Impact of sensorimotor pathway integrity on hand motor recovery in stroke survivors

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PROJECT SUMMARY / ABSTRACT The objective of the parent grant (R01 HD094731) is to determine if combining TheraBracelet with hand task practice is superior to hand task practice alone for recovery of hand function post-stroke in an adequately powered study. The parent grant focuses on determining the effect of TheraBracelet on hand functional recovery, sensorimotor grip control, and neural communication. This diversity supplement will provide a new insight into how sensorimotor pathway integrities explain individual patients’ hand functional recovery. Specifically, three sensorimotor pathway integrities will be examined including the sensory pathway, sensorimotor integration, and motor pathway, all measured as part of the assessment for neural communication. This supplement has two aims. Aim 1: Determine the effects of the three sensorimotor pathway integrities on motor recovery. It is hypothesized that the integrity of all three components of the sensorimotor pathways at baseline will independently contribute to the extent of motor recovery with upper extremity rehabilitation intervention. Aim 2: Determine neuroplasticity of the three sensorimotor pathways with motor recovery. It is hypothesized that the integrity of the three components of the sensorimotor pathways will improve from pre to post upper extremity rehabilitation intervention. Impact: This diversity supplement research will elucidate the importance of considering the sensory pathway and sensorimotor integration in addition to the motor pathway integrity for post- stroke motor recovery prognosis (Aim 1) and neuroplasticity (Aim 2). Consideration of all neural pathways associated with sensorimotor control, rather than just the motor pathway, is expected to enhance prognosis of motor recovery following stroke. In addition, the complete picture of the changes occurring in the sensorimotor pathways is expected to elucidate the neural mechanisms of motor recovery. Most importantly, this award will foster the candidate with a disadvantaged background (Ms. Jenna Blaschke) as an OTD/PhD researcher. The training activities will focus on developing new research skills for Ms. Blaschke to perform the supplement research and begin her research career. Specifically, Mr. Blaschke will (1) enhance the overall knowledge of the neurorehabilitation research field, (2) develop proficiency in quantifying, analyzing, and interpreting EEG and TMS for sensory, sensorimotor integration, and motor pathway integrities and their relations to motor recovery, and (3) advance her professional development including dissemination, grantsmanship, development of a successful application for a PhD program. The training from this supplement award will form the foundation for her future career as a clinician researcher to improve post-stroke motor recovery and diversify biomedical workforce.