Mentoring translational cognitive science for stroke recovery

描述（由申请人提供）：中风后的功能性视觉问题通常是脑部而非眼部问题。然而，大脑系统并不是当前康复的基础。即使美国估计有 230,000 名急性中风幸存者因空间忽视而获得稍微更好的结果，也可能导致每年节省超过 2 亿美元。候选人提出，适当的受试者分层可能会带来更好的空间忽视康复结果：多巴胺能“瞄准”系统支持的表现，以及已建立的感知“哪里”大脑网络，在经典动物研究中确定了恢复。凭借出色的指导和培训，她获得了 K08 奖项，开发并验证了一种量化这些恢复成分的空间忽视评估方法。新颖的 K02 研究进一步证明，“瞄准”和“何处”功能分层与临床治疗的恢复和反应相关。自 1999 年以来，美国国立卫生研究院 (NIH) 的持续资助使她能够将转化分层假说应用于神经康复研究，吸引了众多临床医生兼研究员实习生进行实践培训。最近，R01 资金使她能够扩大她的研究目标，调查更大的空间忽视的中风幸存者群体的恢复轨迹的平移分层。她是一位认知神经科学家，将心理学理论应用于中风康复，是三个不同级别的医学实习生的独特榜样。医学生竞争研究实验室轮换，并在临床研究中接受单独指导。物理科住院医师接受临床研究指导，物理科住院医师和博士后研究员在她的实验室进行项目所需的研究，产生实习生撰写的手稿和演示文稿（2008 年有 5 篇）。 K24机制为候选人提供了关键的保护时间来扩展其临床研究的理论基础，并适当地致力于指导活动。提案活动还建立了她与医学博士 Anne Foundas 的合作。他们正在开发的转化神经解剖模型可以预测中风后的恢复和对空间忽视治疗的反应，预计将为进一步的实习生导师合作和资助申请产生新的假设。

DESCRIPTION (provided by applicant): Post-stroke, functional visual problems are frequently cerebral rather than ocular. However, brain systems are not the basis of current rehabilitation. Even marginally better outcomes in estimated 230,000 US acute stroke survivors with spatial neglect could result in annual savings > $200 million. The Candidate proposed that better spatial neglect rehabilitation outcomes may result from appropriate subject stratification: performance supported by dopaminergic "aiming" systems, as well as established perceptual "where" brain networks, determined recovery in classical animal studies. With outstanding mentoring and training, under a K08 award she developed and validated a spatial neglect assessment method quantifying these recovery components. Novel K02 studies further demonstrated that "aiming" and "where" functional stratification correlated with recovery and response to clinical treatment. Continuous NIH funding since 1999 allowed her to apply the translational stratification hypothesis to neurorehabilitation research, attracting numerous clinician-researcher trainees for hands-on training. Recently, R01 funding allows her to expand her research goals, investigating translational stratification of recovery trajectory in larger groups of stroke survivors with spatial neglect. A physician cognitive neuroscientist applying psychological theory to stroke rehabilitation, she is a unique role model for medical trainees at three distinct levels. Medical students compete for research laboratory rotations, and are mentored individually in clinical research. Physiatric resident physicians are mentored in clinical research, and physiatric residents and post-doctoral fellows perform program-required research in her laboratory, resulting in trainee-authored manuscripts and presentations (5 in 2008). The K24 mechanism provides critical protected time for the Candidate to expand the theoretical basis of her clinical research, and commit appropriately to mentoring activities. The proposal activities also build her collaboration with Anne Foundas, MD. Their developing translational neuro- anatomic model, to potentially predict recovery and response to spatial neglect treatment after stroke, is expected to generate novel hypotheses for further trainee-mentor collaboration and grant applications.