2021-2022 Pilot Project Grant Awardees

Dorothea Jenkins, M.D.

Medical University of South Carolina

Combining taVNS with early CIMT to improve rehabilitation of infants with Hemiplegia

Brain injury from preterm or complicated term birth increase the risk for one-sided motor weakness, called hemiplegic cerebral palsy (CP). Constraint-induced movement therapy (CIMT) is an intensive intervention designed to treat early motor deficits in these infants, but requires practicing for hours a day over many successive weeks, and is not widely available or feasible in many cases. Our aim in this study is to determine if adding neurostimulation via the transcutaneous auricular vagus nerve (taVNS) is feasible during a short course of CIMT and improves infant motor skills. We anticipate that this first application combining neuromodulation and the proven intervention of CIMT in infants with hemiplegia, will help prove the feasibility of the taVNS technique during CIMT and provide preliminary data for a future trial

Jinsook Roh, Ph.D.

University of Houston, Biomedical Engineering

Examining the effects of operant conditioning of wrist extensor MEP on arm intermuscular coordination after stroke

Stroke often leads to abnormal intermuscular coordination and impaired motor function of the upper extremity (UE). Operant conditioning of a stimulus-triggered muscle response, which produces targeted plasticity in the targeted pathway and produces wider beneficial plasticity in multiple spinal/supraspinal pathways, could be one of the methods that improve corticospinal excitability and intermuscular coordination in the affected limb after stroke. This project aims to characterize the multiple UE muscles represented within a discrete primary motor cortex, by examining multiple muscle motor evoked potential (MEP) representation for UE muscle synergies post-stroke, and assess the effects of wrist extensor MEP up-conditioning on the impaired muscle synergy and motor function in post-stroke UE.

Ryan Solinsky, M.D.

Spaulding Rehabilitation Hospital, Harvard Medical School

Transcutaneous spinal neuromodulation to normalize autonomic phenotypes after spinal cord injury

Autonomic dysfunction is rampant following spinal cord injury, with significant clinical consequences and few options to improve its function. The goal of this research is to assess if transcutaneous spinal cord stimulation may normalize autonomic neuroregulation for these individuals.

Mary Ellen Stoykov, Ph.D., MS, OTR/L

Shirley Ryan AbilityLab, Feinberg School of Medicine

Functional Connectivity in the Upper Limb for Individuals Post-Stroke

The neuroplastic mechanisms that enable some people with stroke to regain high quality control of their paretic arm post-stroke are unknown. There is broad consensus that the presence or absence of motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) over the primary motor cortex is the most useful biomarker to explain treatment response. However, some studies have shown that individuals who are MEP (-) can make clinically meaningful changes in impairment and function. This indicates the need to assess, in detail, the link between MEP (-) status and descending neural connectivity post-stroke. We intend to investigate a biomarker that is cost-effective and that may effectively predict treatment response (e.g., MEPs elicited by direct activation of corticospinal axons). Internationally, there is great interest in the prediction of treatment response post-stroke due to rising medical costs and frustration with minimal improvements in standard of care approaches.

Mike Urbin, Ph.D.

Veterans Health Foundation of Pittsburgh, VA Pittsburgh Healthcare System

Therapeutic potential of acute noradrenergic activation via auricular stimulation to support motor retraining after stroke

A monoaminergic surge that coincides with task-relevant events promotes neural plasticity to support learning. Our recent work demonstrates that short trains of electrical current applied to specific anatomical landmarks on the external ear acutely activates noradrenergic mechanisms. The broad objective of this project is to confirm biomarker engagement and test therapeutic potential in individuals with longstanding motor impairment secondary to stroke.