The Center for Functional Electrical Stimulation (FES Center) is a 25 year consortium that develops and deploys rehabilitation treatments based on functional electrical stimulation (FES) for Veterans and civilians with neurological, autonomic, psychiatric, pain, and other disorders. The VISION of the Cleveland FES Center is broad - to perform cutting edge research and creative engineering, and to then transition these discoveries and technologies into the clinical environment to create effective, clinically-available options for patients and the people who care for them. The MISSION of the FES Center, however, is very clear and tightly focused - to develop interventions based on the electrical stimulation of the nervous system to replace or compensate for natural neural function lost due to neurological disease or injury. The scope of FES Center research has evolved and expanded significantly during the current five year funding cycle to reflect new scientific discoveries and new clinical opportunities. This proposal represents this evolution and thus describes the five research thrusts of the FES Center for the next five years: (1) MOVEMENT RESTORATION: restoring limb, respiratory, and other body movements; (2) BRAIN HEALTH: brain stimulation interventions for movement disorders (e.g., Parkinson's disease), stroke and traumatic brain injuries, epilepsy, and neuropsychiatric disorders, as well as brain recording technologies; (3) PAIN: pain mitigation through stimulation of peripheral nerves and the spinal cord; (4) AUTONOMIC SYSTEMS: autonomic nervous system stimulation for restoration and/or regulation of internal body and visceral functions; and (5) TECHNOLOGY AND TOOLS: development of basic stimulation techniques, implantable systems and electrodes, modeling and simulation tools, and other rehabilitation approaches complementary to FES. These seemingly diverse research thrusts in fact share a deep foundation of basic knowledge, use similar and often identical technologies, and rely on a proven model of genuine clinical-technical partnerships. The FES Center has built a critical mass of investigators in each of these research thrust areas, and will continue to pursue research in important new clinical areas where FES may provide effective treatments. FES Center research thrusts are tightly aligned with the priorities of the VA RR&D Service, and FES Center investigators are leaders in the national and local rehabilitation communities. The FES Center operates with core funding from the VA Rehabilitation Research and Development Service and uses these resources to broadly enable the success of its investigators by providing a unique technical infrastructure, specialized research services (regulatory, statistical, medical illustration, inter-institutional administrative support), development of key industrial and academic relationships, and communication to potential patients, other scientists, and to the general public. The consortium structure of the FES Center continues to effectively leverage the amazingly rich academic and clinical expertise across the Cleveland area. The FES Center focus on community building, collaboration and inclusion, and shared infrastructure ? rather than on funding specific projects ? has promoted continuous innovation and growth, enabled MANY investigators to successfully pursue major projects that would otherwise be impractical, and has realized economic efficiencies through core facilities and economies of scale. AND, the FES Center has steered this major enterprise to focus on the rehabilitation challenges of Veterans! The FES Center and its investigators have been highly successful over the past five years in terms of research productivity and collaboration, clinical impact, leadership in rehabilitation research, and training and career development of VA investigators. We have developed ambitious but obtainable goals for the coming 5 years, as well as a clear plan for achieving these goals. The FES Center will continue to provide core resources that can be leveraged by our investigators and their interdisciplinary teams to conduct unique, cutting-edge research and clinical deployment. The scope of FES Center research has been expanded over the past five years, but our overriding objective - to achieve increasingly meaningful impact on the lives of Veterans and civilians with disabilities - remains unchanged. The FES Center is thus poised to have continued impact on rehabilitation research into the future.
Functional electrical stimulation (FES) is the use of small electrical currents applied to the nervous system to replace or compensate for the actions of neurons that have been damaged by injury or disease. The Center for Functional Electrical Stimulation (FES Center) develops new, FES-based rehabilitation treatments for Veterans and civilians with neurological disorders such as spinal cord injury, stroke, traumatic brain injury, Parkinson's disease, chronic pain, psychiatric disorders, epilepsy, and internal body functions (for example, hypertension, inflammation, appetite, bladder and bowel function). FES Center investigators (1) explore new approaches for interfacing with the nervous system, (2) develop new stimulation technologies, (3) establish teams of scientist, engineers, and clinicians with specialized expertise who explore the effectiveness and practicality of the FES treatment, and (4) endeavor to move effective new FES treatment into clinical deployment. The FES Center maintains a uniquely rich environment that actively promotes new discoveries and provides the critical resources needed for innovation.