Dynamic Imaging of Cerebral Palsy Gait

脑瘫步态的动态成像

• 批准号: 10707422
• 负责人: Max J Kurz
• 金额: $ 65.06万
• 依托单位: FATHER FLANAGAN'S BOYS' HOME
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-20 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10707422
• 关键词: Acceleration; Address; Adolescence; Adult; Affect; Biological Markers; Brain imaging; Cerebral Palsy; Childhood; Clinical; Clinical assessments; Complement; Cortical Cord; Corticospinal Tracts; Coupled; Development; Direct Costs; Economic Burden; Electroencephalography; Elements; Environment; Equation; Equilibrium; Esthesia; Exhibits; Functional disorder; Gait; Image; Individual; Interneurons; Knowledge; Leg; Magnetic Resonance Imaging; Magnetoencephalography; Methods; Modeling; Modernization; Motor; Movement; Muscle; Musculoskeletal System; Nervous System; Neurologic; Neurosciences; Participant; Perinatal Brain Injury; Peripheral; Persons; Play; Population; Protocols documentation; Proxy; Resolution; Role; Seminal; Sensory; Sensory Process; Series; Societies; Somatosensory Cortex; Specificity; Spinal Cord; Techniques; Testing; Therapeutic; Therapeutic Intervention; Time; Tissues; United States; Work; Youth; cost; design; experience; experimental study; flexibility; foot; gray matter; improved; indexing; innovation; kinematics; multimodal neuroimaging; multimodality; neural; neuroimaging; neurophysiology; novel; novel therapeutics; sensory integration; somatosensory; spasticity; temporal measurement; therapeutic target; white matter

PROJECT SUMMARY/ABSTRACT Cerebral palsy (CP) results from a perinatal brain injury and is one of the most prevalent and costly pediatric neurologic conditions in the United States. Individuals with CP frequently experience lifelong mobility challenges. The modern treatment approaches being used to overcome these challenges place greater emphasis on the neurological basis for how youth with CP plan their leg movements, execute motor actions, and integrate sensory information. Despite this neuroscience-informed approach, these new therapies are still limited by substantial knowledge gaps regarding how the aberrant sensorimotor cortical activity and/or spinal cord specifically affects the gait of youth with CP. Our ultramodern magnetoencephalographic (MEG) brain imaging results have revealed that cortical aberrations play a substantial role in the uncharacteristic leg motor actions and sensory processes seen in youth with CP. Furthermore, our high-resolution MRI pipelines have shown that the structural integrity of spinal cord tissue is compromised in individuals with CP. From these experiments, we have inferred that the altered cortical dynamics and spinal cord integrity likely impacts the ability of youth with CP to make feed-forward predictions and/or online corrections to their leg kinematics during gait. However, this conjecture has yet to be fully established due to physical limitations of the MEG/MRI recording environments. To move forward, we will use our extensive MEG foundational work to develop new electroencephalographic (EEG) methods that have the scientific rigor and flexibility to precisely quantify the sensorimotor cortical activity during real-time gait. Furthermore, we will utilize cutting-edge neurophysiological tests to concurrently quantify how the spinal cord interneuronal dynamics are modulated during gait. The Aims of this study will: (1) establish multimodal MEG-EEG neuroimaging proxies of the aberrant sensorimotor cortical oscillations seen in youth with CP that are known to impact the extent of the mobility deficits, (2) quantify the sensorimotor EEG cortical oscillations and spinal cord interneuronal dynamics of youth with CP during gait, and (3) decipher if alterations in the sensorimotor cortical oscillations and spinal cord interneuronal dynamics are better predictors of the mobility deficits seen in youth with CP relative to the most commonly used clinical metrics. To achieve these Aims, youth with CP and neurotypical controls will undergo a series of experiments that will use simultaneous MEG-EEG neuroimaging, EEG neuroimaging during gait, and assessments of the spinal cord interneuronal dynamics during gait. Furthermore, the participants will undergo a battery of clinical assessments (e.g., balance, spasticity, selective control, strength and sensation). We foresee that the body of new knowledge gained through this project will set-the-stage for the design and testing of innovative therapeutic protocols that target the specific neurophysiological deficits that are limiting the mobility of youth with CP.

项目概要/摘要 脑瘫 (CP) 由围产期脑损伤引起，是最常见和最昂贵的儿科疾病之一 美国的神经系统疾病。患有脑瘫的人经常会遇到终生行动不便的挑战。 用于克服这些挑战的现代治疗方法更加强调 脑瘫青少年如何计划腿部运动、执行运动动作和整合感觉的神经学基础 信息。尽管采用了这种基于神经科学的方法，但这些新疗法仍然受到实质性限制 关于异常感觉运动皮层活动和/或脊髓如何具体影响的知识差距 与CP一起青春的步态。 我们的超现代脑磁图 (MEG) 脑成像结果表明，皮质畸变 脑瘫青少年中异常的腿部运动动作和感觉过程中发挥着重要作用。 此外，我们的高分辨率 MRI 管道表明脊髓组织的结构完整性是 患有 CP 的个体受到损害。从这些实验中，我们推断出改变的皮质动力学 脊髓完整性可能会影响患有脑瘫的青少年进行前馈预测和/或在线预测的能力 步态过程中腿部运动学的修正。但由于这一猜想尚未完全成立 MEG/MRI 记录环境的物理限制。为了向前迈进，我们将使用我们广泛的 MEG 开发新的脑电图 (EEG) 方法的基础工作，该方法具有科学严谨性和 灵活地精确量化实时步态期间的感觉运动皮层活动。此外，我们将利用 尖端的神经生理学测试，同时量化脊髓间神经元动力学的情况 在步态期间进行调节。本研究的目的是：（1）建立多模态 MEG-EEG 神经影像代理 患有 CP 的青少年中出现异常的感觉运动皮层振荡，已知会影响 移动性缺陷，(2) 量化感觉运动脑电图皮质振荡和脊髓间神经元动力学 步态中患有 CP 的青少年的比例，以及 (3) 破译感觉运动皮层振荡和脊柱是否发生变化 与普通人相比，脊髓间神经元动态是 CP 青少年活动能力缺陷的更好预测指标。 最常用的临床指标。为了实现这些目标，具有 CP 和神经正常控制能力的青少年将 进行一系列实验，将同时使用 MEG-EEG 神经成像，EEG 神经成像 步态，以及步态期间脊髓间神经元动力学的评估。此外，参与者将 接受一系列临床评估（例如平衡、痉挛、选择性控制、力量和感觉）。 我们预计，通过该项目获得的新知识将为设计和 针对限制特定神经生理缺陷的创新治疗方案进行测试 CP 青年的流动性。