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Deciphering Preserved Autonomic Function after Spinal Cord Injury

解读脊髓损伤后保留的自主功能

基本信息

批准号：
10904518
负责人：
Ryan Solinsky
金额：
$ 15.52万
依托单位：
MAYO CLINIC ROCHESTER
依托单位国家：
美国
项目类别：
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/10904518
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 Educational process of instructing Exercise Functional Magnetic Resonance Imaging Functional disorder Funding Future Galvanic Skin Response Goals Grant Health Care Costs Healthcare Home Hospitals Human Image Incidence Individual Injury Intervention Knowledge Laboratories 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 Physical Rehabilitation 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 career career development clinical application clinical translation clinically actionable computational neuroscience cost design dorsal horn experimental study foot functional improvement 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

项目摘要

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.

项目总结/摘要：这项培训补助金寻求资金来支持物理医学和心理学博士Ryan Solinsky的职业发展波士顿斯波尔丁康复医院和哈佛医学院的康复医生兼科学家，马萨诸塞州。Solinsky博士正在确立自己作为临床应用和翻译的早期职业调查员的地位。自主神经科学，以改善脊髓损伤后的个人功能结果。K23奖将为Solinsky博士提供必要的支持，以实现以下培训目标：1）加深他对计算神经科学，重点是发展直接交感神经系统记录的专业知识，锋电位训练解码，并在动态监测自主神经指标; 2）开发新的功能自主神经通过与当地专家合作进行神经影像学检查3）在先进的统计方法，适当的对于经常异质性人群（如脊髓损伤患者）的小样本研究;以及4）扩大研究项目管理、财务和临床研究技能。为了实现这些目标，Solinsky博士制定了一个培训计划，J. Andrew Taylor博士是他的主要导师。博士泰勒是一位备受尊敬的博士科学家，在心血管系统的自主控制方面也有研究专长这个系统是如何受到运动的影响，特别是在脊髓损伤的个体中。索林斯基博士会其他共同导师：Teresa金伯利博士，PT，博士，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结果，和罗伊弗里曼博士，MBChB，神经学家和研究人员专门从事自主神经功能障碍的临床评估。在功能性神经影像学方面具有专业知识的进一步合作者，统计方法和临床脊髓损伤护理包括在这一建议，这将是总部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，导致死亡率和增加医疗费用。不幸的是，我们对这一人群的自主神经功能障碍的理解还处于起步阶段。整体本研究的目的是用一种新的方法来描述脊髓损伤后心血管自主神经功能障碍的特征。一系列实验室、门诊和成像工具。这些将集中在心血管自主神经功能，因为这具有最高的临床转化潜力，具有与自主神经的其他成分相关的结构研究神经系统。研究将专门着眼于回答两个问题：1）离散心血管在脊髓损伤患者中确定自主神经表型，并与临床继发性自主神经并发症？2)那些心血管自主神经表型失调最严重的人，脊髓功能连接异常的证据吗回答这些问题将帮助我们理解脊髓损伤后的调节变化以及这些变化如何转化为临床继发性并发症。