CSULB Professor, UCI Doctor Partner to Receive Grant From Roman Reed Spinal Cord Injury Research FundsMichael Lacourse, chair of the Kinesiology and Physical Education Department at Cal State Long Beach, is part of a team that has been awarded a $90,000 grant from the Roman Reed Spinal Cord Injury Research Funds for a one-year project examining the effects of a planned motor imagery treatment protocol on stimulating brain activity and improving corticospinal tract function in spinal cord injured patients.
The project is a collaboration with Dr. Steven Cramer, a neurologist from UC Irvine, who is serving as the grant’s principal investigator.
“Our study is actually the first one funded by Roman Reed that will study human behavior in the sense that most funded researchers use animals to look at repairing the spinal cord itself,” said Lacourse, who notes that most spinal cord research funded by Roman Reed focuses on rebuilding connections between the brain and muscles of patients. “Our project is really the first one to look at treatment interventions.”
The study will involve 30 individuals, 15 who have suffered spinal cord injuries and 15 who have no such injuries but are in the same age range so the rate of improvement can be measured in somewhat consistent subjects.
This particular project has grown out of motor imagery work that Lacourse has been working on for many years, much of it conducted at his laboratory at the Veterans Hospital in Long Beach.
The study will use functional magnetic resonance imaging (fMRI) and transcranial magnetic stimulation (TMS) techniques to map changes in brain organization associated with the planned motor imagery treatment. TMS takes a device shaped like a round magnetic coil and places it over a particular point of the brain that, for example, controls the leg. The coil creates a magnetic field and discharges neurons that connect all the way down into the muscle of the targeted limb. Using that process, it can be determined if that circuitry is still in place and maybe even strengthen it. In addition, it can measure the response of a muscle to see how strong the neural pathway is down to the particular muscle.
As part of the study, they will take preliminary measurements of people with spinal cord injuries, then go through a week of intensive motor imagery training. Then, they will use TMS and fMRI again after a one-week training period to see if there are changes as to how the muscle responds and to see if there has been any enhancement or improvement in the motor circuitry as a result.
“Ideally, we want to use motor imagery immediately after an injury to maintain the way the brain functions because it has a certain organization and function to it,” said Lacourse. “When you have a spinal cord injury that basically eliminates traffic to and from a limb to the brain, then the brain is going to change as a result of that. And, it changes in a very short period of time. It’s not like months and years, it’s days and weeks. The brain reorganizes as a result of the disconnection and sometimes that reorganization is a detriment to recovery.
“Right after the initial injury patients are immobilized. We want to use imagery at this point to activate the brain. So, we ask people to imagine themselves doing functional tasks (such as driving a car, walking around, etc.) and it keeps the brain active and by doing so it helps maintain the circuits so that at some point in time when they begin physical therapy the speed of or the extent of recovery can be improved. It can serve as a complement for physical therapy.”
In simple terms, Lacourse and Cramer want the brain to continue practicing, even though the spinal cord injury may be so severe it, at the time, does not allow a patient to physically react.
The reason this method has a lot of potential value for rehabilitation, Lacourse explained, is that studies have shown the same circuits and networks are activated in the brain when you imagine yourself moving as when you actually move. It’s not exactly the same because there is no feedback from limbs affected by spinal cord injury, but there are some similarities of how the brain responds to those kinds of tasks.
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