Project Summary
Over the last 20 years, upper limb rehabilitation intervention trials for severe and chronic post stroke
hemiparesis have largely failed to find significant differences in functional improvement between intervention
and control groups. This has resulted in a dearth of treatment options for at least 50% of stroke survivors who
continue to experience deficits which limit their independence in activities of daily living. To remedy this
shortcoming in field of neurorehabilitation, it is necessary to understand the neural mechanisms which are
central to the motor recovery process following a stroke. We can then develop experiments to exploit these
mechanisms with the goal of optimizing treatment efficacy and facilitating increased independence for the
individual.
Our lab recently published a pilot study on individuals with chronic stroke and moderate to severe impairments
in the UL which suggests that bilateral motor priming in combination with task specific training is an effective
treatment option that can benefit people with severe post-stroke hemiparesis. However, the neurophysiological
mechanisms behind the positive behavioral changes remain unknown. This proposed research will use
transcranial magnetic stimulation (TMS) data from an ongoing clinical trial to investigate the impact of bilateral
motor priming on corticomotor excitability and transcallosal inhibition of the ipsilesional and contralesional
hemispheres in people with chronic stroke (Aims 1 & 2) and determine the relationship between changes in
neurophysiological and behavioral measures (Aim 3) to better understand how and why priming is effective.
The proposed work will provide new insight into the mechanisms underlying priming and, more broadly,
illuminate mechanisms of post stoke motor recovery. These results have the potential to improve functional
restoration of the arm and hand thereby improving quality of life for stroke survivors.
This research will be conducted in the Therapeutic Interventions for Neurological Disorders laboratory under
the direction of Dr. Daniel Corcos at Northwestern University’s (NU) department of Physical Therapy and
Human Movement Sciences (PTHMS). The facilities at NU PTHMS provide everything needed to complete this
research successfully including expert personnel, state-of-the-art laboratories, and the necessary equipment.
The training plan as outlined, will include formal and informal educational opportunities, training in data
processing and analysis and support for manuscript preparation and dissemination of findings.
