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）：对物体抓握和操纵的有效控制依赖于将单个数字的力调整到被抓住的物体属性的能力，例如其重量，质量或质地中心或纹理。这些调整依赖于（a）通过主要来自指尖和手动肌肉中受体得出的感觉反馈来检测对象特性，以及（b）将这种反馈与适合抓握和操纵的手动肌肉的激活相结合。但是，手动肌肉活动对物体特性的微调可能会被许多神经系统和肌肉骨骼疾病（例如腕管综合征（CTS））破坏。这种中位神经的这种综合神经病是影响手功能的最常见和令人衰弱的疾病之一。 CTS会导致手动敏捷性丧失（例如，操纵精细，掉落物体等的困难），这是由于拇指，索引，中间和侧向的拇指，索引，中半部和侧向的体感缺陷引起的，在严重的情况下，拇指中的运动缺陷。由于全手抓握需要所有数字的传感对象属性以准确调整其力，因此对CTS的研究为整个手抓握和操纵期间的感觉运动集成的机制提供了独特的机会。将通过使用CTS作为研究模型来解决这些主要目标的主要目标，以解决有关握把的感觉运动控制的重要问题。另一个次要目标是利用拟议研究的结果来提高我们对神经功能障碍的障碍的程度的理解，这会影响学习和执行熟练对象操纵的特定方面所需的感觉运动转换。我们将追求两个具体的目标：（1）量化CT患者在更改对象性能（质量，体重和质地中心）时能够协调所有数字力和接触点的程度，以及在五位数抓住期间的可预测性； （2）确定CT患者能够在多大程度上能够协调数字力与掌握的数字数量（两个，三个，四个，四个和五个）的函数。在这两个目标中，将比较轻度和中等严重CT患者的GRASP对照的多维测量，将与年龄和性别匹配的健康对照者获得的掌握。公共卫生相关性。 拟议的研究的目标与公共卫生有关，因为它们解决了腕管综合征（CTS）的令人衰弱的神经肌肉疾病，该疾病影响了美国6至1400万成年人的生活质量。我们建议使用CTS作为模型，以提高我们对负责熟练对象操作的感觉运动集成的机制的理解。通过我们提出的研究获得的知识将为神经功能的电诊断量度与GRASP控制的特定方面相关，从而提高这些临床指标的可解释性和应用。