motor recovery occur following damage of the motor cortex or its descending pathways. Although there appears to be considerable functional plasticity in the adult brain, the mechanisms underlying motor recovery following subtotal brain injury remain poorly understood. In adult rhesus monkeys, our major goal is to test the hypothesis that a central mechanism of functional recovery of arm movement occurs through reorganization of the corticospinal projection from intact cingulate motor areas located ipsilateral to a subtotal brain lesion. At clinically significant time intervals, we will test this hypothesis by studying neuroplastic adaptations of the corticospinal projection from the arm areas of the rostral (M3) and caudal (M4) cingulate motor cortices following isolated resection of the ipsilateral arm areas of a) the primary motor cortex (M1); b) M1 and dorsolateral area 6 (LPMCd) and; c) M1, LPMCd and the supplementary motor cortex (M2). The first two lesion categories model the most common form of stroke, namely middle cerebral artery infarction. Hand recovery will be carefully tracked by analyzing 3-D hand trajectory during reaching, force control during grasping and lifting, and monitoring functional hand performance using 2 specialized assessment methods. This project will lead to a greater understanding of the role of the cingulate motor cortices in the recovery process of arm movement following ipsilateral damage to the frontal motor cortices. This work will also assess whether the integrity of spared corticospinal projections from intact motor areas positioned ipsilateral to a lesion of the cerebral cortex underlie functional restitution of hand movement control and whether long-term reorganization of intact corticospinal terminals accompany the recruitment of parallel cortical motor areas after subtotal brain injury. We will determine the type of motor/premotor cortical lesion that activates natural (i.e., non-therapeutic) recruitment of the cingulate corticospinal system, the timing of the activation process and how this affects the reaching and grasping process. This information will assist in establishing predictors to identify a large patient population that may develop favorably after stroke since the origin of the cingulate corticospinal projection is supplied by the anterior cerebral artery (ACA) and the ACA is spared in greater than 97% of all first time ischemic stroke victims. Furthermore, it will assist in guiding creative rehabilitative intervention approaches aimed at enhancing anterior cingulate participation in the recovery process.

描述（由申请人提供）：中风是导致功能性残疾的主要原因，在美国每年影响超过 780,000 人。这种疾病对个人、社会和经济的负面影响是惊人的。在临床实践中，常见的观察结果是，运动皮层或其下行通路受损后，运动恢复水平会有所不同。尽管成人大脑似乎具有相当大的功能可塑性，但次全脑损伤后运动恢复的机制仍然知之甚少。在成年恒河猴中，我们的主要目标是检验这样的假设：手臂运动功能恢复的中心机制是通过位于次全脑病变同侧的完整扣带回运动区的皮质脊髓投射的重组而发生的。在临床上显着的时间间隔，我们将通过研究在分离切除 a) 原发同侧手臂区域后，头侧 (M3) 和尾侧 (M4) 扣带皮层的手臂区域的皮质脊髓投射的神经塑性适应性来检验这一假设。运动皮层（M1）； b) M1 和背外侧区域 6 (LPMCd) 和； c) M1、LPMCd 和辅助运动皮层 (M2)。前两种病变类别模拟了最常见的中风形式，即大脑中动脉梗塞。将通过分析伸手过程中的 3D 手部轨迹、抓握和举起过程中的力控制以及使用 2 种专门的评估方法监测手部功能表现来仔细跟踪手部恢复情况。该项目将有助于更好地了解扣带运动皮层在额叶运动皮层同侧损伤后手臂运动恢复过程中的作用。这项工作还将评估位于大脑皮层病变同侧的完整运动区的幸存皮质脊髓投射的完整性是否是手部运动控制功能恢复的基础，以及完整皮质脊髓末梢的长期重组是否伴随着平行皮质运动区的招募脑部次全损伤后。我们将确定激活扣带皮质脊髓系统自然（即非治疗性）募集的运动/前运动皮质损伤的类型、激活过程的时间以及这如何影响到达和抓握过程。该信息将有助于建立预测因子，以识别中风后可能发展良好的大量患者群体，因为扣带回皮质脊髓投射的起源是由大脑前动脉 (ACA) 提供的，并且在所有中风患者中，超过 97% 的患者都没有受到 ACA 的影响。时间缺血性中风患者。此外，它将有助于指导创造性的康复干预方法，旨在增强前扣带回对恢复过程的参与。