Sohn Won J, Niu Chuanxin M, Sanger Terence D
Department of Biomedical Engineering, University of Southern California, 1042 Downey Way, Los Angeles, CA 90089, USA.
J Neural Eng. 2015 Jun;12(3):036010. doi: 10.1088/1741-2560/12/3/036010. Epub 2015 May 6.
Childhood dystonia is a movement disorder that interferes with daily movements and can have a devastating effect on quality of life for children and their families. Although injury to basal ganglia is associated with dystonia, the neurophysiological mechanisms leading to the clinical manifestations of dystonia are not understood. Previous work suggested that long-latency stretch reflex (LLSR) is hyperactive in children with hypertonia due to secondary dystonia. We hypothesize that abnormal activity in motor cortices may cause an increase in the LLSR leading to hypertonia.
We modeled two possibilities of hyperactive LLSR by either creating a tonic involuntary drive to cortex, or increasing the synaptic gain in cortical neurons. Both models are emulated using programmable very-large-scale-integrated-circuit hardware to test their sufficiency for producing dystonic symptoms. The emulation includes a joint with two Hill-type muscles, realistic muscle spindles, and 2,304 Izhikevich-type spiking neurons. The muscles are regulated by a monosynaptic spinal pathway with 32 ms delay and a long-latency pathway with 64 ms loop-delay representing transcortical/supra-spinal connections.
When the limb is passively stretched, both models produce involuntary resistance with increased antagonist EMG responses similar to human data; also the muscle relaxation is delayed similar to human data. Both models predict reduced range of motion in voluntary movements.
Although our model is a highly simplified and limited representation of reflex pathways, it shows that increased activity of the LLSR is by itself sufficient to cause many of the features of hypertonic dystonia.
儿童肌张力障碍是一种运动障碍,会干扰日常活动,对儿童及其家庭的生活质量产生毁灭性影响。尽管基底神经节损伤与肌张力障碍有关,但导致肌张力障碍临床表现的神经生理机制尚不清楚。先前的研究表明,继发性肌张力障碍导致的儿童高张力患者的长潜伏期牵张反射(LLSR)亢进。我们假设运动皮层的异常活动可能导致LLSR增加,进而导致高张力。
我们通过两种方式模拟LLSR亢进的情况,一是对皮层产生持续性非自主驱动,二是增加皮层神经元的突触增益。两种模型均使用可编程超大规模集成电路硬件进行模拟,以测试它们产生肌张力障碍症状的充分性。模拟包括一个带有两块希尔型肌肉的关节、逼真的肌梭以及2304个Izhikevich型发放神经元。肌肉由一条延迟32毫秒的单突触脊髓通路和一条延迟64毫秒的长潜伏期通路调节,后者代表经皮层/脊髓上连接。
当肢体被动伸展时,两种模型都会产生非自主阻力,拮抗肌肌电图反应增加,类似于人体数据;肌肉放松也会延迟,类似于人体数据。两种模型都预测自主运动中的运动范围会减小。
尽管我们的模型是对反射通路的高度简化和有限表示,但它表明LLSR的活动增加本身足以导致高张力性肌张力障碍的许多特征。