Movement Asymmetries following Spinal Cord Injury
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abstract
Cervical spinal cord injury (SCI) in humans largely damages both sides of the spinal cord resulting in asymmetrical impairments in bilateral arm function. Recent evidence showed that during bilateral arm movements the more impaired arm delays the motion of the less impaired arm, resulting in large movement asymmetries. These movement asymmetries take place during the grasping phase of the task (hand opening and closing) significantly impacting the ability to grasp an object. This proposal has two main goals: 1) examine the neurophysiology of pathways contributing to bilateral arm movement asymmetries, and 2) target cortical connections to spared descending motor pathways as a novel approach for improving movement symmetries during bilateral grasping in individuals with cervical SCI. In Aim 1, we propose to use noninvasive transcranial magnetic stimulation (TMS) to investigate bilateral physiological interactions between CNS pathways following SCI during hand opening and closing. Peripheral nerve stimulation will be used to assess the excitability of spinal motor neurons during the same phases of the task. In Aim 2, we propose to improve bilateral grasping by using a repetitive paired-pulse TMS protocol that target cortical connections to spared descending motor pathways and motor training using a bilateral reaching and grasping training protocol driven by force and EMG coupling. The proposed research will provide new knowledge on the neural control of bilateral grasping in individuals with and without cervical SCI (Aim 1) and might lead to the development of a novel mechanistic-driven therapeutic intervention to enhance grasping function during functionally relevel motor tasks (Aim 2). Importantly, the possibility of obtaining this award will provide Dr. Lei the opportunity to receive training in electrophysiology in humans with and without SCI. (CHN: SCIRTS chn:wdg)
