The Career Development Award (CDA) experience includes research, professional, and clinical experience that will be prepare the nominee for a career as an independent investigator within the VA. The nominee is currently a Research Biomedical Engineer at the VA Pittsburgh Healthcare System and an Assistant Professor at the University of Pittsburgh. Her research interests include restoring or augmenting function for veterans with motor impairments through novel rehabilitation paradigms or assistive technologies. The research and training proposed in this CDA will allow her to improve her skills related to neuroanatomy/physiology, statistical analysis of high dimensional neural data, grantsmanship, and written and oral communication skills. The mentorship team includes experts in the fields of neuroanatomy (Peter Strick, PhD), rehabilitation research (Michael Boninger, MD), and neural engineering (Douglas Weber, PhD) who will facilitate this project. As part of this CDA, the nominee will attend journal clubs, research seminars, and professional conferences relevant to neuroplasticity, neurorehabilitation, and neural engineering. She will also take classes in Systems Neuroscience and Neural Data Processing. One half day every other week will be spent in the Physical and Occupational Therapy clinic to learn the strengths and limitations of currently available therapies as well as the needs of veterans with disabilities. As part of professional development, she will present her work regularly both locally and at professional conferences. At least three first author publications are expected to result from this work and the nominee will submit a CDA2 proposal as the CDA1 nears completion. Developing these research and professional skills will allow the nominee to pursue an independent research career related to neuroscience and neurorehabilitation with the goal of developing new rehabilitation strategies and assistive technologies. The proposed research is an investigation of cortical changes related to motor planning in individuals with cervical spinal cord injury (SCI). SCI results in the loss of motor control below the level of injury and individuals with tetraplegia have identified restoration of hand function as a priority to increase independence and improve quality of life. Researchers are working to develop neuroprosthetics restore function to people with motor impairments. Others are working towards spinal cord repair or regeneration techniques. Both of these promising therapies require intact motor control networks in the brain. However, following SCI, the disruption of efferent and afferent neural pathways likely leads to changes at the level of the brain. In order to develop new rehabilitative strategies or assistive technologies, it is important to understand how SCI affects the areas of the brain that are responsible for motor control. In the proposed study, MEG will be used to examine spatial and temporal patterns of activation in motor, visual, and parietal association areas in persons with SCI and able-bodied control participants performing visually guided covert (imagined and observed) and overt movements. Two types of movements will be studied, one that subjects with tetraplegia cannot perform overtly due to complete paralysis and a second movement limited by paresis, which is defined as a slight or partial paralysis. Cortical activity during movement may differ with the degree of impairment in the associated musculature leading to different rehabilitation strategies. Results from this study will provide important insight into the effects of chronic SCI on the functioning of sensorimotor regions of cerebral cortex and will guide the development of neurofeedback training paradigms for enhancing activation of motor cortical areas to strengthen corticospinal connection to muscles weakened by SCI.

Public Health Relevance

Of the estimated 225,000-296,000 people in the United States with spinal cord injury (SCI), more than 25,000 receive care through the VA Health Care System. There are currently no well-established rehabilitative methods for restoring motor function. This proposal focuses on understanding cortical (brain) changes related to the control of hand movement in individuals with tetraplegia who have paralysis of the legs and arms/hands. Magnetoencephalography is a non-invasive tool that allows us to measure brain activity during real, imagined, or observed movements. Imagined or observed movement may allow us to access the brain areas responsible for movement in individuals with tetraplegia. Understanding how SCI impacts brain activity will inform the development of neurorehabilitation techniques. Neurorehabilitation training (real-time feedback of brain activity) may be able to enhance movement-related brain activity and possibly improve function for veterans with disabilities.

National Institute of Health (NIH)
Veterans Affairs (VA)
Veterans Administration (IK1)
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Veterans Health Administration
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Foldes, Stephen T; Weber, Douglas J; Collinger, Jennifer L (2017) Altered modulation of sensorimotor rhythms with chronic paralysis. J Neurophysiol 118:2412-2420