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Trigeminal Nerve Stimulation in Chronic Hemiparetic Stroke

Award Number: F31NS120500
ORGANIZATION: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS
PERIOD OF PERFORMANCE START DATE: 12/01/2020
PERIOD OF PERFORMANCE END DATE: 11/30/2022

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Trigeminal Nerve Stimulation in Chronic Hemiparetic Stroke - Project Summary Emerging research has suggested that chronic stroke induced motor impairments exhibit a dependence on heighted brainstem mediated monoaminergic drive. Explicitly, an increase in descending monoamines is believed to increase spinal motoneuron excitability and thus (1) generate spasticity and (2) amplify the diffuse commands that are responsible for flexion synergy expression. Though modulating this descending monoaminergic drive yields tremendous potential in affecting both impairments, current pharmacological approaches prove inadequate and require lengthy titration schedules and elicit burdensome side effects. Thus, I propose the novel application of transcutaneous electrical ophthalmic trigeminal nerve stimulation (TNS). This non-invasive stimulus has been shown to attenuate systemic measures of monoamines and is believed to modulate monoaminergic brainstem areas such as the locus coeruleus. Such an ability to non-invasively reduce monoamines represents the possibility for substantial improvements in stroke induced movement impairments. To investigate this potential, the goal of the proposed project is to elucidate the effects of TNS on (1) upper limb spinal motoneuron excitability and (2) flexion synergy expression in chronic stroke survivors. Highly quantitative metrics will be employed for both aims. Spinal motoneuron excitability will be quantified through the tonic vibration reflex and deep tendon reflex and flexion synergy expression will be quantified with precise robotic measures of upper extremity work area. These measures will be conducted before, during and after either a real or sham TNS stimulus condition, with stimulus induced changes in the metrics compared between conditions and against a quantitative metric of systemic monoamines (salivary α-amylase). Preliminary work has highlighted the feasibility of the proposed measures and supported the posited rationale. Specifically, initial efforts have shown a reduction of motor impairments during TNS in individuals with chronic hemiparetic stroke. Findings from this study will act to inform an understanding of the functional role of monoaminergic contributions to human motor control. This will deepen our understanding of human motor control and could facilitate substantive efforts in the development of neurorehabilitation paradigms. Specifically, through the application of TNS detailed here, this project will supply initial evidence for a neuromodulatory probe with the potential to alter monoaminergic drive and reduce chronic stroke induced motor impairments. This will provide insight into the magnitude of monoaminergic contributions to upper extremity motoneuron excitability and flexion synergy expression and their susceptibility to changes in monoaminergic drive.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2023 ( Subtotal = -$716 )
2023	2022	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	2	9/27/2023	NON-COMPETING CONTINUATION	-$716
														Subtotal = -$716

Issue Date FY: 2022 ( Subtotal = $42,525 )
2022	2022	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	2	4/27/2022	NON-COMPETING CONTINUATION	$717
2022	2022	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	2	11/26/2021	NON-COMPETING CONTINUATION	$41,809
2022	2022	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	002	2	6/2/2022	NON-COMPETING CONTINUATION	-$1
														Subtotal = $42,525

Issue Date FY: 2020 ( Subtotal = $40,733 )
2020	2020	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	1	9/18/2020	NEW	$0
2020	2020	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	1	9/18/2020	NEW	$40,733
														Subtotal = $40,733

Grand Total All Awards = $82,542

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Trigeminal Nerve Stimulation in Chronic Hemiparetic Stroke

Award Number: F31NS120500

ORGANIZATION: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS

PERIOD OF PERFORMANCE START DATE: 12/01/2020

PERIOD OF PERFORMANCE END DATE: 11/30/2022

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