Effects of Parkinson's Disease on Perception, Cognition, and Gait

帕金森病对知觉、认知和步态的影响

基本信息

批准号：
7770253
负责人：
Alice Cronin-Golomb
金额：
$ 65.18万
依托单位：
BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-30 至 2014-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7770253
关键词：
Adult Affect Area Attention Basal Ganglia Behavioral Brain Clinical Cognition Cognitive Comprehension Contralateral Contrast Sensitivity Corpus striatum structure Diagnosis Diagnostic Discipline Ensure Environment Esthesia Freezing Functional Magnetic Resonance Imaging Functional disorder Gait Gait abnormality Goals Hallucinations Handedness Image Imaging Techniques Impaired cognition Impairment Individual Kinesiology Lateral Lead Left Literature Marshal Measures Moods Motor National Institute of Neurological Disorders and Stroke Nerve Degeneration Neuropsychological Tests Neuropsychology Parkinson Disease Patient Self-Report Patients Perception Performance Process Psychometrics Psychophysiology Quality of life Relative (related person)Reporting Research Research Personnel Review Literature Role Scientist Side Sleep Source Structure Subgroup Symptoms Testing Translations Vision Visual Visual Fields Visual Psychophysics Visuospatial clinically relevant cognitive neuroscience daily functioning motor impairment neuroimaging neuropsychological patient oriented public health relevance relating to nervous system visual process visual processing visual stimulus

项目摘要

DESCRIPTION (provided by applicant): Non-motor aspects of Parkinson's disease (PD) such as deficient sensation, perception, and cognition are a source of a significant decline in everyday function and quality of life. Among the most important of daily functions that is affected in PD is visuospatial ability, which enables the perceptual and cognitive comprehension and navigation of the visual environment. Deficits in this domain arise from pathological changes in high-order association areas of the brain as well as from defective input from more basic visual processing areas, reflecting dysfunction of specific aspects of corticostriatal loops. Of potential importance to understanding the visuospatial sequelae of PD is consideration of the side of initial motor impairment, as PD nearly always has unilateral onset of neurodegeneration, and the right hemisphere is especially engaged in many aspects of visuospatial processing. We aim to define the relation between basic vision and visuospatial problems in PD and to examine underlying neural changes. In particular, we aim to elucidate the causal role of specific corticostriatal structures in visuospatial cognition and to define functional connectivity between specific cortical areas and striatal regions. We hypothesize, first, that cognitive impairments in PD reflect dysfunction in corticostriatal loops involving the rostrodorsal caudate. Second, we hypothesize that side of motor symptom onset as well as hemifield presentation of visual stimuli predict the hemispheric laterality of hypoactivation in corticostriatal loops, with stronger effects for patients with onset on the left body side (LPD) (right basal ganglia) and for left visual hemifield presentation. Our third focus is on the relation of visual and visuospatial impairments to daily function, including gait, motoric freezing, subjective quality of life, hallucinations, mood and other patient-centered features of PD. To accomplish our goals, we will marshal the expertise of scientists from complementary disciplines, including neuropsychology, visual psychophysics, cognitive neuroscience and neuroimaging, and clinical movement science. Our proposed fMRI studies provide a direct test of the hypothesis that dysfunction in specific components of corticostriatal loops, especially frontostriatal and parietostriatal loops, underlie problems on specific visuospatial and visuocognitive tasks in PD. As most cortical regions are connected with the striatum, the studies will fill a significant gap in understanding the likely ubiquitous role of corticostriatal circuits in cognition. The application of psychophysical, cognitive and imaging techniques that could predict the integrity of higher-level cognitive and daily functions in PD will be useful clinically, enabling the identification of potential spatial problems for the patient at diagnosis. Our tests target visual, visuospatial, and functional symptoms reported by the patients themselves, ensuring that the elucidation of mechanisms will have clinical relevance. PUBLIC HEALTH RELEVANCE: A principal goal of the proposed project is to relate the neuroimaging, cognitive, and psychometric findings with patient-centered features of PD, including gait abnormalities and motor freezing, subjective quality of life, visual complaints, hallucinations, mood, and self-reported sleep quality. We plan to bridge the psychometric, cognitive and imaging findings to the functional measures, which we expect will lead to translations to diagnostic and management strategies. If visuospatial differences between PD subgroups (such as left and right symptom onset) distinguish their performance on functional measures, then we should target the more affected subgroup with information on what to expect and how best to manage the symptoms that are part of that subgroup's profile.

描述（由申请人提供）：帕金森氏病（PD）的非运动方面，例如不足的感觉，感知和认知是日常功能和生活质量显着下降的根源。在PD中受到影响的每日功能中最重要的功能之一是视觉空间能力，这使视觉环境具有感知和认知的理解和导航。该领域的缺陷源于大脑高阶区域的病理变化以及来自更基本的视觉处理区域的缺陷输入，这反映了皮质纹状体环的特定方面的功能障碍。对于理解PD的视觉空间后遗症的潜在重要性是考虑初始运动障碍的一侧，因为PD几乎总是具有神经变性的单侧发作，并且右半球尤其参与了视觉整体处理的许多方面。我们旨在定义PD中基本视力与视觉空间问题之间的关系，并检查基本的神经变化。特别是，我们旨在阐明特定皮质纹状体结构在视觉空间认知中的因果作用，并定义特定皮质区域和纹状体区域之间的功能连通性。我们首先假设PD中的认知障碍反映了涉及尾尾的皮质纹状体环的功能障碍。其次，我们假设运动症状发作的那一侧以及视觉刺激的半场表现预测皮质纹状体环中低温激活的半球横向性，对左身体发作的患者（LPD）（右基底神经节）以及对左侧的患者（右基底神经节）以及对患者的影响更强。左视觉半场演示。我们的第三个重点是视觉和视觉空间障碍与日常功能的关系，包括步态，摩托车冻结，主观生活质量，幻觉，情绪，情绪和其他以患者为中心的特征。为了实现我们的目标，我们将从互补学科的科学家那里纳入包括神经心理学，视觉心理物理学，认知神经科学和神经影像学以及临床运动科学的专业知识。我们拟议的功能磁共振成像研究提供了直接检验的假设，即皮质纹状体环的特定组成部分的功能障碍，尤其是额叶和层状纹状体环，这是PD中特定视觉空间和视觉认知任务的问题。由于大多数皮质区域都与纹状体有关，因此研究将填补显着的空白，以理解皮质纹状体回路在认知中的无处不在作用。可以预测PD中高级认知和每日功能的完整性的心理物理，认知和成像技术的应用将在临床上有用，从而使患者在诊断时可以鉴定潜在的空间问题。我们的测试针对患者本身报告的视觉，视觉空间和功能症状，以确保机制的阐明将具有临床相关性。公共卫生相关性：拟议项目的主要目标是将神经成像，认知和心理测量结果与以患者为中心的PD特征联系起来，包括步态异常和运动冻结，主观的生活质量，视觉申诉，幻觉，情绪，情绪和情绪，情绪和情绪，情绪和情绪，情绪和情绪自我报告的睡眠质量。我们计划将心理测量，认知和成像发现桥接到功能措施上，我们期望这将导致转化为诊断和管理策略。如果PD亚组之间的视觉空间差异（例如左和右症状发作）会区分其在功能措施上的表现，那么我们应该以有关期望的信息以及如何最好地管理该亚组概况一部分的症状的信息来定位。。