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Mechanistic and neuroanatomic bases of disparity between arm capacity and use in stroke

Award Number: R01HD104637
ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/01/2022
PERIOD OF PERFORMANCE END DATE: 05/31/2027

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Mechanistic and neuroanatomic bases of disparity between arm capacity and use in stroke - Project Summary More than 750,000 individuals in the U.S. have a stroke each year, and as many as 94% of stroke survivors exhibit reduced use of one arm, with adverse consequences for disability, caregiver burden, and quality of life. Approximately 40%-80% of individuals who fail to use the affected arm in daily life possess adequate sensory- motor capacity to do so. The disparity between arm use and capacity (i.e., Use/Capacity Disparity -- UCD) occurs across a broad spectrum of sensory-motor severity and is a perplexing and urgent problem in neuro- rehabilitation. Perhaps in part because UCD lies at the interface of sensory-motor processing and cognitive/affective phenomena, no past research has assessed its underlying mechanisms or neuroanatomic biomarkers. Given its prevalence, an understanding of the mechanisms of UCD across a range of severity is required to develop targeted treatments to ameliorate the disorder. Moreover, individuals with stroke are rarely assessed for the presence of UCD, in part because such assessment is challenging. The proposed research will address these gaps in our knowledge and capacity by testing the predictions of 3 hypotheses of the mechanisms underlying UCD: the sensorimotor, attention, and apathy/motivation accounts. In Aim 1 we will administer a targeted battery of sensorimotor and neuropsychological tests to test the predictions of each of the 3 hypotheses in a sample of 100 mild to moderate left- and right-hemisphere chronic stroke patients. We will determine the association of these measures as well as demographic and stroke-related variables with UCD. Aim 2 will use advanced neuroimaging methods with data from resting-state functional magnetic resonance imaging to develop imaging biomarkers associated with UCD. In Aim 3 we will validate a novel virtual reality assessment tool to rapidly and reliably evaluate UCD. In addition to its clinical utility, the task enables built-in assessment of the attention hypothesis by determining whether UCD is influenced by attentional task demands. By the end of the grant period, we will have determined the demographic, sensorimotor, neuropsychological, and neuroanatomical factors that predict UCD and validated a clinically-useful VR assessment tool. Given the limited knowledge base in this area, this comprehensive research will pave the way for development of treatments targeted to underlying mechanisms and enhanced identification of at-risk individuals.


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: 2025 ( Subtotal = $485,197 )
2025	2025	JEFFERSON HEALTH CORPORATION	1101 MARKET ST STE 2400	PHILADELPHIA	PA	19107	PHILADELPHIA	USA	Child Health and Human Development Extramural Research	001	4	9/20/2025	NON-COMPETING CONTINUATION	-$485,197
2025	2025	JEFFERSON HEALTH CORPORATION	1101 MARKET ST STE 2400	PHILADELPHIA	PA	19107	PHILADELPHIA	USA	Child Health and Human Development Extramural Research	000	4	5/21/2025	NON-COMPETING CONTINUATION	$970,394
														Subtotal = $485,197

Issue Date FY: 2024 ( Subtotal = $482,048 )
2024	2024	ALBERT EINSTEIN HEALTHCARE NETWORK	5501 OLD YORK RD	PHILADELPHIA	PA	19141	PHILADELPHIA	USA	Child Health and Human Development Extramural Research	000	3	5/28/2024	NON-COMPETING CONTINUATION	$482,048
														Subtotal = $482,048

Issue Date FY: 2023 ( Subtotal = $485,197 )
2023	2023	ALBERT EINSTEIN HEALTHCARE NETWORK	5501 OLD YORK RD	PHILADELPHIA	PA	19141	PHILADELPHIA	USA	Child Health and Human Development Extramural Research	001	2	5/14/2023	NON-COMPETING CONTINUATION	$485,197
2023	2022	ALBERT EINSTEIN HEALTHCARE NETWORK	5501 OLD YORK RD	PHILADELPHIA	PA	19141	PHILADELPHIA	USA	Child Health and Human Development Extramural Research	000	1	5/13/2023	NEW	$0
														Subtotal = $485,197

Issue Date FY: 2022 ( Subtotal = $517,253 )
2022	2022	ALBERT EINSTEIN HEALTHCARE NETWORK	5501 OLD YORK RD	PHILADELPHIA	PA	19141	PHILADELPHIA	USA	Child Health and Human Development Extramural Research	000	1	7/25/2022	NEW	$517,253
														Subtotal = $517,253

Grand Total All Awards = $1,969,695

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Mechanistic and neuroanatomic bases of disparity between arm capacity and use in stroke

Award Number: R01HD104637

ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 08/01/2022

PERIOD OF PERFORMANCE END DATE: 05/31/2027

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