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 post-
stroke 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 stroke-
induced 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 Experimental Research

Subjects Manipulations Data Statistics

Database Extension Interface

Neuroanatomical Core Neurochemical

Experimental
Concepts Concepts
Framework

Database Federation Interface

Model Neuron Literature

DB DB 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.