Neural Adaptation to Strabismus Surgery

斜视手术的神经适应

• 批准号: 8918626
• 负责人: VALLABH E DAS
• 金额: $ 33.19万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-01 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8918626
• 关键词: 3 year old; Accounting; Affect; Animals; Appearance; Area; Behavior; Binocular Vision; Brain; CNS processing; Cell Nucleus; Cells; Child; Data; Data Set; Development; Disease; Excision; Eye; Eye Movements; Failure; Feedback; Goals; Head; Human; Implant; Infant; Laboratories; Lateral; Lead; Location; Medial; Medicine; Methods; Monkeys; Motor; Motor Neurons; Muscle; Neurons; Oculomotor nucleus; Operative Surgical Procedures; Outcome; Patients; Pattern; Population; Procedures; Process; Property; Relative (related person); Residual state; Role; Sensory; Source; Strabismus; Surgeon; Syndrome; System; Techniques; Testing; Time; Training; Treatment outcome; United States; Universities; Vision; Work; abducens nucleus; behavioral study; college; developmental disease; fighting; improved; insight; lateral rectus muscle; monocular; muscle strength; nerve supply; neuroadaptation; neuromechanism; oculomotor; operation; orbit muscle; relating to nervous system; research study; response; success

DESCRIPTION (provided by applicant): Although surgical correction is often the preferred treatment method for strabismus, there can be problems with the outcome. By some accounts, 20-40% of strabismus correction surgeries fail in one way or another and therefore re-operation is required. We suggest that a reason strabismus surgery sometimes fails is that there are adaptive processes that follow the treatment that may work to negate the effects of surgery and revert the eyes to a previous state of misalignment. These adaptive processes might be localized to muscle itself (muscle remodeling) or might involve neural processes (central nervous system remodeling). The goal of this project is to develop a better understanding of the neural adaptive changes that follow strabismus correction surgery which in turn may provide additional insight into reasons for failure or success following treatment. Studies from our laboratory have shown that specially rearing infant monkeys under conditions that disrupted binocular vision reproduced a sensory strabismus syndrome with large horizontal misalignment, A/V patterns, Dissociated Horizontal Deviation (DHD) and Dissociated Vertical Deviation (DVD). Our strategy for this project is first to characterize the neural drive to horizontal extraocular muscles (medial and lateral recti) of the strabismic monkeys by recording from motoneurons in the oculomotor and abducens nuclei. Thereafter, we will treat the strabismus in these animals using similar resection or recession surgery techniques to those used in human patients. Following treatment, we will record neural responses from the same motor nuclei. Comparison of the pre- and post-surgery population neural drive to horizontal extraocular muscles will provide data on how the brain adapts to a muscle strengthening or weakening procedure. In the final aim, we will record from cells in the supraoculomotor area to examine whether the neural adaptation that follows surgical treatments has its origin in vergence circuits. Completion of our studies will be of benefit to the understanding and treatment of developmental forms of strabismus.

描述（由申请人提供）：虽然手术矫正通常是斜视的首选治疗方法，但结果可能存在问题。据统计，20-40% 的斜视矫正手术都以某种方式失败，因此需要重新手术。我们认为，斜视手术有时会失败的一个原因是，治疗后存在适应性过程，可能会抵消手术的影响并将眼睛恢复到之前的错位状态。这些适应性过程可能局限于肌肉本身（肌肉重塑）或可能涉及神经过程（中枢神经系统重塑）。该项目的目标是更好地了解斜视矫正手术后的神经适应性变化，这反过来又可能为治疗后失败或成功的原因提供更多见解。我们实验室的研究表明，在双眼视觉受损的条件下专门饲养的幼猴会产生感觉斜视综合症，伴有较大的水平错位、A/V 模式、分离水平偏差 (DHD) 和分离垂直偏差 (DVD)。我们这个项目的策略是首先通过记录动眼核和外展核中的运动神经元来表征斜视猴水平眼外肌（内侧和外侧直肌）的神经驱动。此后，我们将使用与人类患者相似的切除或后退手术技术来治疗这些动物的斜视。治疗后，我们将记录来自相同运动核的神经反应。手术前和手术后群体神经驱动与水平眼外肌的比较将提供有关大脑如何适应肌肉强化或削弱程序的数据。在最终目标中，我们将从上眼运动区域的细胞中进行记录，以检查手术治疗后的神经适应是否起源于聚散回路。完成我们的研究将有助于了解和治疗发育性斜视。