Stroke is the leading cause of long-term disability in the United States. Frequently, stroke results in significant impairment of arm function which contributes heavily to the resulting disability. This proposed project will examine the neural mechanisms of practice-induced improvements in functional arm movements in individuals with chronic stroke, with the broad, long-term objective of reducing stroke-related disability due to arm impairment through novel rehabilitation interventions. The rationale is that knowing the neural bases of post- stroke arm movements is crucial for the development of targeted intervention strategies for those with significant impairment. This project will directly contribute to the NIH mission of reducing """"""""the burdens of illness and disability."""""""" The aims of the project are to 1) identify brain areas involved in movement performance of the stroke-affected arm, 2) identify brain areas involved in practice-induced improvements in arm function, and 3) determine whether practice-induced improvements could be enhanced with targeted brain stimulation applied during practice. To address these aims, functional magnetic resonance imaging (fMRI) will be used to measure brain activation during reaching movements in moderately-impaired stroke patients and transcranial magnetic stimulation (TMS) and TMS-fMRI co-registration techniques will be used to upregulate activity in specific brain areas associated with practice-induced performance improvement during practice. PHS 398/2590 (Rev. 09/04, Reissued 4/2006) Page Continuation Format Page

Public Health Relevance

The development of interventions to improve motor abilities of the affected arm after stroke is a vital part of alleviating the disability that results from this prevalent condition. In order to develop effective rehabiliation interventions, the mechanisms of motor recovery in people with substantial stroke-induced arm impairment must be understood.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Research Scientist Development Award - Research & Training (K01)
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Special Emphasis Panel (ZHD1-DSR-Z (HM))
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Michel, Mary E
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National Rehabilitation Hospital
United States
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Harris-Love, Michelle L; Chan, Evan; Dromerick, Alexander W et al. (2016) Neural Substrates of Motor Recovery in Severely Impaired Stroke Patients With Hand Paralysis. Neurorehabil Neural Repair 30:328-38
Mohapatra, Sambit; Harrington, Rachael; Chan, Evan et al. (2016) Role of contralesional hemisphere in paretic arm reaching in patients with severe arm paresis due to stroke: A preliminary report. Neurosci Lett 617:52-8
Harrington, Rachael M; Chan, Evan; Turkeltaub, Peter E et al. (2015) Simple Partial Status Epilepticus One-day Post Single-pulse TMS to the Affected Hemisphere in a Participant With Chronic Stroke. Brain Stimul 8:682-3
Lee, Sang Wook; Landers, Katlin; Harris-Love, Michelle L (2014) Activation and intermuscular coherence of distal arm muscles during proximal muscle contraction. Exp Brain Res 232:739-52
Godfrey, Sasha B; Lum, Peter S; Chan, Evan et al. (2013) Cortical effects of repetitive finger flexion- vs. extension-resisted tracking movements: a TMS study. J Neurophysiol 109:1009-16
Harris-Love, Michelle (2012) Transcranial magnetic stimulation for the prediction and enhancement of rehabilitation treatment effects. J Neurol Phys Ther 36:87-93
Harris-Love, Michelle L; Morton, Susanne M; Perez, Monica A et al. (2011) Mechanisms of short-term training-induced reaching improvement in severely hemiparetic stroke patients: a TMS study. Neurorehabil Neural Repair 25:398-411