Feasibility of Rehabilitation Robots and fMRI in Stroke

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DESCRIPTION (provided by applicant): Broad long-term objectives: To improve the rehabilitation and quality of life of stroke patients. Hypothesis: Optimally designed Magnetic Resonance (MR) compatible robotic devices can assist in movement rehabilitation of stroke-induced pathological or traumatic changes by stimulating plasticity of primary motor cortex representations and cell properties. Specific Aims: (1) To build novel MR compatible rehabilitation force-feedback robotic devices and tested them in healthy volunteers using an optimal functional MR imaging (fMRI) protocol: and (2) demonstrate the relevance of combining these robotic devices and fMRI for evaluating rehabilitation in stoke patients. Health relatedness: An increasing number of patients suffer from stroke, a major cause of invalidity in modern society. Monitoring and validating the effectiveness of stroke rehabilitation therapy is challenging, since its physiological requirements include both peripheral and central nervous system plasticity. State-of-the-art functional MR methods combined with novel MR compatible robotic rehabilitation devices, which are developed and tested in this proposal, can provide accurate, sensitive and specific information about the effectiveness of rehabilitation therapy beyond traditional approaches. Research design and methods: This exploratory study will generate pilot data for the feasibility of monitoring rehabilitation maneuvers in stroke patients with a state-of-the-art MR system using novel IvR compatible robotic devices. Stroke patient appropriate tasks suitable for our MR compatible robots will be designed, tested and optimized with an MR system that uses phased-array coils, to increase sensitivity and resolution. fMRI will be performed on 6 healthy adult volunteers and 6 stroke patients; and methods will be optimized to measure activation in voluntary movement-related cortical areas. Project rationale and significance: By demonstrating the utility of fMRI to monitor the effectiveness of rehabilitation maneuvers in stroke patients, these studies can ultimately provide an additional method for the future evaluation of stroke rehabilitation therapies. To this end, the anticipated results may lead to the development of a novel optimized method for stroke patient rehabilitation; and upon further development this method could become a valuable tool to illuminate stroke-induced pathological and traumatic changes, and to provide unique prospective information for stroke patient management.