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Mechanisms and Rehabilitation of Cerebellar Ataxia

Award Number: R01HD040289
ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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View Award Abstract

Cerebellar damage impairs movement coordination and adaptive motor learning abilities, making actions like reaching inaccurate and very difficult to control. There are currently no medications that systematically improve cerebellar movement incoordination or `ataxia', making rehabilitation therapy the main treatment option. Yet, people with ataxia are notoriously difficult to treat with physical therapy, likely due to the fact that they are limited in their ability to learn new movement patterns. The studies proposed here address this challenge through the development of a staged, individualized approach to understanding if distinct interventions will be helpful to different people. We will use mathematical modeling of patient-specific movement deficits, alternative learning mechanisms, and robotic control of reaching to test whether we can systematically reduce arm ataxia. In Aim 1, we will determine if reinforcement based motor learning can be used as an alternative strategy in people with cerebellar damage. Our preliminary data show that reinforcement based motor learning is much more effective than adaptive motor learning for reaching movements in people with ataxia. We will test whether this can be used to change complex elements of 3D reaching that are more clinically meaningful for people with ataxia. In Aim 2, we will test whether long-term reinforcement-based training can reduce ataxia and improve 3D reaching performance. Here we will test whether people who show learning via reinforcement on a single day in Aim 1. We will determine if they benefit more from a 2-week course of virtual reality-based reinforcement reach training compared to 2 weeks of standard reaching practice. We will study how training transfers to natural reaching movements (i.e. those outside of the virtual reality environment) and clinical rating scales of arm ataxia and function. In Aim 3, we will develop compensatory robotic assistance for people with ataxia based on individualized models of cerebellar function. This is essential for individuals with the most severe ataxia and learning problems who do not learn at all in Aim 1. In sum, this proposal provides a scientific framework for determining an individual's motor learning potential for rehabilitation versus the need for intelligent compensatory robotic assistance. Our overarching goal is to provide a foundation for devising and choosing new rehabilitation strategies.


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: 2024 ( Subtotal = $0 )
2024	2022	HUGO W. MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER, INC.	707 N BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	000	19	6/25/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $418,507 )
2022	2022	HUGO W. MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER, INC.	707 N BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	000	19	3/4/2022	NON-COMPETING CONTINUATION	$376,657
2022	2022	HUGO W. MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER, INC.	707 N BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	001	19	4/19/2022	NON-COMPETING CONTINUATION	$41,850
														Subtotal = $418,507

Issue Date FY: 2021 ( Subtotal = $418,507 )
2021	2021	HUGO W. MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER, INC.	707 N BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	000	18	3/3/2021	NON-COMPETING CONTINUATION	$418,507
														Subtotal = $418,507

Issue Date FY: 2020 ( Subtotal = $427,048 )
2020	2020	HUGO W. MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER, INC.	707 N BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	000	17	2/20/2020	NON-COMPETING CONTINUATION	$427,048
														Subtotal = $427,048

Issue Date FY: 2019 ( Subtotal = $432,011 )
2019	2019	HUGO W. MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER, INC.	707 N BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	000	16	3/25/2019	NON-COMPETING CONTINUATION	$432,011
														Subtotal = $432,011

Issue Date FY: 2018 ( Subtotal = $452,747 )
2018	2018	HUGO W. MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER, INC.	707 N BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	000	15	3/22/2018	COMPETING CONTINUATION	$452,747
														Subtotal = $452,747

Issue Date FY: 2017 ( Subtotal = $0 )
2017	2015	HUGO W. MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER, INC.	707 N BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	000	14	8/7/2017	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2016 ( Subtotal = $0 )
2016	2015	HUGO W MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER INC	707 NORTH BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	000	14	4/13/2016	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2015 ( Subtotal = $353,179 )
2015	2015	HUGO W MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER INC	707 NORTH BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	000	14	3/31/2015	NON-COMPETING CONTINUATION	$353,179
														Subtotal = $353,179

Issue Date FY: 2014 ( Subtotal = $347,185 )
2014	2014	HUGO W MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER INC	707 NORTH BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	000	13	3/28/2014	NON-COMPETING CONTINUATION	$347,185
														Subtotal = $347,185

Issue Date FY: 2013 ( Subtotal = $366,923 )
2013	2013	HUGO W MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER INC	707 NORTH BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	001	12	5/24/2013	NON-COMPETING CONTINUATION	$18,945
2013	2013	HUGO W MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER INC	707 NORTH BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	000	12	4/4/2013	NON-COMPETING CONTINUATION	$347,978
														Subtotal = $366,923

Issue Date FY: 2012 ( Subtotal = $379,459 )
2012	2012	HUGO W MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER INC	707 NORTH BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	000	11	3/19/2012	NON-COMPETING CONTINUATION	$379,459
														Subtotal = $379,459

Issue Date FY: 2011 ( Subtotal = $388,874 )
2011	2011	HUGO W MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER INC	707 NORTH BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	000	10	12/23/2010	COMPETING CONTINUATION	$388,874
														Subtotal = $388,874

Issue Date FY: 2010 ( Subtotal = $259,554 )
2010	2010	HUGO W MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER INC	707 NORTH BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	000	9	5/3/2010	NON-COMPETING CONTINUATION	$259,554
														Subtotal = $259,554

Issue Date FY: 2009 ( Subtotal = $260,906 )
2009	2009	HUGO W MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER INC	707 NORTH BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	000	8	4/29/2009	NON-COMPETING CONTINUATION	$260,906
														Subtotal = $260,906

Issue Date FY: 2008 ( Subtotal = $260,700 )
2008	2008	HUGO W MOSER RESEARCH INSTITUTE AT KENNEDY KRIEGER INC	707 NORTH BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	000	7	4/1/2008	NON-COMPETING CONTINUATION	$260,700
														Subtotal = $260,700

Issue Date FY: 2007 ( Subtotal = $265,290 )
2007	2007	KENNEDY RESEARCH INSTITUTE, INC	707 NORTH BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	000	6	5/10/2007	NON-COMPETING CONTINUATION	$265,290
														Subtotal = $265,290

Issue Date FY: 2006 ( Subtotal = $271,600 )
2006	2006	KENNEDY RESEARCH INSTITUTE, INC	707 NORTH BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Child Health and Human Development Extramural Research	000	5	4/27/2006	COMPETING CONTINUATION	$271,600
														Subtotal = $271,600

Issue Date FY: 2005 ( Subtotal = $231,614 )
2005	2005	KENNEDY RESEARCH INSTITUTE, INC	707 NORTH BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Center for Medical Rehabilitation Research	000	4	1/26/2005	NON-COMPETING CONTINUATION	$231,614
														Subtotal = $231,614

Issue Date FY: 2004 ( Subtotal = $229,455 )
2004	2004	KENNEDY RESEARCH INSTITUTE, INC	707 NORTH BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Center for Medical Rehabilitation Research	000	3	1/9/2004	NON-COMPETING CONTINUATION	$229,455
														Subtotal = $229,455

Issue Date FY: 2003 ( Subtotal = $228,655 )
2003	2003	KENNEDY RESEARCH INSTITUTE, INC	707 NORTH BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Center for Medical Rehabilitation Research	000	2		NON-COMPETING CONTINUATION	$228,655
														Subtotal = $228,655

Issue Date FY: 2002 ( Subtotal = $226,274 )
2002	2002	KENNEDY RESEARCH INSTITUTE, INC	707 NORTH BROADWAY	BALTIMORE	MD	21205	BALTIMORE CITY	USA	Center for Medical Rehabilitation Research	000	1	2/18/2002	NEW	$226,274
														Subtotal = $226,274

Grand Total All Awards = $6,218,488

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Mechanisms and Rehabilitation of Cerebellar Ataxia

Award Number: R01HD040289

ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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