Deciphering Preserved Autonomic Function after Spinal Cord Injury

解读脊髓损伤后保留的自主功能

• 批准号: 10040464
• 负责人: Ryan Solinsky
• 金额: $ 17.06万
• 依托单位: SPAULDING REHABILITATION HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-24 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10040464
• 关键词: Affect; Ambulatory Monitoring; Animal Model; Autonomic Dysfunction; Autonomic Dysreflexia; Autonomic nervous system; Autopsy; Blood Pressure; Boston; Cardiovascular system; Caring; Catecholamines; Clinical; Clinical Research; Clinical assessments; Collaborations; Complication; Doctor of Philosophy; Exercise; Foundations; Functional Magnetic Resonance Imaging; Functional disorder; Funding; Future; Galvanic Skin Response; Goals; Grant; Health Care Costs; Healthcare; Home environment; Hospitals; Human; Image; Incidence; Individual; Injury; Intervention; Knowledge; Laboratories; Lead; Link; Maps; Massachusetts; Mentored Patient-Oriented Research Career Development Award; Mentors; Methods; Motor; Neuroanatomy; Neurologic; Neurologist; Neurons; Neurosciences; Paralysed; Pathway interactions; Pattern; Persons; Phenotype; Physical Medicine; Physicians; Physiological; Physiology; Population; Population Heterogeneity; Proxy; Quality of life; Questionnaires; Recovery of Function; Regulation; Rehabilitation therapy; Reporting; Research; Research Personnel; Research Project Grants; Research Proposals; Resources; Rest; Role; Scientist; Secondary to; Sensory; Severities; Signal Transduction; Skin Temperature; Spinal Cord; Spinal cord injury; Statistical Methods; Structure; Sympathetic Nervous System; Symptoms; System; Techniques; Testing; Training; Translating; Translations; Work; base; career; career development; clinical application; clinical translation; clinically actionable; computational neuroscience; cost; design; dorsal horn; experimental study; foot; functional outcomes; heart rate variability; improved; improved outcome; infancy; insight; medical schools; mortality; nervous system disorder; neuroimaging; neuroregulation; novel; preservation; prevent; response; skills; smart watch; spinal cord mapping; stressor; tool

Project summary/abstract: This training grant seeks funding to support the career development of Dr. Ryan Solinsky, a Physical Medicine & Rehabilitation physician-scientist at Spaulding Rehabilitation Hospital and Harvard Medical School, Boston, Massachusetts. Dr. Solinsky is establishing himself as an early career investigator in the clinical application and translation of autonomic neuroscience to improve functional outcomes for individuals after spinal cord injury. This K23 award will provide Dr. Solinsky the necessary support to accomplish the following training goals: 1) Broaden his understanding in computational neuroscience, with a focus on developing expertise in direct sympathetic nervous system recordings and spike train decoding, and in ambulatory monitoring of autonomic indicators; 2) Develop novel functional autonomic neuroimaging through collaboration with local experts 3) Grow his expertise in advanced statistical methods, appropriate for small-n studies of often heterogeneous populations such as those with spinal cord injury; and 4) Expand research project management, grantsmanship, and clinical research skills. To achieve these goals, Dr. Solinsky has developed a training plan with Dr. J. Andrew Taylor as his primary mentor. Dr. Taylor is a well-respected PhD scientist, with research expertise in autonomic control of the cardiovascular system as well as how this system is affected by exercise, specifically in individuals with spinal cord injury. Dr. Solinsky will have additional co-mentors: Dr. Teresa Kimberley, PT, PhD whose research focuses on translation of autonomic neuromodulation to improve outcomes after neurologic disease, and Dr. Roy Freeman, MBChB, a Neurologist and researcher specializing in clinical assessments of autonomic dysfunction. Further collaborators with expertise in functional neuroimaging, advanced statistical methods, and clinical spinal cord injury care are included in this proposal, which will be headquartered at Spaulding Rehabilitation Hospital in Boston, Massachusetts. Autonomic dysfunction following spinal cord injury is a significant clinical issue contributing to mortality and increased healthcare costs. Unfortunately, our understanding of autonomic dysfunction in this population is in its infancy. The overall objective of this research proposal is to characterize cardiovascular autonomic dysfunction after spinal cord injury using a battery of laboratory, ambulatory, and imaging-based tools. These will be focused on cardiovascular autonomic function, as this has the highest potential for clinical translation, with correlative structures to other components of the autonomic nervous system investigated. Research will specifically look to answer two questions: 1) Can discrete cardiovascular autonomic phenotypes be identified within those with spinal cord injury and correlated to clinical secondary autonomic complications? 2) Do those with the most dysregulated cardiovascular autonomic phenotypes demonstrate the highest rates of aberrant spinal cord functional connectivity on fMRI? Answering these questions will help us understand how autonomic regulation changes after spinal cord injury and how alterations translate to clinical secondary complications.

项目概要/摘要： 该培训补助金寻求资金支持 Ryan Solinsky 博士的职业发展，他是一位物理医学和 波士顿斯波尔丁康复医院和哈佛医学院的康复医师兼科学家， 马萨诸塞州。 Solinsky 博士正在将自己定位为临床应用和转化领域的早期职业研究者 自主神经科学可改善脊髓损伤后个体的功能结果。这个K23奖将 为索林斯基博士提供必要的支持，以实现以下培训目标： 1) 拓宽他对以下领域的理解： 计算神经科学，重点是发展直接交感神经系统记录和 尖峰序列解码，以及自主神经指标的动态监测； 2）开发新颖的功能性自主神经 通过与当地专家合作进行神经影像学 3) 适当增长先进统计方法方面的专业知识 用于通常异质人群（例如脊髓损伤患者）的小样本研究； 4）扩大研究项目 管理、资助和临床研究技能。 为了实现这些目标，索林斯基博士制定了一项培训计划，并以 J.安德鲁·泰勒博士为主要导师。博士。 泰勒是一位备受尊敬的博士科学家，在心血管系统自主控制方面也拥有研究专长 运动如何影响该系统，特别是对于脊髓损伤的个体。索林斯基博士将有 其他共同导师：Teresa Kimberley 博士，PT，PhD，其研究重点是自主神经调节的翻译 改善神经系统疾病后的治疗效果，Roy Freeman 博士（MBChB）是一位神经科医生和研究员，专门从事 自主神经功能障碍的临床评估。其他具有功能性神经影像专业知识的合作者，高级 该提案包括统计方法和临床脊髓损伤护理，其总部将设在 马萨诸塞州波士顿的斯波尔丁康复医院。 脊髓损伤后的自主神经功能障碍是导致死亡率和增加的重要临床问题 医疗费用。不幸的是，我们对这一人群自主神经功能障碍的了解还处于起步阶段。整体 本研究计划的目的是使用以下方法来表征脊髓损伤后的心血管自主功能障碍： 一系列实验室、流动和基于成像的工具。这些将集中于心血管自主功能， 因为这具有与自主神经的其他组成部分相关的结构，具有最高的临床转化潜力 神经系统进行了研究。研究将特别寻求回答两个问题：1）能否离散心血管 在脊髓损伤患者中识别自主神经表型，并与临床继发性自主神经相关 并发症？ 2) 那些心血管自主神经表型失调最严重的人表现出最高的比率吗？ 功能磁共振成像中脊髓功能连接异常？回答这些问题将有助于我们了解自主性如何 脊髓损伤后的调节变化以及变化如何转化为临床继发性并发症。