The purpose of this research career development proposal is to extend Dr. Sanger's training beyond his current theoretical background into clinicallyoriented research on children with movement disorders. Dr. Sanger's past research has focused on computational models of movement and motor learning. This research plan proposes to apply this background in a clinical research setting by performing a quantitative investigation of increased upperextremity movement in children with hyperkinetic cerebral palsy (CP). It is not known whether abnormal movements result from random noise, decreased ability to modulate the amplitude of movements, or inappropriate planning of motor sequences. This proposal suggests two related hypotheses: (1) Hyperkinetic CP is a result of a restriction in the variability of motor commands such that desired smooth movements are not available, and (2) Progression of abnormal movements over time is reflected by an increasing restriction in the variability of motor commands and worsening energetic efficiency. To test these hypotheses, position sensors and surface electomyographic (EMG) recordings of reaching movements will be made at 6 month intervals in children of different ages with hyperkinetic CP. Kinematic and EMG data will be analyzed to determine energy expenditure, variability of the set of kinematic patterns, and total information content of movement. If the hypotheses are correct, then we expect progression of symptoms in dyskinetic CP to be reflected in decreasing dimensionality, information content, and energy efficiency of the patterns of movements. The results of this study may allow early identification of children at risk for hyperkinetic CP as well as prediction of the progression and ultimate severity of symptoms. Dr. Andriacchi, Dr. Mobley, and Dr. Hlatky will serve as mentors for Dr. Sanger's work on this project. Dr. Andriacchi will provide instruction on the measurement of kinematics and energetics in children, Dr. Mobley will provide instruction on the clinical evaluation of children with movement disorders, and Dr. Hlatky will guide the design and implementation of clinical trials and outcome measure validation. The proposal includes coursework in cellular and molecular neurobiology and in the design of clinical research studies.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
1K23NS041243-01
Application #
6317279
Study Section
Special Emphasis Panel (ZNS1-SRB-L (01))
Program Officer
Spinella, Giovanna M
Project Start
2001-07-15
Project End
2006-06-30
Budget Start
2001-07-15
Budget End
2002-06-30
Support Year
1
Fiscal Year
2001
Total Cost
$151,645
Indirect Cost
Name
Stanford University
Department
Neurology
Type
Schools of Medicine
DUNS #
800771545
City
Stanford
State
CA
Country
United States
Zip Code
94305
Chu, Way Tong Virginia; Sanger, Terence D (2009) Force variability during isometric biceps contraction in children with secondary dystonia due to cerebral palsy. Mov Disord 24:1299-305
Sanger, Terence D (2007) Bayesian filtering of myoelectric signals. J Neurophysiol 97:1839-45
Malfait, Nicole; Sanger, Terence D (2007) Does dystonia always include co-contraction? A study of unconstrained reaching in children with primary and secondary dystonia. Exp Brain Res 176:206-16
Sanger, Terence D (2006) Arm trajectories in dyskinetic cerebral palsy have increased random variability. J Child Neurol 21:551-7
Sanger, Terence D; Kaiser, Jason; Placek, Brian (2005) Reaching movements in childhood dystonia contain signal-dependent noise. J Child Neurol 20:489-96
Sanger, Terence D (2004) Severe resting clonus caused by thyrotoxicosis in a 16-year-old girl with hereditary spastic paraparesis: a case report. Mov Disord 19:712-3
Sanger, Terence D (2004) Toward a definition of childhood dystonia. Curr Opin Pediatr 16:623-7
Sanger, Terence D (2004) Failure of motor learning for large initial errors. Neural Comput 16:1873-86
Sanger, Terence D (2003) Neural population codes. Curr Opin Neurobiol 13:238-49
Sanger, T D (2003) Childhood onset generalised dystonia can be modelled by increased gain in the indirect basal ganglia pathway. J Neurol Neurosurg Psychiatry 74:1509-15

Showing the most recent 10 out of 11 publications