Cerebral networks of locomotor learning and retention in older adults

老年人运动学习和保留的大脑网络

• 批准号: 9918164
• 负责人: David J Clark
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-01 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9918164
• 关键词: Address; Age; Aging; Brain; Brain region; Cerebrum; Characteristics; Clinical; Complex; Consumption; Data; Effectiveness; Elderly; Enrollment; Future; Individual Differences; Intervention; Knowledge; Learning; Magnetic Resonance Imaging; Measures; Motor; Motor Skills; Neurologic; Participant; Performance; Physical Performance; Prefrontal Cortex; Publishing; Randomized; Recovery; Rehabilitation therapy; Research; Rest; Short-Term Memory; Structure; Task Performances; Time; Training; Veterans; Walking; Work; age related; base; cognitive function; cognitive task; cooking; cost; design; experience; gray matter; improved; intervention participants; motor learning; neuroimaging; neurological rehabilitation; neuroregulation; novel strategies; primary outcome; relating to nervous system; sedentary lifestyle; segregation; skills; walking rehabilitation; walking speed

Aging often leads to substantial declines in walking function, especially for walking tasks that are more complex such as obstacle crossing. This is due in part to a lack of continued practice of complex walking (sedentary lifestyle) combined with age-related deficits of brain structure and the integrity of brain networks. Neurorehabilitation can contribute to recovery of lost walking function in older adults, but major and persistent improvements are elusive. A cornerstone of neurorehabilitation is motor learning, defined as an enduring change in the ability to perform a motor task due to practice or experience. Unfortunately, in most clinical settings, the time and cost demands of delivering a sufficiently intensive motor learning intervention is not feasible. There is a need for research to develop strategies for enhancing motor learning of walking (“locomotor learning”) in order to improve the effectiveness of neurorehabilitation. The objective of this study is to use non-invasive brain stimulation to augment locomotor learning and to investigate brain networks that are responsible for locomotor learning in mobility-compromised older adults. We have shown that frontal brain regions, particularly prefrontal cortex, are crucial to control of complex walking tasks. Our neuroimaging and neuromodulation studies also show that prefrontal cortex structure and network connectivity are important for acquisition and consolidation of new motor skills. However, a major gap exists regarding learning of walking tasks. The proposed study is designed to address this gap. Our pilot data from older adults shows that prefrontal transcranial direct current stimulation (tDCS) administered during learning of a complex obstacle walking task contributes to multi-day retention of task performance. In the proposed study we will build upon this pilot work by conducting a full scale trial that also investigates mechanisms related to brain structure, functional activity, and network connectivity. We will address the following specific aims: Specific Aim 1: Determine the extent to which prefrontal tDCS augments the effect of task practice for retention of performance on a complex obstacle walking task. Specific Aim 2: Determine the extent to which retention of performance is associated with individual differences in baseline and practice-induced changes in brain measures (working memory, gray matter volume, task- based prefrontal activity, and brain network segregation). Specific Aim 3: Investigate the extent to which tDCS modifies resting state network segregation. We anticipate that prefrontal tDCS will augment retention of locomotor learning, and that our data will provide the first evidence of specific brain mechanisms responsible for locomotor learning/retention in older adults with mobility deficits. This new knowledge will provide a clinically feasible intervention approach as well as reveal mechanistic targets for future interventions to enhance locomotor learning and rehabilitation.

衰老通常会导致步行功能的大幅下降，尤其是对于步行任务而已 复杂的障碍物交叉。这部分是由于缺乏持续的复杂行走练习 （久坐的生活方式）结合了与年龄相关的大脑结构和大脑网络完整性的缺陷。 神经康复可能有助于恢复老年人失去的步行功能，但很持久 改进是难以捉摸的。神经居住的基石是运动学习，定义为持久 由于练习或经验而导致执行运动任务的能力改变。不幸的是，在大多数临床上 设置，提供足够密集的运动干预的时间和成本需求不是 可行的。有必要研究制定增强步行运动学习的策略 （“运动学习”），以提高神经居住的有效性。 这项研究的目的是利用非侵入性大脑刺激来增强运动学习和 研究在流动性强大的老年人中负责运动的大脑网络。 我们已经表明，额叶大脑区域，尤其是前额叶皮层，对于控制复合物至关重要 步行任务。我们的神经影像学和神经调节研究还表明，前额叶皮层结构和 网络连接对于获取和合并新运动技能很重要。但是，一个主要差距 关于学习任务的学习。拟议的研究旨在解决这一差距。我们的飞行员数据 从老年人中表明，在 学习复杂的障碍行走任务有助于多天的任务绩效保留。在 拟议的研究我们将通过进行全面试验来基于这项试点工作，该试验也调查了 与大脑结构，功能活动和网络连接有关的机制。我们将解决 遵循特定目的： 特定目的1：确定前额叶TDC在多大程度上增强任务实践的保留效果 在复杂的障碍行走任务上的性能。 特定目的2：确定绩效保留与个体差异有关的程度 在基线和实践引起的大脑测量变化中（工作记忆，灰质体积，任务 - 基于前额叶活动和大脑网络隔离）。 特定目标3：研究TDCS修改静息状态网络隔离的程度。 我们预计前额叶TDCS将增加运动性学习的保留，我们的数据将提供 负责老年人运动/保留率的特定大脑机制的第一个证据 移动性定义。这些新知识将提供临床上可行的干预方法，并揭示 未来干预措施的机械目标，以增强运动和康复。