CAREER: Neuro-navigation guided non-invasive brain stimulation for individualized precision rehabilitation in stroke

该项目的目标是推进中风后大脑功能变化的科学研究，并开创适合每个人需求的量身定制的康复策略。中风后的运动障碍是这个国家成人残疾的主要原因。由于缺乏对临床实践中脑功能变化的充分了解，常规治疗尚未对每个人都是最佳的。这个项目试图结合不同的成像方法来引导对大脑的电刺激，从而改善运动的恢复。该项目的成果有可能广泛推进中风或脑损伤研究，以帮助每年接受康复治疗的50多万人。这将减少因中风和其他类似脑损伤导致的长期残疾的医疗保健和护理费用。透过本计划的教育活动，将建立一个多学科的研究教育“生态系统”，连接工程学生、临床实习生和STEM教育者，以促进下一代康复先锋的教育。尽管为脑损伤后的运动康复开发了许多新技术，从脑成像到神经调节方法，但由于缺乏成像指导和实时神经反馈来为每个人量身定制康复策略，最佳恢复仍然受到限制。本项目将解决这一局限，并基于一种新颖的多模态脑成像方法和闭环高清经颅直流电刺激（HD-tDCS）平台，建立一种独特的康复工程研究范式。这种新方法将精确地评估受伤大脑中运动控制的变化，并确定更精确的HD-tDCS刺激的关键网络。研究者将采用综合实验和计算方法：1)识别和表征损伤大脑运动控制的个性化大脑网络；2)建立模型并评估HD-tDCS对“活体”大脑的动态影响，以实现对大脑网络的靶向、精确刺激；3)发展闭环成像和神经反馈引导的HD-tDCS，以改善脑功能和行为结果。这项跨学科计划将与教育和外展活动相结合，以提高人们对工程与康复科学之间相互依存关系的认识，并促进跨学科教育和培训下一代康复工程师，其教育目标有三个：1)通过暑期研究训练促进工程和物理治疗学生的参与，2)通过培训高中教师将康复工程知识转化为适合年级的STEM教育，3)通过博物馆活动提高公众对工程对康复的贡献的认识。该项目由残疾和康复工程项目和促进竞争性研究的既定项目（EPSCoR）共同资助。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

The goal of this project is to advance the scientific study of brain functional changes after a stroke and pioneer a tailored rehabilitation strategy that fits each individual’s needs. Movement impairments following a stroke are a major cause of adult disability in this country. The routine treatment is not yet optimal for every individual due to a lack of sufficient understanding of brain functional changes to inform clinical practice. This project seeks to combine different imaging methods to guide electrical stimulation to the brain that improves the recovery of movement. The outcomes of this project have the potential to advance stroke or brain injury research broadly to help over half a million people who undergo rehabilitation each year. This will reduce the healthcare and nursing costs for long-term disability caused by stroke and other similar brain injuries. Through education activities in this project, a multi-disciplinary research-education “eco-system” will be built to connect engineering students, clinician trainees, and STEM educators to promote the education of next-generation rehabilitation pioneers. Despite numerous efforts to develop new technologies for movement rehabilitation post-brain injuries, from brain imaging to neuromodulation approaches, optimal recovery is still limited due to a lack of imaging guidance and real-time neurofeedback to tailor rehabilitation strategies for each individual. This project will address this limitation and establish a unique rehabilitation engineering research paradigm based on a novel multi-modal brain imaging approach and a closed-loop high-definition transcranial direct current stimulation (HD-tDCS) platform. This new approach will precisely assess the changes to motor control in an injured brain and identify the key network to target for more precise HD-tDCS stimulation. The investigator will take integrated experimental and computational approaches to: 1) Identify and characterize individualized brain networks for movement control in injured brains; 2) Model and evaluate the dynamic effect of HD-tDCS on a “live” brain to enable targeted, precision stimulation of brain networks; and 3) Develop closed-loop imaging and neurofeedback guided HD-tDCS to improve brain function and behavior outcomes. This interdisciplinary project will be integrated with education and outreach activities to promote awareness of interdependencies between engineering and rehabilitation sciences and promote interdisciplinary education and training for next-generation rehabilitation engineers, with three educational objectives: 1) Promote the engagement of engineering and physical therapy students via summer research training, 2) Translate rehabilitation engineering knowledge to grade-appropriate STEM education via training high school teachers, and 3) Increase public awareness of engineering’s contributions to rehabilitation via museum events.This project is jointly funded by the Disability and Rehabilitation Engineering Program and the Established Program to Stimulate Competitive Research (EPSCoR).This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.