Sensorimotor integration underlying hand control in Carpal Tunnel Syndrome

腕管综合症中手部控制的感觉运动整合

• 批准号: 7523938
• 负责人: MARCO SANTELLO
• 金额: $ 27.25万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-30 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7523938
• 关键词: Address; Adult; Affect; Age; Behavior; Carpal Tunnel Syndrome; Clinical; Complex; Data; Digit structure; Disease; Drops; Ensure; Feedback; Fingers; Freedom; Friction; Gender; Hand; Hand functions; Impairment; Individual; Knowledge; Lateral; Lead; Learning; Left; Location; Manuals; Maps; Measures; Medial; Memory; Modeling; Motor; Muscle; Musculoskeletal Diseases; Nerve; Neurologic; Neuromuscular Diseases; Neuropathy; Neurosciences; Numbers; Outcome; Patient Self-Report; Patients; Performance; Population; Process; Property; Public Health; Quality of life; Randomized; Relative (related person); Research; Research Proposals; Ring Finger Domain; Role; Sensory; Severities; Skeletal system; Spatial Distribution; Surface; Syndrome; Tactile; Testing; Texture; Thumb structure; United States; Visual; Weight; clinical application; concept; design; grasp; improved; indexing; insight; lifetime risk; median nerve; motor control; motor deficit; pressure; receptor; response; sensory feedback; size; somatosensory

DESCRIPTION (provided by applicant): Effective control of object grasping and manipulation relies on the ability to adjust forces of individual digits to the properties of the object being grasped such as its weight, center of mass or texture. These adjustments rely on (a) detecting object properties through sensory feedback derived primarily from receptors in the fingertips and hand muscles and (b) integrating this feedback with activation of hand muscles appropriate for grasping and manipulation. However, the fine tuning of hand muscle activity to object properties can be disrupted by a number of neurological and musculo-skeletal diseases such as Carpal Tunnel Syndrome (CTS). This compresion neuropathy of the median nerve is one of the most common and debilitating diseases affecting hand function. CTS results in self-reported loss of manual dexterity (e.g., difficulties with fine manipulation, dropping objects, etc.) which is due to somatosensory deficits in the thumb, index, middle and lateral half of the ring finger, and, in severe cases, motor deficits in the thumb. As whole- hand grasping require sensing object properties from all digits to accurately adjust their forces, the study of CTS offers a unique opportunity to improve our understanding the mechanisms underlying sensorimotor integration during whole-hand grasping and manipulation. This primary objective will be pursued by using CTS as a research model to address these important questions of sensorimotor control of grasping. An additional secondary objective is to use the results of the proposed research to improve our understanding of the extent to which increasing impairment in nerve function affects sensorimotor transformations necessary for learning and executing specific aspects of skilled object manipulation. We will pursue two Specific Aims: (1) to quantify the extent to which patients with CTS are able to coordinate all digit forces and contact points when altering object properties (center of mass, weight and texture) and their predictability during five-digit grasping; and (2) to determine the extent to which patients with CTS are able to coordinate digit forces as a function of the number of digits (two, three, four, and five) involved in the grasp. In both Aims, multi-dimensional measures of grasp control from patients with mild and moderately severe CTS will be compared with those obtained from age- and gender-matched healthy controls. PUBLIC HEALTH RELEVANCE. The objectives of the proposed research are relevant to public health as they address a debilitating neuromuscular disease of the hand, Carpal Tunnel Syndrome (CTS), that affects the quality of life in 6 to 14 million adults in the United States. We propose to use CTS as a model to improve our understanding of the mechanisms underlying sensorimotor integration responsible for skilled object manipulation. The knowledge gained through our proposed research will provide significant insight into how electrodiagnostic measures of nerve function relate to specific aspects of grasp control, thus improving the interpretability and applications of these clinical measures.

描述（由申请人提供）：对物体抓取和操纵的有效控制依赖于根据被抓取物体的属性（例如其重量、质心或纹理）调整各个手指的力的能力。这些调整依赖于（a）通过主要来自指尖和手部肌肉中的感受器的感觉反馈来检测物体特性，以及（b）将该反馈与适合抓握和操作的手部肌肉的激活相结合。然而，手部肌肉活动对物体属性的微调可能会受到许多神经系统和肌肉骨骼疾病的干扰，例如腕管综合症（CTS）。这种正中神经的压迫性神经病是影响手功能的最常见和衰弱的疾病之一。 CTS 导致自我报告的手动灵活性丧失（例如，精细操作困难、掉落物体等），这是由于拇指、食指、无名指的中指和外侧半部的体感缺陷，并且在严重的情况下，拇指运动缺陷。由于全手抓取需要从所有手指感知物体属性来准确调整其力量，因此 CTS 的研究提供了一个独特的机会来提高我们对全手抓取和操作过程中感觉运动整合的机制的理解。这一主要目标将通过使用 CTS 作为研究模型来解决抓取的感觉运动控制的这些重要问题来实现。另一个次要目标是利用所提出的研究结果来提高我们对神经功能损伤的增加在多大程度上影响学习和执行熟练物体操作的特定方面所必需的感觉运动转换的程度的理解。我们将追求两个具体目标：（1）量化 CTS 患者在改变物体属性（质心、重量和纹理）时能够协调所有手指力和接触点的程度及其在五位数抓取过程中的可预测性; (2) 确定 CTS 患者能够协调手指力量的程度，作为参与抓握的手指数量（两个、三个、四个和五个）的函数。在这两个目标中，轻度和中度重度 CTS 患者的掌握控制多维测量将与年龄和性别匹配的健康对照获得的测量进行比较。公共卫生相关性。 拟议研究的目标与公共卫生相关，因为它们涉及一种使人衰弱的手部神经肌肉疾病，即腕管综合症 (CTS)，该疾病影响美国 6 至 1400 万成年人的生活质量。我们建议使用 CTS 作为模型来提高我们对负责熟练物体操作的感觉运动整合基础机制的理解。通过我们提出的研究获得的知识将为神经功能的电诊断测量如何与抓握控制的特定方面相关提供重要的见解，从而提高这些临床测量的可解释性和应用。