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Harnessing Neuroplasticity of Postural Sensorimotor Networks Using Non-Invasive Spinal Neuromodulation to Maximize Functional Recovery After Spinal Cord Injury

Award Number: R01NS119587
ORGANIZATION: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 12/01/2021
PERIOD OF PERFORMANCE END DATE: 08/31/2027

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Harnessing Neuroplasticity of Postural Sensorimotor Networks Using Non-Invasive Spinal Neuromodulation to Maximize Functional Recovery After Spinal Cord Injury - ABSTRACT Transcutaneous (TSS) and epidural spinal stimulation (ESS) are both electrophysiological techniques that have been used to investigate the interactions between exogenous electrical stimuli and spinal sensorimotor networks that integrate descending motor signals with afferent inputs from the periphery during motor tasks such as standing and stepping. Recently, pilot phase clinical trials using each of these stimulation modalities have demonstrated restoration of motor functions that were previously lost due to spinal cord injury (SCI). However, the spinal network interactions that occur in response to TSS or ESS with rehabilitation training have yet to be characterized and directly compared. Thus, it is imperative to (1) understand the neurophysiological profiles of individual participants comprehensively, thereby delineating the underlying mechanisms and (2) establish the relative effectiveness of TSS versus ESS in regaining motor function. Our central hypothesis is that ESS and TSS will promote similar levels of stimulation-augmented standing. We will compare the immediate functional and neurophysiological effects of TSS versus ESS in the same participants (Aim 1). We hypothesize that ESS and TSS will generate comparable motor output during standing due to similar level of modulated excitability of sensorimotor networks. Then, we will compare immediate and delayed effects of standing training combined with TSS versus ESS (Aim 2). We hypothesize that both TSS- and ESS-combined trainings will result in similar functional gain. We further predict that after one month of rest following standing training with TSS or ESS, the excitability and responsiveness of spinal and supraspinal sensorimotor networks will differ from baseline levels and Sham. Completion of this study will establish the efficacy of both non-invasive and invasive spinal neuromodulatory approaches to improve functions after SCI, impacting both research and clinical communities. Further, it will shed light on the underlying mechanisms of spinal neuromodulation, allowing ourselves and others to refine and improve stimulation protocols to maximize functional recovery.


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 = $632,816 )
2025	2025	METHODIST HOSPITAL, THE	6670 BERTNER AVE	HOUSTON	TX	77030	HARRIS	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	4	8/15/2025	NON-COMPETING CONTINUATION	$632,816
														Subtotal = $632,816

Issue Date FY: 2024 ( Subtotal = $613,832 )
2024	2024	METHODIST HOSPITAL, THE	6670 BERTNER AVE	HOUSTON	TX	77030	HARRIS	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	3	9/10/2024	NON-COMPETING CONTINUATION	$613,832
														Subtotal = $613,832

Issue Date FY: 2023 ( Subtotal = $640,123 )
2023	2023	METHODIST HOSPITAL, THE	6670 BERTNER AVE	HOUSTON	TX	77030	HARRIS	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	2	8/11/2023	NON-COMPETING CONTINUATION	$640,123
2023	2022	METHODIST HOSPITAL, THE	6670 BERTNER AVE	HOUSTON	TX	77030	HARRIS	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	1	5/18/2023	NEW	$0
														Subtotal = $640,123

Issue Date FY: 2022 ( Subtotal = $657,591 )
2022	2022	METHODIST HOSPITAL, THE	6670 BERTNER AVE	HOUSTON	TX	77030	HARRIS	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	1	11/29/2021	NEW	$657,591
														Subtotal = $657,591

Grand Total All Awards = $2,544,362

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Harnessing Neuroplasticity of Postural Sensorimotor Networks Using Non-Invasive Spinal Neuromodulation to Maximize Functional Recovery After Spinal Cord Injury

Award Number: R01NS119587

ORGANIZATION: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 12/01/2021

PERIOD OF PERFORMANCE END DATE: 08/31/2027

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