Stroke is the leading cause of disability in the United States. Stroke frequently devastates movement, limiting the ability to feed, bathe, dress, and care for oneself. Although the brain is capable of some reorganization after stroke, recovery is generally incomplete and inadequate. We believe that neurorehabilitation can--and should--do better.
Our central mission is to restore motor function after stroke by harnessing the brain's neuroplastic potential. We focus on developing methods to accelerate motor learning and recovery, and on understanding the mechanisms that underlie this acceleration. We study individuals who are healthy and who have had a stroke. Our research seeks to hone neurorehabilitation strategies, guided by our understanding of neuroplasticity and learning.
One major area of research is developing a tool to objectively quantify movement dose (i.e., the number of functional movements trained) in individuals undergoing upper limb stroke rehabilitation. From animal models of stroke, we know that early and high-dose rehabilitation results in better motor recovery. The early rehabilitation dose that best maximizes recovery in humans is unknown. This gap in knowledge stems from the lack of tools that can precisely quantify what and how much patients are doing in an actual rehabilitation setting. We are using a combination of wireless sensors and machine learning algorithms to automatically count functional movement repetitions. We aim to use this tool in quantitative dose-response rehabilitation trials in the future.
mechanisms of neurorecovery
How does the brain learn to move skillfully? Furthermore, how does it re-learn to move skillfully after stroke? Another major area of research in the lab is understanding the neural mechanisms of motor skill learning and recovery, and using this information to guide the development of novel therapeutic strategies. We use noninvasive brain stimulation and advanced neuroimaging techniques to probe these mechanisms. Using transcranial magnetic stimulation (TMS) and diffusion kurtosis imaging (DKI), we seek changes in neural circuitry that are associated with learning and recovery. Using transcranial electrical stimulation (TES), we induce a "gain of function" effect to better understand cortical and subcortical networks contributing to learning and recovery. This collective methodological approach not only enables us to identify drivers of motor learning and recovery, but also helps us to build rational therapeutics for potentiating recovery after stroke.