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Project

Motor Cortex and Spinal Neuromodulation to Optimize Physical Rehabilitation after Spinal Cord Injury

Funder: Craig H Neilsen Foundation

Funding period
USD 150 K
Funding amount
Abstract
Injury to the cervical cord is the most common and debilitating form of SCI, often damaging the corticospinal tract (CST), the main pathway responsible for fine voluntary movement. CST damage interrupts connections between supraspinal motor centers and spinal motor circuitry, resulting in muscle paralysis, weakness and loss of control. The standard therapy for individuals with SCI is physical rehabilitation. However, most forms of rehab result in modest functional improvements. This is primarily because after SCI, axons that transmit descending motor signals are too few and too weak, especially axons of the CST, to produce movements. To enhance the efficacy of rehabilitation, the spared CST connections must be strengthened.
We previously showed that two forms of neuromodulation, motor cortex intermittent theta burst stimulation (iTBS) and cathodal transspinal direct current stimulation (tsDCS) have differential effects on the motor systems. iTBS upregulates axon growth signaling in CST neurons and produces sprouting of spared axons. tsDCS enhances spinal cord excitability after injury, to facilitate the effects of motor cortex stimulation.
The overall objective of this proposal is to understand the anatomical and physiological effects of neuromodulation on spinal neuroplasticity, and how to best harness its actions effectively to optimize neuromodulation-assisted rehabilitation after SCI.
This proposal has 3 aims.
Aim 1 will examine the anatomical and physiological mechanisms underlying corticospinal system repair produced by iTBS and by tsDCS. Aim 2 will determine, independently, the effects of M1 iTBS and cathodal tsDCS on physical rehabilitation after cervical SCI. Aim 3 will combine iTBS with cathodal tsDCS and examine the effect on physical rehabilitation. The basic premise of independent and combined use of iTBS and tsDCS to make rehab more effective is grounded in their differential actions on the nervous system. (CHN: SCIRTS chn:wdg)
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System

Categories
  • FOR (ANZSRC)

    1106 Human Movement and Sports Science

  • FOR (ANZSRC)

    1109 Neurosciences

  • RCDC

    Injury (total) Accidents/Adverse Effects

  • RCDC

    Injury - Trauma - (Head and Spine)

  • RCDC

    Neurosciences

  • RCDC

    Rehabilitation

  • RCDC

    Spinal Cord Injury

  • RCDC

    Neurodegenerative

  • RCDC

    Physical Rehabilitation

  • HRCS HC

    Neurological

  • Health Research Areas

    Biomedical

  • Broad Research Areas

    Basic Science