The Contribution of Eye-Hand Coordination Impairment to Functional Deficits in Stroke

眼手协调障碍对中风功能缺陷的影响

• 批准号: 10704112
• 负责人: John Ross Rizzo
• 金额: $ 25.12万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-13 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10704112
• 关键词: Abnormal coordination; Activities of Daily Living; Address; Affect; Area; Articular Range of Motion; Ataxia; Behavioral Paradigm; Brain; Caring; Clinical; Clinical assessments; Coupling; Data; Diffusion; Etiology; Eye; Eye Movements; Failure; Foundations; Future; Goals; Hand; Hand Strength; Hand functions; Impairment; Individual; Intervention; Knowledge; Lesion; Limb structure; Magnetic Resonance Imaging; Measurable; Measures; Mediating; Middle Cerebral Artery Infarction; Motor; Movement; Neuroanatomy; Paresis; Patients; Performance; Physical Rehabilitation; Process; Quality of life; Radial; Reaction Time; Recovery; Recovery of Function; Rehabilitation therapy; Research; Role; Saccades; Stroke; Structure; Survivors; System; Telephone; Testing; Time; Training; Translating; Translational Research; Upper Extremity; Visual; arm function; arm movement; direct application; disability; experience; eye hand coordination; functional independence; grasp; improved; limb movement; middle cerebral artery; motor deficit; motor impairment; motor recovery; neglect; neurological rehabilitation; oculomotor; post stroke; standard of care; stroke recovery; stroke rehabilitation; stroke survivor; tool; visual performance

PROJECT SUMMARY Current standard of care in post-stroke upper-limb motor training has measurably reduced impairment and increased both active range of motion and movement quality. However, such improvements rarely generalize to performance gains for activities of daily living and functional independence. One of the hallmarks of functional arm movement is the seamless integration of visual inputs and limb control, mediated by the ocular motor system. However, this important foundation of functional performance and recovery has not been incorporated into stroke rehabilitation. This gap exists because not enough is known about basic eye-hand coordination (EHC), associated neuroanatomy, and how EHC is affected by stroke. Our preliminary data provide strong evidence that specific eye-hand coordination deficits can result from MCA stroke. The eye-hand coordination system is currently not addressed in neurorehabilitation research or clinical rehabilitation because of a lack of understanding of the mechanisms that underlie this coordination and how such mechanisms may be affected by stroke. This proposal will examine the neuroanatomical foundations of eye-hand coordination and how these networks are affected by middle cerebral artery stroke. The results are expected to provide a foundation for improved understanding of eye-hand coordination in functional deficits and functional recovery, post-stroke. This advanced understanding should provide the basis for a line of translational research that will lead to new clinical assessments and interventions to address eye-hand coordination deficits in stroke survivors. This knowledge may, in turn, address the current gap between motor recovery and functional recovery in stroke survivors with eye-hand coordination dyscoordination (EHdC). Our primary hypotheses are that MCA stroke can produce deficits in EHC through damage to specific frontoparietal circuits, and that changes in these circuits can predict functional recovery following stroke. We will address these hypotheses through the following two Aims. In Aim 1, we will determine the contribution of EHdC to motor recovery and function in MCA stroke. Hypothesis: MCA stroke produces EHC deficits that interfere with functional upper-limb recovery and functional independence. Aim 2: To identify microstructural changes to frontoparietal networks related to motor recovery and EHdC in MCA stroke. Hypothesis: Microstructural integrity in MCA stroke will relate to dyscoordination (mistiming). The findings from this proposal will detail the functional neuroanatomy underlying eye-hand coordination, and the functional implications of lesions in this system to functional performance. This foundation of knowledge will provide for a translational line of research to determine contributions of eye-hand coordination to functional deficits and functional stroke recovery.

项目摘要 中风后上限运动训练中的当前护理标准可降低障碍和 提高了主动运动范围和运动质量。但是，这种改进很少概括 为日常生活和功能独立性活动的绩效增长。的标志之一 功能臂运动是视觉输入和肢体控制的无缝整合，由眼介导 电机系统。但是，功能性能和恢复的重要基础尚未 纳入中风康复。存在此差距，因为对基本眼睛的知之甚少 协调（EHC），相关的神经解剖学以及中风的影响。我们的初步数据 提供有力的证据表明，MCA中风可能导致特定的眼手配位缺陷。眼睛 目前在神经康复研究或临床康复中尚未解决协调系统，因为 缺乏对这种协调基础的机制以及这种机制如何可能的理解 受到中风的影响。该建议将检查眼手协调的神经解剖基础 以及这些网络如何受大脑中动脉中风的影响。结果预计将提供 改善对功能缺陷和功能恢复中眼手协调的理解的基础， 冲程后。这种先进的理解应该为一系列翻译研究提供基础 导致新的临床评估和干预措施，以解决中风的眼手协调不足 幸存者。这些知识反过来又可以解决电动机回收与功能性之间的当前差距 通过眼手协调dyscordination（EHDC）的中风幸存者的恢复。我们的主要假设是 MCA中风可以通过对特定的额叶电路损坏EHC中的缺陷，并且 这些电路的变化可以预测中风后的功能恢复。我们将解决这些假设 通过以下两个目标。在AIM 1中，我们将确定EHDC对运动回收的贡献 MCA中风的功能。假设：MCA中风会产生EHC缺陷，从而干扰功能上限 恢复和功能独立性。目标2：确定对额心网络的微观结构变化 与MCA中风中的运动恢复和EHDC有关。假设：MCA中风中的微观结构完整性将 与dyssoordination（Missiming）有关。该提案的发现将详细介绍功能性神经解剖学 基础眼手配位以及该系统病变对功能的功能含义 表现。知识的基础将提供转化的研究线，以确定 眼手协调对功能缺陷和功能中风恢复的贡献。