Campus: CSU, Long Beach -- May 18, 2001

U.S. Department of Veterans Affairs Awards $680,000 Grant to CSULB Professor for Project Dealing with Spinal Cord Injuries

The U.S. Department of Veterans Affairs has awarded a three-year, $680,000 grant to a Cal State Long Beach professor for a project that will focus on the rehabilitation of veterans with traumatic spinal cord injuries, announced CSULB President Robert C. Maxson.

Michael Lacourse, professor and chair of the CSULB Kinesiology and Physical Education Department, is the principle investigator for the project, titled "Motor Imagery and Cortical Sensorimotor Plasticity," that will have him working with the Neuroimaging Research Laboratory at the Long Beach VA Medical Center.

The goal of the project is to develop a successful therapeutic intervention strategy using motor imagery, a process in which a patient imagines him or herself executing body movements, to facilitate or speed up motor recovery following a traumatic spinal cord injury.

"Obviously, motor imagery is not the same as exercising or moving. But, are the benefits of motor imagery of sufficient value to develop a more formal therapeutic intervention that would be used as a standard with spinal cord injuries," asked Lacourse, who has been collaborating with the VA hospital system for seven years. "That is what we will be looking at through this project, and a successful treatment would facilitate recovery by helping to maintain functional organization of the cortical motor system."

When a person suffers a traumatic spinal cord injury, Lacourse explained, he or she is immobilized or in bed for some period of time, and during that time, the brain is rapidly reorgani-

zing itself. Through this project, he will be researching whether or not motor imagery can be used to maintain the organization of the motor systems of the brain so that it would facilitate recovery when the person is ready to begin physical rehabilitation.

As a result of damage to the spinal cord, neural traffic to and from the limbs of the body is eliminated. So, for example, the area of the brain that receives information from the legs is no longer receiving, and other body parts that are still intact begin to expand or take over that area of the brain. Consequently, when a person is ready to begin physical rehabilitation, there is a chance the neural circuits involved in moving the legs no longer exist or are not intact as they were before the injury.

"After a spinal cord injury, it is not the injury itself that creates most of the problems," Lacourse noted. "It is the body's bio-chemical response to the injury. Certain types of cells attack neural cells, and those damaged cells around the spinal cord injury die, which eliminates or limits skilled motor behavior."

Motor imagery training would likely be most effective during the acute and sub-acute injury phases of a spinal cord injury, and it may have both protective and restorative value in maintaining or re-establishing cortical sensorimotor processes controlling motor behavior. It has also been reported that motor imagery training alone could increase muscle strength by as much as 22 percent over four weeks.

Through the use of a measurement technique known as functional magnetic resonance imaging (fMRI), Lacourse evaluates brain activity by measuring the BOLD (blood, oxygen-level dependent) response. What it shows is that when a person moves a hand, there is increased blood flow to the area of the brain that controls the hand. The fMRI is used to measure that response.

"We just completed an experiment showing that for a week of daily practice using motor imagery training of the hand that the brain is more active in the area that controls hand movement," Lacourse said. "We essentially showed that the cortical representation of the hand increased through a week of imagery practice. So, we did see the changes in the brain, and that is actually the pilot data we used for this project."

He also noted that there is substantial evidence of increased blood flow to cortical and sub-cortical sensorimotor regions during motor imagery performance that is similar in magnitude to the blood flow observed during actual movement. This evidence suggests an activation throughout the brain's motor systems during motor imagery.

The project is made up of five experiments that will test the specific effects of motor imagery training on serial and discrete motor performance and muscle strength as well as associated neuronal activity patters in primary and secondary cortical sensorimotor areas. The findings of the experiments will provide the critical data needed to formulate future experiments that would specifically test the effectiveness of motor imagery training for preserving and/or restoring motor behavior with spinal cord injury patients.

"While we're doing this basic research, we might also initiate some clinical research and try to introduce these interventions using patients with spinal cord injuries to test their effectiveness with patients," Lacourse pointed out. "There is no guarantee that this is going to work. We have some data that shows, preliminarily, it does work. If, in the end, it does work, we will want to implement these interventions in the clinical environment as soon as we possibly can."

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