Weeks Heidi M, Therrien Amanda S, Bastian Amy J
Department of Biomedical Engineering, The Johns Hopkins School of Medicine, Baltimore, MD, USA.
Kennedy Krieger Institute, 707 N. Broadway, G04, Baltimore, MD, 21205, USA.
Cerebellum. 2017 Apr;16(2):427-437. doi: 10.1007/s12311-016-0819-4.
It has been hypothesized that an important function of the cerebellum is predicting the state of the body during movement. Yet, the extent of cerebellar involvement in perception of limb state (i.e., proprioception, specifically limb position sense) has yet to be determined. Here, we investigated whether patients with cerebellar damage have deficits when trying to locate their hand in space (i.e., proprioceptive localization), which is highly important for everyday movements. By comparing performance during passive robot-controlled and active self-made multi-joint movements, we were able to determine that some cerebellar patients show improved precision during active movement (i.e., active benefit), comparable to controls, whereas other patients have reduced active benefit. Importantly, the differences in patient performance are not explained by patient diagnosis or clinical ratings of impairment. Furthermore, a subsequent experiment confirmed that active deficits in proprioceptive localization occur during both single-joint and multi-joint movements. As such, it is unlikely that localization deficits can be explained by the multi-joint coordination deficits occurring after cerebellar damage. Our results suggest that cerebellar damage may cause varied impairments to different elements of proprioceptive sense. It follows that proprioceptive localization should be adequately accounted for in clinical testing and rehabilitation of people with cerebellar damage.
据推测,小脑的一项重要功能是在运动过程中预测身体状态。然而,小脑在肢体状态感知(即本体感觉,特别是肢体位置感)中的参与程度尚未确定。在此,我们研究了小脑损伤患者在试图在空间中定位其手部(即本体感觉定位)时是否存在缺陷,这对日常运动非常重要。通过比较被动机器人控制和主动自主多关节运动期间的表现,我们能够确定一些小脑患者在主动运动期间表现出更高的精度(即主动优势),与对照组相当,而其他患者的主动优势则降低。重要的是,患者表现的差异不能通过患者诊断或损伤的临床评分来解释。此外,随后的一项实验证实,在单关节和多关节运动中均会出现本体感觉定位的主动缺陷。因此,定位缺陷不太可能由小脑损伤后出现的多关节协调缺陷来解释。我们的结果表明,小脑损伤可能会对本体感觉的不同要素造成不同程度的损害。因此,在对小脑损伤患者进行临床测试和康复时,应充分考虑本体感觉定位。