Surgical and Rehabilitative Management of Facial Nerve Injury

面神经损伤的手术和康复治疗

• 批准号: 9177513
• 负责人: THERESA A HADLOCK
• 金额: $ 62.99万
• 依托单位: MASSACHUSETTS EYE AND EAR INFIRMARY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9177513
• 关键词: Address; Algorithms; Animals; Biocompatible; Blinking; Clinical; Contralateral; Coupled; Coupling; Custom; Data; Devices; Digital Signal Processing; Distal; Electric Stimulation; Electrodes; Eyelid structure; Face; Facial Expression; Facial Muscles; Facial Nerve Injuries; Facial nerve structure; Facial paralysis; Frequencies; Generations; Goals; Human; Implant; Joints; Knowledge; Link; Longitudinal Studies; Measures; Modeling; Motion; Motor Neurons; Movement; Muscle; Myopathy; Natural regeneration; Nerve; Nerve Block; Nerve Regeneration; Nerve Transfer; Neuropathy; Operative Surgical Procedures; Paralysed; Physiological; Polymers; Process; Rehabilitation therapy; Research; Rodent; Rodent Model; Side; Signal Transduction; Smiling; Source; Speech; Stimulus; System; Telemetry; Testing; Time; Tissues; United States; Vibrissae; awake; clinically relevant; design; disability; effective therapy; expectation; implantation; mathematical model; neural stimulation; neuroprosthesis; novel; novel strategies; prevent; relating to nervous system

Project Summary The long-term goal of our research is to investigate mechanisms to restore and optimize facial movement in cases of facial paralysis. The specific goal of the proposed research is to develop and study the long-term feasibility of a functional electrical stimulation (FES) paradigm to restore dynamic symmetrical facial motion in a rodent model of unilateral facial palsy (UFP). We will utilize conductive polymer electrode arrays to detect normal rodent facial muscle EMG activity on one side of the face, and nerve cuff electrodes to evoke contralateral-side corresponding muscle activity. We will couple the two systems via an implantable signal acquisition and generation platform, and anticipate that digital signal processing can be applied to trigger near- simultaneous and symmetric facial movement in rodents with UFP. We will begin by establishing the relationship between EMG activity and normal rodent facial movement, and the relationship between neural stimulation and evoked facial movements, under the hypothesis that there exists a mathematical model that links electrical and functional data. We will then construct a control algorithm for online processing of EMG input signals to drive FES, to examine the hypothesis that it is possible to subjugate the movements on one side of the face to normal movements on the opposite side. Importantly, we will also introduce proximal neural blockade on the subjugated side in order to prevent undesired physiologic activation of the facial musculature, to mimic clinically relevant scenarios for the application of these devices. Finally, we plan to implement the FES paradigm using a novel implantable neuroprosthetic device powered through inductive coupling, and demonstrate that neither the device, the presence of electrodes, nor the application of electrical stimulation induces neuropathy or myopathy in the long term. Knowledge gained from this research would be of immediate impact to the implementation of an analogous system in humans suffering from UFP, and provide significant impetus for the re-establishment of motor-neuron input to preserve native facial musculature following severe facial nerve injury. Furthermore, the novel approach proposed here could be applied to other clinical scenarios – such as functional muscle and nerve transfers – where poor control and undesirable physiologic activation of a muscle occurs.

项目摘要 我们研究的长期目标是调查恢复和优化面部的机制 在面部瘫痪的情况下运动。拟议研究的具体目标是发展 并研究功能电刺激（FES）范式的长期可行性以恢复 单方面面对麻痹（UFP）的啮齿动物模型中的动态对称面部运动。我们将 利用导电聚合物电极阵列来检测正常的啮齿动物面部肌肉EMG活性 在面部的一侧和神经袖口电极以唤起对侧对应 肌肉活动。我们将通过可植入的信号获取来对两个系统进行综述，并 生成平台，并预计可以应用数字信号处理来触发接近 - 用UFP同时进行对称的面部运动。我们将从 建立EMG活动与正常啮齿动物面部运动之间的关系，以及 在假设下，神经刺激与诱发面部运动之间的关系 存在将电气和功能数据链接的数学模型。然后我们会 构建一种控制算法，用于在线处理EMG输入信号以驱动FES，到 检查可以将面部一侧的运动征服的假设 另一侧的正常运动。重要的是，我们还将引入中性近端 为了防止面部的封锁一侧的封锁，以防止脱离面部的生理激活 肌肉组织，以模仿临床上相关的情景以应用这些设备。最后， 我们计划使用一种新型的可植入神经假体装置实现FES范式 通过电感耦合供电，并证明设备都不存在 电极以及电气模拟的应用也诱导神经病或肌病 长期。从这项研究中获得的知识将对 在患有UFP的人类中实施类似系统，并提供重要的 推动重新建立运动神经元输入以保留本地面部肌肉组织 严重的面神经损伤。此外，这里提出的新方法可能是 应用于其他临床方案（例如功能性肌肉和神经转移） 肌肉的控制和不良生理激活发生。