NEUROREHABILITATION THERAPEUTICS IN STROKE PATIENTS

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DESCRIPTION (provided by applicant): Stroke is the leading cause of serious, long-term disability among American adults and places a tremendous burden on both the private 'and public health resources of the nation. Of all impairments that result from stroke, one of the most in need of effective rehabilitation studies is hemiparesis of the upper limb, which significantly impacts functional independence and health of stroke survivors. One approach that has shown promise in rehabilitation of upper limb disabilities is Constraint Induced Movement Therapy (CIMT), which emphasizes repetitive use of the impaired limb using task-specific training, while restricting movement of the better limb. However, the "best practice" strategy for the rehabilitation of upper limb paresis using CIMT is still unclear, and little is known about how critical factors such the focus of therapy (skilled learning vs. motor activity), the intensity and timing of therapy, patient motivation, initial impairment and the neural mechanisms that underlie the recovery process interact to impact the effectiveness of rehabilitation therapy. In order to make significant advances in the field of stroke rehabilitation we believe that a concerted interdisciplinary approach among the biological, engineering, computer, and clinical sciences will be needed to solve this complex problem. The studies proposed in this planning grant are designed to meet this challenge and will examine the synergy between neural plasticity and treatment strategies that promote the recovery of upper limb motor function after stroke-induced brain injury. Participants include faculty from the biological, behavioral, computational and engineering sciences with expertise in methods encompassing molecular and cell biology, behavioral neuroscience, bioinformatics, computational modeling, virtual environment technology, haptics, biostatistics and physical rehabilitation. The long-term goals of our study are: 1) to broaden our understanding of the key factors that modulate neuroplasticity and the recovery of function after brain injury, 2) build a foundation of interdisciplinary scientific knowledge that can be used in the development of innovative and more effective therapeutic interventions to enhance the health and independence of persons with post-stroke disabilities; and 3) provide an interdisciplinary training opportunity for (basic science and clinical) graduate and post-doctoral students to develop as independent research scientists equipped to work both within and across scientific disciplines.