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2018-2019 Pilot Project Grant Awardees

 

Stacey DeJong, Ph.D., PT

University of Iowa, Department of Physical Therapy and Rehabilitation Science

Effects of Operant Up-Conditioning of Motor Evoked Potentials on Corticospinal and Spinal Reflex Excitability in People with Wrist Flexor Hypertonia after Stroke

Paresis after stroke is associated with diminished corticospinal excitability and often results in loss of upper limb function. This study expands the application of operant conditioning by examining whether people with stroke are able to increase wrist flexor motor evoked potentials elicited by transcranial magnetic stimulation. We will quantify the effects of this neuromodulation strategy on cortical representations, spinal reflex excitability, and wrist motor control.

Emily J. Fox, Ph.D., DPT, NCS & David. J. Clark, ScD

University of Florida, Department of Physical Therapy and Brooks Rehabilitation and University of Florida, Institute on Aging

Neuromodulation of Spinal Circuits to Enhance Practice-Related Performance on a Complex Walking Task

This study evaluates excitatory neuromodulation of the spinal cord during walking to enhance practice-related gains in performance and retention on an obstacle walking task. If transcutaneous direct current stimulation (tsDCS) shows promise for improving practice effects, this study will provide the necessary data and justification for designing intervention trials that use spinal tsDCS an adjuvant to walking rehabilitation. The proposed intervention techniques are low cost and translatable to real-world settings, which enhances the potential impact of this work on the well-being of older adults.

Bernadette Gillick, Ph.D., MSPT, PT

McKnight Land Grant Professor, Department of Rehabilitation Medicine,University of Minnesota Medical School

Comparing Two Montages of Transcranial Direct Current Stimulation in Pediatric Stroke

Neuromodulatory interventions such as tDCS have recently been studied in children with unilateral cerebral palsy to enhance movement function, with many studies applying inhibitory tDCS to the contralesional hemisphere to balance interhemispheric inhibition between hemisphere. However, the optimal tDCS montage to produce changes in cortical excitability has not been thoroughly investigated. Using a single application of tDCS, we will test the effects of two tDCS montages, cathodal contralesional or anodal ipsilesional, on the cortical excitability after-effects. This research will guide future large clinical intervention trials incorporating tailored applications of non-invasive neuromodulation. Further study information can be found on the University of Minnesota, Department of Rehabilitation Medicine's website.

Dorothea Jenkins, M.D.

Medical University of South Carolina, Department of Pediatrics and Neonatology

Noninvasive Brain Stimulation to Improve Oromotor Function in Neonates

Preterm infants and term infants who suffer birth asphyxia are at high risk for motor problems, such as learning to take feeds by mouth, and may have to have a gastrostomy tube surgically placed into their stomach to be able to feed well enough to go home. Even after significant brain injury, we know that pairing rehabilitative training and brain stimulation increases neuroplasticity by remodeling motor cortex, leading to improved motor skills. As the first application of brain stimulation technology in human neonates, we will simultaneously deliver transcutaneous auricular vagus nerve stimulation with bottle feeding to boost motor cortical plasticity which may lead to better feeding.

C. Nikki Arrington, Ph.D.

Georgia State University, Department of Psychology, GSU/GT Center for Advanced Brain Imaging

Examining the Effects of Intermittent Theta Burst Stimulation on the Neural Network Associated with Reading in Adult Struggling Readers

Developmental dyslexia (DD) is the most prevalent cause of brain-based reading deficits. This project’s goal is to advance our understanding of the neurobiological foundations of reading in adults with treatment-resistant DD. We will utilize intermittent theta burst stimulation, along with prestimulation neuroimaging, to systematically investigate targeted node engagement of specific regions of the reading network

Lisa McTeague, Ph.D.

Medical University of South Carolina, Department of Psychiatry

Neuromodulation and Plasticity in Cognitive Control Neurocircuitry in Chronic Stroke

As a first test of whether repetitive transcranial magnetic stimulation (rTMS) will induce plasticity in the cognitive control network among chronic stroke patients with neurocognitive impairments, we propose to apply excitatory rTMS to the contralesional dorsolateral prefrontal cortex. We also propose to implement a novel high-dose accelerated protocol (i.e., multiple sessions over three days). A typical course of rTMS entails one treatment/day for 4 to 6 weeks, which can be burdensome and reduce adherence. Accelerated protocols have been safe and effective in treating mood disorders. Establishing the safety and feasibility in chronic stroke is an essential short-term goal toward our longer-term goal of determining the optimal dose for enhancing neurocognition.