Supraspinal Contributions to Locomotor Control and Recovery after Stroke

描述（由申请人提供）：神经成像技术的进步，如功能性磁共振成像（fMRI），使得有可能检查中风后人群运动期间的人脑功能。随着技术的进步和对中风后脑功能的更好理解，脑成像可用于预测治疗效果和识别恢复的生理标志物。这些进展将特别有助于运动康复，因为步行能力受损是中风后生活质量的主要障碍。然而，技术上的挑战使得在类似运动的运动中对大脑进行成像变得困难。这里提出的研究项目的目的是使用功能磁共振成像来了解大脑如何控制中风后下肢的运动样运动。踏板将被用作运动的模型。PI将检验以下假设：卒中后运动能力受损与大脑未受损侧大脑皮层中与踩踏相关的大脑活动异常升高相关，运动能力改善与大脑活动焦点转移至大脑受损侧的备用皮质区域和小脑相关。这是一个指导研究科学家发展奖的应用程序，将允许申请人发展所需的研究技能，追求独立的，富有成效的职业生涯在康复研究。申请人是一名物理治疗师，在康复研究方面接受过博士和博士后培训。她的长期目标是领导一个独立的，国家认可的实验室，研究神经损伤的人运动的脊髓上控制。这是运动控制中一个重要的新兴领域，候选人可以在她的职业生涯中做出有意义的贡献。候选人将利用她的发现开发和测试康复活动，提高中风后的运动恢复。该申请包括一个职业发展计划，该计划建立在申请人在运动神经控制方面的现有技能基础上，并提供功能性脑成像，运动的脊髓上控制，神经适应的生理基础，临床试验的设计和分析以及负责任的研究行为的额外培训。她选择了三位知名科学家（Brian Schmit博士，Kristina Ropella博士和Jules Dewald博士）作为导师，他们在相关内容领域和资助的研究项目方面具有专业知识。每个导师都对自己的成功有着坚定的承诺。 公共卫生相关性：许多中风幸存者未能恢复行走能力，导致生活质量低下。更好地了解大脑如何控制运动可能会导致更有效的治疗。这项研究的结果将提供深入了解中风后大脑如何控制运动，并可能导致改善中风后运动的新治疗方法。

DESCRIPTION (provided by applicant): Advances in neural imaging technologies, such as functional magnetic resonance imaging (fMRI), have made it possible to examine human brain function during movement in people post stroke. As technologies advance and a better understanding of post-stroke brain function emerges, brain imaging may be used to predict treatment effectiveness and to identify physiological markers of recovery. These advances will be particularly helpful for locomotor rehabilitation, because impaired walking ability is a major obstacle to quality of life post stroke. However, technical challenges have made it difficult to image the brain during locomotor-like movements. The purpose of the research project proposed here is to use fMRI to understand how the brain controls locomotor-like movements of the lower extremities in people post stroke. Pedaling will be used as a model of locomotion. The PIs will test the hypotheses that impaired locomotor ability post stroke is associated with abnormally elevated pedaling-related brain activity in the cerebral cortex on the undamaged side of the brain and that improved locomotor ability is associated with a shift in the focus of brain activity to spared cortical regions on the damaged side of the brain and to the cerebellum. This is an application for a Mentored Research Scientist Development Award that will allow the applicant to develop the research skills required to pursue an independent, productive career in rehabilitation research. The applicant is a physical therapist with doctoral and postdoctoral training in rehabilitation research. Her long term goal is to lead an independent, nationally recognized laboratory that examines supraspinal control of locomotion in people with neural injury. This is an important, emerging area in motor control to which the candidate can make meaningful contributions across her career trajectory. The candidate will use her discoveries to develop and test rehabilitation activities that enhance locomotor recovery after stroke. This application includes a career development plan that builds on the applicant's existing skills in neural control of movement and provides additional training in functional brain imaging, supraspinal control of locomotion, the physiological basis of neural adaptation, design and analysis of clinical trials, and the responsible conduct of research. She has selected as mentors three established scientists (Drs. Brian Schmit, Kristina Ropella, and Jules Dewald) with expertise in relevant content areas and funded research programs. Each mentor has a strong commitment to her success. PUBLIC HEALTH RELEVANCE: Many stroke survivors fail to regain walking ability which leads to poor quality of life. A better understanding of how the brain controls locomotion many lead to more effective treatments. The results of this study will provide insight into how the post-stroke brain controls locomotion and may lead to novel treatments for improving locomotion after stroke.