Individual-specific engagement of cortical resources for standing balance control in aging and post stroke

个体特定的皮质资源参与衰老和中风后的站立平衡控制

• 批准号: 10641666
• 负责人: Michael Robert Borich
• 金额: $ 57万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-15 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10641666
• 关键词: Address; Affect; Age; Aging; Anatomy; Attention; Behavior; Behavioral; Biological Markers; Biomechanics; Biometry; Brain; Brain imaging; Clinical; Clinical assessments; Cognitive; Compensation; Data; Disease; Dissociation; Early Diagnosis; Elderly; Electrodes; Electroencephalography; Electromyography; Electrophysiology (science); Equilibrium; Fall prevention; Gait; Goals; Health; Human; Impairment; Individual; Intervention; Kinetics; Lateral; Leg; Lesion; Link; Longevity; Measures; Mediating; Methods; Motor; Muscle; Musculoskeletal Diseases; Neurologic; Neuromechanics; Orthopedics; Paresis; Performance; Phase; Prevention strategy; Publishing; Quality of life; Reaction; Resources; Risk Factors; Scientific Advances and Accomplishments; Sensory; Signal Transduction; Stroke; Surface; Testing; Translations; Walking; balance recovery; cognitive task; density; equilibration disorder; fall risk; functional MRI scan; improved; individual variation; innovation; leg paresis; nervous system disorder; neuromechanism; neuropathology; neurophysiology; novel; personalized intervention; personalized strategies; post stroke; precision medicine; prognostic tool; prospective; response; stroke rehabilitation; stroke survivor; young adult

Project Summary Our long-term goal is to identify neural mechanisms of healthy and impaired balance to guide mechanistically- based predictors, assessments, and interventions for addressing balance and gait impairments common in aging and neurological disorders. It is well-known clinically that engagement of cortical resources in balance control is an indicator of fall risk in older adults including stroke survivors, as inferred by the degradation of balance and/or gait performance when a concurrent cognitive task shifts attention away from balance control. A scientific barrier to improving prognostic tools, preventive strategies, and interventions for balance impairments is that we lack an understanding of how and when cortical resources are engaged in balance control, particularly with balance task difficulty. An innovation of our proposal is to identify direct, mechanistic measures of cortical activity during reactive balance. We will combine MPI Ting’s expertise in the neuromechanics of reactive balance control and MPI Borich’s expertise in human electrophysiology to identify relationships between brain activity and motor function to improve stroke rehabilitation. Our objective is to identify cortical activity signatures that distinguish individual-, task-, and group-level differences in the engagement of cortical resources for balance control amongst young adults (Aim 1), older adults (Aim 2), and older adults with unilateral lesions due to stroke (Aim 3). We will measure electroencephalographic (EEG), electromyographic (EMG), and biomechanical signals during reactive balance recovery to support-surface translations. We propose to use both clinically feasible electrode-based analysis approaches, as well as mechanistically-important anatomically-informed functional analyses using high-density EEG in combination with structural and functional MRI scans. We hypothesize that cortical activity signatures during balance control increase in an individual-, age-, and disease-specific manner as balance task difficulty increases. Within groups, we predict individual variability in cortical activity to be explained by balance challenge, i.e., balance task difficulty normalized to step threshold, a measure of balance function. However, between groups, we predict cortical activity signatures and their relation to balance challenge will differ. Our Aims are motivated by our preliminary data that show 1) increases in N1 and beta power over leg sensorimotor regions with balance task difficulty depend on balance function in young and older adults 2) opposite relationships between sensorimotor functional connectivity and balance task difficulty in younger vs. older adults; 3) distinct aspects of balance function associated with sensorimotor vs. prefrontal-motor connectivity in older adults; and 4) sensorimotor functional connectivity in stroke survivors associated with walking function. If successful, we will identify neurophysiological indicators of balance health that will be broadly applicable across the lifespan, and across neurological and orthopedic balance disorders to significantly advance the scientific framework to enable precision-medicine strategies for personalized, mechanistic assessments and interventions to improve quality of life those with poor balance health.

项目摘要 我们的长期目标是确定健康和受损平衡的神经机制，以机械指导 - 基于衰老中常见的平衡和步态障碍的基于基于的预测因素，评估和干预措施 和神经系统疾病。临床上众所周知，皮质资源参与平衡控制 是余额降解所推断的，包括中风存活在内的老年人的跌倒风险的指标 和/或步态性能时，当并发认知任务将注意力转移到平衡控制上时。科学 改善预后工具，预防策略和平衡障碍的干预措施的障碍是我们 缺乏对皮质资源如何以及何时参与平衡控制的了解，尤其是 平衡任务困难。我们建议的创新是确定皮质的直接机械措施 反应性平衡期间的活动。我们将在反应性的神经力学上结合MPI Ting的专业知识 平衡控制和MPI Borich在人类电生理学方面的专业知识，以识别大脑之间的关系 活动和运动功能以改善中风康复。我们的目标是确定皮质活动特征 这区分了个人，任务和群体级别的差异，以平衡皮质资源 在年轻人（AIM 1），老年人（AIM 2）和由于中风而具有单侧病变的老年人中的控制 （目标3）。我们将测量脑电图（EEG），肌电图（EMG）和生物力学信号 在反应性平衡恢复期间，向表面翻译。我们建议使用两种临床上可行的 基于电极的分析方法以及机械最重要的解剖功能 使用高密度脑电图与结构和功能性MRI扫描结合进行分析。我们假设这一点 平衡控制期间的皮质活动特定方式增加 随着平衡任务困难的增加。在组内，我们预测皮质活性的个体变异性 由平衡挑战（即，平衡任务困难到阶级阈值）的解释，衡量平衡 功能。但是，在小组之间，我们预测皮层活动的特征及其关系以平衡挑战 会有所不同。我们的目标是由我们的初步数据激励的，该数据显示1）N1和beta的力量增加 具有平衡任务困难的腿感觉运动区域取决于年轻人和老年人的平衡功能2） 感官功能连通性与平衡任务难度之间的相反关系在年轻人VS中。 老年人； 3）与感觉运动功能与前额叶运动相关的平衡功能的不同方面 老年人的连通性； 4）中风存活中的感觉运动功能连通性与 步行功能。如果成功，我们将确定平衡健康的神经生理学指标 适用于整个生命周期，以及神经和骨科平衡障碍，可显着 推进科学框架，以实现精密的医学策略来实现个性化机械 评估和干预措施，以改善健康状况不佳的生活质量。