The Role of the Cortex in Discoordination After Stroke

皮质在中风后协调障碍中的作用

基本信息

批准号：
7569034
负责人：
JULIUS P DEWALD
金额：
$ 20.7万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-05-20 至 2011-02-28
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): Loss of independent control of joint movement in the impaired limb is a cardinal sign of stroke that is expressed in the form of stereotypic multi-joint movement patterns. Work from our laboratory has produced evidence for a loss of certain muscle coactivation patterns and associated abnormal shoulder/elbow torque coupling in the paretic arm of individuals with hemiparetic stroke. The general aim of this proposal is to elucidate the role of sensorimotor cortices in the loss of independent joint control of the paretic upper limb following stroke. We propose to study 20 individuals with chronic stroke and 20 control subjects to identify and quantify the characteristics of sensorimotor cortical activity related to the generation of isometric shoulder abduction/adduction and elbow flexion/extension torques. We hypothesize that an increased overlap of sensorimotor cortical activity is present in individuals with stroke (Aim 1). This aim will be realized using a 6 degree of freedom (DOF) load cell to provide simultaneous measurements of elbow and shoulder torques while measuring EEC from 163 scalp sites and EMG from 10 muscles in each arm. We postulate and have provided preliminary evidence for a significant overlap between cortical activity related to shoulder abduction and elbow flexion torque generation in chronic stroke subjects while not in able-bodied subjects. Subsequently, we plan to elucidate the relationship between the overlap of cortical activity and abnormal shoulder/elbow torque coupling in the paretic arm (Aim 2). We postulate that an increase in the overlap of cortical current activity is a reason for the abnormal torque coupling and serves as a predictor of the severity of discoordination in individuals with stroke. Finally, we propose to investigate the effect of a novel multidegree of freedom isometric training protocol on the overlap of cortical activity in individuals with stroke (Aim 3). Results from our recent work, using this training protocol, have shown a reduction in abnormal torque coupling between shoulder and elbow following an eight week intervention in all stroke subjects (n=7). We postulate and have provided preliminary evidence for a reduction in cortical-activity overlap in concurrence with a training-induced reduction in abnormal torque coupling. In conclusion, the combination of multichannel EEG imaging with a well controlled isometric elbow/shoulder torque generating task in subjects with chronic hemiparetic stroke is unmatched in the current literature. This study will provide new indices in the evaluation and study of discoordination as well as dynamic information on cortical plasticity in individuals with chronic hemiparetic stroke undergoing an upper extremity physical intervention. As such, the proposed study will substantially enhance our understanding of mechanisms driving discoordination in hemiparetic stroke and will provide foundations for further scientific inquiry into the development of more effective therapeutic interventions.

描述（由申请人提供）：肢体受损中关节运动独立控制的丧失是中风的主要迹象，以刻板印象的多关节运动模式的形式表达。我们实验室的工作已经提供了证据表明，在偏瘫中风的个体的副臂中丧失了某些肌肉共激活模式以及相关的肩部/肘部扭矩耦合。该提案的一般目的是阐明感觉运动皮质在中风后偏长的上肢独立关节控制中的作用。我们建议研究20名患有慢性中风和20个对照对象的人，以识别和量化与等距肩部外展/内收和肘屈曲/延伸扭矩有关的感觉运动皮质活性的特征。我们假设中风的个体中存在感官皮质活性的重叠增加（AIM 1）。该目标将使用6度的自由度（DOF）负载电池实现，以同时测量肘部和肩tr虫，同时从163个头皮部位测量EEC，并从每个手臂的10个肌肉中测量EEC。我们假设并提供了初步证据，证明与肩部绑架和肘部屈曲相关的皮质活性之间存在显着重叠，而慢性中风受试者则没有受试者。随后，我们计划阐明皮质活性的重叠与右臂中异常的肩部/肘部扭矩耦合之间的关系（AIM 2）。我们假设，皮质电流活性的重叠是异常扭矩耦合的原因，并可以预测中风个体中脱节的严重程度。最后，我们建议研究一种新型的自由等距训练方案对中风个体皮质活性重叠的新型多维的影响（AIM 3）。使用此训练方案的最新工作的结果显示，在所有中风受试者进行八周干预后，肩膀和肘部之间的异常扭矩耦合降低（n = 7）。我们假设并提供了降低皮质活性重叠的初步证据，这与训练引起的异常扭矩偶联的减少同时重叠。总之，在当前文献中，多通道脑电图成像与慢性偏瘫中风受试者中的受试者中产生的任务的组合结合在一起。这项研究将在评估和研究脱节和研究中提供新的指标，以及有关慢性偏瘫中风患者的皮质可塑性的动态信息，接受了上肢的身体干预。因此，拟议的研究将大大增强我们对偏瘫中风中脱节的机制的理解，并将为进一步的科学探究提供更有效的治疗干预措施的发展。