Deciphering Preserved Autonomic Function after Spinal Cord Injury

项目摘要/摘要： 这笔培训赠款寻求资金，以支持瑞安·索林斯基博士的职业发展，他是一名物理医学和 波士顿斯波尔丁康复医院和哈佛医学院的康复内科医生兼科学家， 马萨诸塞州。索林斯基博士正在确立自己在临床应用和翻译方面的早期职业研究人员的地位 自主神经科学，以改善脊髓损伤后个体的功能结果。这个K23奖项将 为索林斯基博士提供必要的支持，以实现以下培训目标：1)扩大他对 计算神经科学，专注于发展直接交感神经系统记录和 2)开发新的功能自主神经 通过与当地专家合作进行神经成像3)在先进的统计方法方面增长专业知识，适当 用于经常是不同人群的小规模研究，例如脊髓损伤人群；以及4)扩大研究项目 管理、勇气和临床研究技能。 为了实现这些目标，索林斯基博士制定了一项培训计划，J·安德鲁·泰勒博士是他的主要导师。Dr。 泰勒是一位备受尊敬的博士科学家，在心血管系统的自主神经控制方面也有研究专长。 运动是如何影响这一系统的，特别是在有脊髓损伤的人身上。索林斯基博士将会有 其他合作导师：Teresa Kimberley博士，PT，博士，专注于自主神经调节的翻译研究 为了改善神经系统疾病后的预后，MBCHB的罗伊·弗里曼博士是一名神经学家和研究员，专门从事 自主神经功能障碍的临床评估。更多具有功能神经成像专业知识的合作者，高级 统计方法和临床脊髓损伤护理包含在这项提案中，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一个重要的临床问题，导致死亡率和死亡率增加。 医疗保健成本。不幸的是，我们对这一人群自主神经功能障碍的理解还处于初级阶段。整体而言 这项研究的目的是用一种新的方法来表征脊髓损伤后的心血管自主神经功能障碍。 实验室、移动和基于成像的工具的电池。这些将集中在心血管自主神经功能上， 因为这具有最高的临床翻译潜力，具有与自主神经的其他组成部分相关的结构 神经系统检查过了。研究将特别寻求回答两个问题：1)心血管疾病能否离散 自主神经表型可在脊髓损伤患者中识别，并与临床继发性自主神经相关 并发症？2)心血管自主神经表型异常最严重的人的发病率最高吗？ 脊髓功能连接异常在功能磁共振成像上的表现？回答这些问题将有助于我们理解自主 脊髓损伤后的规则变化以及这种变化如何转化为临床继发性并发症。

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.