Supraspinal Contributions to Locomotor Control and Recovery after Stroke

描述(申请人提供)：神经成像技术的进步，如功能磁共振成像(FMRI)，使检测中风后患者在运动过程中的大脑功能成为可能。随着技术的进步和对中风后大脑功能的更好了解，脑成像可能被用于预测治疗效果和识别康复的生理标志。这些进展将特别有助于运动康复，因为行走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很难对大脑进行成像。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人们的腿部运动样运动。踏板将被用作一种运动模式。PIS将测试以下假设：中风后运动能力受损与大脑未受损一侧大脑皮层中与踏板相关的异常升高的大脑活动有关，以及运动能力改善与大脑活动重点转移到受损一侧大脑皮质和小脑的备用区域有关。这是一份申请指导研究科学家发展奖的申请，该奖项将允许申请者发展所需的研究技能，以在康复研究中追求独立的、富有成效的职业生涯。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，检查神经损伤患者的脊柱上运动控制。这是运动控制领域一个重要的新兴领域，求职者在整个职业生涯中都可以在这个领域做出有意义的贡献。这位候选人将利用她的发现开发和测试康复活动，以增强中风后的运动恢复。这份申请包括一份职业发展计划，该计划建立在申请者现有的神经运动控制技能的基础上，并提供额外的脑功能成像、脊柱上运动控制、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指导方面的培训。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具有专业知识，并资助了研究项目。每一位导师都对自己的成功有着坚定的承诺。 公共卫生相关性：许多中风幸存者无法恢复行走能力，这导致生活质量较差。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对中风后大脑如何控制运动的洞察，并可能导致改善中风后运动的新疗法。

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.