The Proactive and Reactive Neuromechanics of Instability in Aging and Dementia with Lewy Bodies

衰老和路易体痴呆中不稳定的主动和反应神经力学

基本信息

批准号：
10749539
负责人：
Emily Kathryn Eichenlaub
金额：
$ 3.95万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2024
资助国家：
美国
起止时间：
2024-01-01 至 2027-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10749539
关键词：
Acceleration Address Affect Age Aging Agreement Alzheimer&apos s Disease Area Basic Science Characteristics Clinic Clinical Communities Complex Cross-Sectional Studies Dementia Dementia with Lewy Bodies Development Diagnostic Elderly Electromyography Enrollment Equilibrium Equipment Equity Exhibits Fellowship Financial cost Goals Heart Impaired cognition Impairment Incidence Injury Laboratories Length Link Measurement Measures Monitor Motion Motor Muscle Neuromechanics Outcome Persons Population Prevalence Probability Public Health Quality of life Reaction Time Rehabilitation therapy Research Research Ethics Research Personnel Self-Help Devices Technical Expertise Translations Ultrasonography Universities Walking Work age effect age-related muscle loss aging population career clinical translation cohort design efficacy evaluation equilibration disorder evidence base executive function fall risk falls high risk improved in vivo innovation insight muscle strength negative affect novel personalized intervention pre-doctoral predictive modeling recruit response sex technological innovation ultrasound walking stability wearable sensor technology young adult

项目摘要

PROJECT SUMMARY Our rapidly aging population remains at an exceptionally high risk of debilitating falls. This is especially concerning given the compounding effects of dementia. In particular, Dementia with Lewy Bodies (DLB) is uniquely associated with an increased prevalence of falls. Developing an improved mechanistic framework to understand balance impairment due to age aging and DLB to mitigate falls risk is at the heart of this proposal. The neuromechanics of standing and walking balance control, and thus the origins of balance impairment due to aging and DLB, are incredibly complex. Proactive responses precede the onset of a balance challenge via feedforward control to prepare the body to accommodate instability. Conversely, reactive responses follow the onset of a balance challenge and are compensatory, requiring rapid corrections to mitigate instability. The overarching scientific premise of this fellowship proposal is that aging negatively affects reactive balance responses, while the compounding effects of age and cognitive decline negatively affect proactive balance responses in people with DLB, thus increasing vulnerability to real-world balance challenges that can precipitate falls. This cross- sectional fellowship study will enroll 25 young adults, 25 older adults with clinically probable DLB, and 25 age- and sex- matched older adults. I will strategically combine quantitative motion capture, electromyography, dynamic in vivo ultrasound imaging, and wearable sensors with an innovative suite of standing and walking perturbation paradigms designed to emulate real-world balance challenges. Aim 1 will determine the effects of age and LBD on whole-body vulnerability to anticipated and unanticipated balance challenges during standing and walking. Aim 2 will characterize the local muscle neuromechanical determinants of reactive and proactive balance responses across these cohorts. Finally, with community- based translation as the ultimate goal of my scientific and professional development, Aim 3 will quantify the viability of wearable sensors to monitor and detect between-group differences in vulnerability to perturbations. This study will be the first to objectively quantify between-group differences in multi-scale characteristics of proactive and reactive balance responses using laboratory-based and wearable-sensor based outcomes designed to move my discoveries from the laboratory to the clinic and the community. This area of mechanistic and hypothesis-driven research has been severely understudied, but has significant and immediate potential to inform novel advances in diagnostics, rehabilitation, mobile monitoring, and wearable assistive technologies to mitigate falls.

项目概要我们迅速老龄化的人口仍然面临着极高的跌倒风险。这尤其令人担忧痴呆症的复合效应。特别是，路易体痴呆 (DLB) 与跌倒发生率增加。开发改进的机制框架来了解由于以下原因导致的平衡障碍年龄老化和降低跌倒风险的 DLB 是该提案的核心。站立和行走平衡的神经力学控制力，以及因衰老和 DLB 导致的平衡障碍的根源非常复杂。积极响应在平衡挑战开始之前，通过前馈控制让身体做好适应不稳定性的准备。相反，反应性反应是在平衡挑战开始后出现的，并且是补偿性的，需要快速纠正减轻不稳定因素。该奖学金提案的总体科学前提是，衰老会对反应性产生负面影响平衡反应，而年龄和认知能力下降的复合效应会对主动平衡反应产生负面影响 DLB 患者更容易面临现实世界的平衡挑战，从而导致跌倒。这个跨部门联谊研究将招募 25 名年轻人、25 名临床上可能患有 DLB 的老年人以及 25 名年龄和性别的成年人匹配的老年人。我将策略性地将定量动作捕捉、肌电图、体内动态结合起来超声成像和可穿戴传感器，具有创新的站立和行走扰动范例套件模拟现实世界的平衡挑战。目标 1 将确定年龄和小黑裙对全身脆弱性的影响站立和行走时预期和意外的平衡挑战。目标 2 将表征局部肌肉这些群体中反应性和主动性平衡反应的神经机械决定因素。最后，与社区一起—— 基于翻译作为我科学和专业发展的最终目标，目标 3 将量化翻译的可行性可穿戴传感器来监测和检测组间易受扰动影响的差异。这项研究将是首次客观量化主动和被动平衡多尺度特征的组间差异使用基于实验室和可穿戴传感器的结果进行响应，旨在将我的发现从实验室中转移出来到诊所和社区。这一机制和假设驱动的研究领域尚未得到充分研究，但具有巨大而直接的潜力，可以为诊断、康复、移动监测和可减轻跌倒的可穿戴辅助技术。