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小脑性共济失调对运动学和动力学需求的敏感性。

Sensitivity of Cerebellar Reaching Ataxia to Kinematic and Dynamic Demands.

作者信息

Oh Kyunggeune, Cao Di, Cowan Noah J, Bastian Amy J

机构信息

Center for Movement Studies, Kennedy Krieger Institute, Baltimore, Maryland.

Department of Neuroscience, Johns Hopkins University, Baltimore, Maryland.

出版信息

bioRxiv. 2025 Feb 8:2024.10.28.620711. doi: 10.1101/2024.10.28.620711.

DOI:10.1101/2024.10.28.620711
PMID:39554081
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11565890/
Abstract

Individuals with cerebellar ataxia face significant challenges in controlling reaching, especially when multi-joint movements are involved. This study investigated the effects of kinematic and dynamic demands on reaching using a virtual reality task. Participants with and without cerebellar ataxia reached to target locations designed to elicit a range of coordination strategies between shoulder and elbow joint movements. Compared with control subjects, cerebellar subjects presented greater initial reaching direction errors, larger hand trajectory curvatures, and more variability. Kinematic simulations indicated that early hand movement errors were sensitive to the required onset times and rates of joint movements and were most impaired when opposite direction joint movements were required (e.g., elbow extension with shoulder flexion). Dynamic analysis revealed that cerebellar participants' movements were more impaired in reaching directions where interaction torques would normally assist the desired elbow and shoulder movements. These reach directions were also those that required joint movements in opposite directions. Overall, our data suggest that reaching deficits in cerebellar ataxia result from 1) the early-phase motion planning deficits that are exacerbated by stringent timing coordination requirements and 2) the inability to compensate for interaction torques, particularly when they assist the intended movement.

摘要

患有小脑共济失调的个体在控制伸手动作时面临重大挑战,尤其是在涉及多关节运动时。本研究使用虚拟现实任务调查了运动学和动力学需求对伸手动作的影响。患有和未患有小脑共济失调的参与者伸手去够目标位置,这些目标位置旨在引发一系列肩肘关节运动之间的协调策略。与对照组受试者相比,小脑共济失调受试者表现出更大的初始伸手方向误差、更大的手部轨迹曲率和更多的变异性。运动学模拟表明,早期手部运动误差对所需的关节运动起始时间和速率敏感,并且在需要相反方向关节运动时(例如,肩屈时肘伸)受损最为严重。动力学分析显示,小脑共济失调参与者在那些交互扭矩通常会辅助所需的肘和肩运动的伸手方向上运动受损更严重。这些伸手方向也是那些需要相反方向关节运动的方向。总体而言,我们的数据表明,小脑共济失调患者的伸手动作缺陷源于1)严格的时间协调要求加剧的早期运动计划缺陷,以及2)无法补偿交互扭矩,特别是当它们辅助预期运动时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edb3/12233792/fed6ed830445/nihpp-2024.10.28.620711v7-f0010.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edb3/12233792/a3705a8bff8c/nihpp-2024.10.28.620711v7-f0006.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edb3/12233792/fed6ed830445/nihpp-2024.10.28.620711v7-f0010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edb3/12233792/e58159a33713/nihpp-2024.10.28.620711v7-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edb3/12233792/1d95f2ec9da3/nihpp-2024.10.28.620711v7-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edb3/12233792/d87274c55af8/nihpp-2024.10.28.620711v7-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edb3/12233792/29505ae8f51b/nihpp-2024.10.28.620711v7-f0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edb3/12233792/18bdf97e7101/nihpp-2024.10.28.620711v7-f0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edb3/12233792/a3705a8bff8c/nihpp-2024.10.28.620711v7-f0006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edb3/12233792/fdff5f532706/nihpp-2024.10.28.620711v7-f0007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edb3/12233792/d79de48bb0ec/nihpp-2024.10.28.620711v7-f0008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edb3/12233792/dc682bb924a1/nihpp-2024.10.28.620711v7-f0009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edb3/12233792/fed6ed830445/nihpp-2024.10.28.620711v7-f0010.jpg

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本文引用的文献

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The Scale for Assessment and Rating of Ataxia Is Reliable and Valid in the Telehealth Setting for Patients With Cerebellar Ataxia.共济失调评估与评分量表在远程医疗环境中对小脑共济失调患者是可靠且有效的。
Phys Ther. 2024 Mar 1;104(3). doi: 10.1093/ptj/pzad166.
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Elife. 2021 Sep 6;10:e67019. doi: 10.7554/eLife.67019.
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Cerebellar patients have intact feedback control that can be leveraged to improve reaching.小脑患者具有完整的反馈控制能力,可以利用这种能力来改善伸手动作。
Elife. 2020 Oct 7;9:e53246. doi: 10.7554/eLife.53246.
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Reinforcement Signaling Can Be Used to Reduce Elements of Cerebellar Reaching Ataxia.强化信号可用于减少小脑性共济失调的运动要素。
Cerebellum. 2021 Feb;20(1):62-73. doi: 10.1007/s12311-020-01183-x.
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Patients with Cerebellar Ataxia Do Not Benefit from Limb Weights.小脑共济失调患者从肢体负重中获益甚微。
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Robotic and clinical evaluation of upper limb motor performance in patients with Friedreich's Ataxia: an observational study.弗里德赖希共济失调患者上肢运动表现的机器人与临床评估:一项观察性研究
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Hedging your bets: intermediate movements as optimal behavior in the context of an incomplete decision.多方下注:在不完全决策背景下,中间行动作为最优行为。
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The human motor system alters its reaching movement plan for task-irrelevant, positional forces.人类运动系统会针对与任务无关的位置力改变其伸手动作计划。
J Neurophysiol. 2015 Apr 1;113(7):2137-49. doi: 10.1152/jn.00901.2014. Epub 2015 Jan 14.