Interdisciplinary Research Centers Workshop

National Institutes of Health
February 9-10, 2006

Research Question What is the “best treatment” strategy to use to enhance the health and independence of persons with post-stroke disabilities?

Stroke is the leading cause of serious, long-term disability among American adults. – Each year over 700,000 people suffer a stroke, and nearly 400,000 survive with some form of neurological disability – The estimated annual financial burden from stroke related disability is $53 billion, with over $20 billion in indirect costs due to lost productivity – Since age is the strongest non-modifiable risk factor for stroke it is expected that as the “baby boom” population progressively ages over the next 40 years the number of stroke survivors with disability will double making the need to develop new and innovative rehabilitation programs to treat the growing number of stroke survivors a national priority.

Neuroplasticity provides the cellular mechanisms by which the damaged brain:
– 1) “relearns” lost behaviors through rehabilitation – 2) develops new strategies in motor learning that underlie the recovery of function

Neuroplasticity is critical for determining the limits of functional recovery that can be expected in the rehabilitation process.

ISNSR Research Team - involves faculty from the clinical, biological, engineering and computer sciences with expertise in methods encompassing:
molecular and cell biology behavioral neuroscience bioinformatics computational modeling virtual environment technology haptics biostatistics physical rehabilitation

Key Issues
To what degree does the severity and location of the lesion effect the responsiveness and outcome of the training paradigm? What are the cellular mechanisms that underlie the recovery process? How does the specific contents of the training paradigm effect recovery? ( i.e. skilled learning vs. motor activity, timing and intensity of training, “window of opportunity” for treatment ect.) How can we maintain a patient’s motivation and engagement during the course of rehabilitation?

Long-Term Goals
build a foundation of interdisciplinary scientific knowledge that can translate the basic principles of neuroplasticity into innovative and more effective therapeutic interventions that can: – 1) lead to functional recovery and, – 2) enhance the health and independence of persons with poststroke disabilities. develop a new interdisciplinary discipline with a focus on treatment strategies that lead to recovery of function after brain injury (i.e. “Functional Neurotherapeutics”

STUDY 1: Neurorehabilitation Therapeutics in Stroke Patients

(Winstein and Chui) uses fMRI and MRI to examine the relationship between severity and location of the initial lesion and functional changes in brain activities patterns following task specific training in stroke patients.

STUDY 2: Cellular Mechanisms of Neuroplasticity in Stroke Neurorehabilitation (McNeill) uses an animal model of ischemic

injury and motor skills learning to define the cellular mechanisms that promote neural plasticity and recovery of function after strokeinduced brain injury.

STUDY 3: Influence of Behavioral Experience on Neuroplasticity in Stroke Neurorehabilitation ( Jones and Schallert) uses an animal

model of ischemic injury to determine how the specific contents of training are important for the degree of functional recovery that can be achieved in rehabilitation therapy.

STUDY 4: Use of Virtual Environments and Haptics in Neurorehabilitation Therapy (Rizzo and McLaughlin) develops novel
virtual environments that can uniquely target a wide range of physical, psychological, and cognitive rehabilitation concerns and research questions in stroke rehabilitation.

STUDY 5: Computational Models of Stroke Neurorehabilitation: Mirror neurons, Observation and Learning (Arbib and Schweighofer)
develops computational models of grasp and reach that predict neuroplastic events related to cortical reorganization after stroke and following rehabilitation; and extend current models of the mirror neuron system to clarify their role in action recognition.

Bioinformatics Core (Azen, Arbib and McNeill) is

developing an integrated database for recording, viewing and sharing data between the 5 research studies as well as new data mining tools for searching and sharing data.
Research Subjects
Experimental Manipulations

Research Data

Statistics

Database Extension Interface

Neuroanatomical Concepts

Core Experimental Framework

Neurochemical Concepts

Database Federation Interface Model DB Neuron DB Literature DB

Summary DB

What have we learned?
Fit the research team to the project, not the project to the research team. Recruit the best-fit faculty to address a specific research question. Foster inter-discipline communication by breaking down the barriers inherent to the use of discipline-specific jargon.

Develop a common understanding of both capabilities and limitations of the approaches used by different disciplines – What kinds of questions can be asked? – What types of data can be measured with the current tools of the discipline? – What types of results can be achieved? – How long does it take to achieve your goal? Develop a management structure that promotes collaboration, interaction and team-decision making

University Commitment and Support
Remove the barriers for both direct and indirect cost sharing amongst different schools and departments. Develop mechanisms for recognizing multiple PI’s in large interdisciplinary awards Develop interdisciplinary graduate programs to provide training opportunities for students to develop as independent research scientists equipped to work both within and across scientific disciplines.

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