EXCEED THE SPACE PROVIDED. This application is for a Mentored Patient-Oriented Research Career Development Award entitled 'fMRI and TMS of Motor Recovery after Hemiparetic Stroke'. The long-term objective of this work is to understand the neural mechanisms underlying motor recovery after hemiparetic stroke, so to be able to develop new rational therapies that maximize post-stroke recovery in patients. Toward this objective, the proposed research project will conduct a functional magnetic resonance imaging (fMRI) study and a transcranial magnetic stimulation (TMS) study to evaluate a causal connection between reoganization in sensorimotor cortical areas and post-stroke motor recovery. Stroke patients, with good recovery of hand motor function, and normal subjects will participate in both studies. The fMRI study will evaluate the modulation of activation in contralateral and ipsilateral sensorimotor cortical areas by the dexterity challenge of motor tasks, and by the extent of corticospinal tract damage (estimated using diffusion MRI methods). The TMS study will target fMRI-defined sensorimotor cortical sites, using a frameless stereotactic image guided system, to investigate the functional significance of each of these cortical areas to motor control. Transient functional disruption of a sensorimotor cortical site, induced by repetitive TMS, will be used to evaluate if that cortical area is more critical to controlling motor performance of the stroke-affected hand as compared to control hands. Single-pulse TMS, with recording of motor evoked potentials in a target hand muscle, will be used to determine which sensorimotor cortical sites show increased corticospinal excitability related to the stroke-affected hand. The combined use of fMRI and TMS is expected to provide insights into a causal link between reorganization in sensorimotor cortical areas and motor recovery after stroke that could not be gained by using each technology in isolation. The candidate proposes to receive training in three areas necessary to become an scientist in the field of stroke recovery: 1) theory and practice of advanced human including fMRI, diffusion-weighted MRI, and TMS; 2) basic science and clinical recovery, especially with regard to motor control; and 3) clinical research design, training will be achieved through executing the proposed research study, didactic learning, and seminars. PERFORMANCE SITE ========================================Section End===========================================

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23HD044425-03
Application #
6841171
Study Section
NST-2 Subcommittee (NST)
Program Officer
Nitkin, Ralph M
Project Start
2003-01-01
Project End
2007-12-31
Budget Start
2005-01-01
Budget End
2005-12-31
Support Year
3
Fiscal Year
2005
Total Cost
$156,559
Indirect Cost
Name
Massachusetts General Hospital
Department
Type
DUNS #
073130411
City
Boston
State
MA
Country
United States
Zip Code
02199
Schaechter, Judith D; van Oers, Casper A M M; Groisser, Benjamin N et al. (2012) Increase in sensorimotor cortex response to somatosensory stimulation over subacute poststroke period correlates with motor recovery in hemiparetic patients. Neurorehabil Neural Repair 26:325-34
Schaechter, Judith D; Fricker, Zachary P; Perdue, Katherine L et al. (2009) Microstructural status of ipsilesional and contralesional corticospinal tract correlates with motor skill in chronic stroke patients. Hum Brain Mapp 30:3461-74
Schaechter, Judith D; Perdue, Katherine L; Wang, Ruopeng (2008) Structural damage to the corticospinal tract correlates with bilateral sensorimotor cortex reorganization in stroke patients. Neuroimage 39:1370-82
Schaechter, Judith D; Perdue, Katherine L (2008) Enhanced cortical activation in the contralesional hemisphere of chronic stroke patients in response to motor skill challenge. Cereb Cortex 18:638-47
Schaechter, Judith D; Moore, Christopher I; Connell, Brendan D et al. (2006) Structural and functional plasticity in the somatosensory cortex of chronic stroke patients. Brain 129:2722-33
Schaechter, Judith D; Stokes, Christopher; Connell, Brendan D et al. (2006) Finger motion sensors for fMRI motor studies. Neuroimage 31:1549-59
Schaechter, Judith D (2004) Motor rehabilitation and brain plasticity after hemiparetic stroke. Prog Neurobiol 73:61-72