Project Grant F31NS149736

DEFINING COGNITIVE MECHANISMS OF UPPER LIMB MOTOR RECOVERY AFTER STROKE - PROJECT SUMMARY/ABSTRACT ARM AND HAND IMPAIRMENTS ARE AMONG THE MOST COMMON AND DISABLING OUTCOMES OF STROKE, CONTRIBUTING TO LONG-TERM LOSS OF INDEPENDENCE. ALTHOUGH MOTOR OUTCOMES ARE OFTEN LINKED TO DAMAGE IN DESCENDING MOTOR PATHWAYS SUCH AS THE CORTICOSPINAL TRACT, SUBSTANTIAL VARIABILITY IN RECOVERY REMAINS UNEXPLAINED. THIS PROJECT INVESTIGATES HOW SPECIFIC COGNITIVE PROCESSES ACCOUNT FOR MEANINGFUL VARIANCE IN UPPER LIMB MOTOR OUTCOMES BEYOND MOTOR SYSTEM INJURY. THE GOAL IS TO IDENTIFY WHICH COGNITIVE FUNCTIONS INFLUENCE UPPER LIMB MOTOR RECOVERY AFTER STROKE AND WHETHER THEY CAN PREDICT RESPONSIVENESS TO REHABILITATION. TO ACHIEVE THIS, THE PROJECT WILL LEVERAGE AN ONGOING NIH- FUNDED CLINICAL TRIAL OF A SIX-WEEK MOTOR REHABILITATION INTERVENTION IN ADULTS WITH SUBACUTE STROKE. PARTICIPANTS WILL COMPLETE DETAILED BEHAVIORAL TESTING AND STRUCTURAL MRI ASSESSMENTS BEFORE AND AFTER INTERVENTION. THE STUDY PROTOCOL WILL BE EXPANDED TO INCLUDE A TARGETED COGNITIVE BATTERY FOCUSED ON ATTENTION CONTROL, EXECUTIVE FUNCTION, WORKING MEMORY, AND PROCESSING SPEED. AIM 1 WILL TEST WHICH COGNITIVE FUNCTIONS BEST EXPLAIN VARIANCE IN UPPER LIMB MOTOR PERFORMANCE AT BASELINE. AIM 2 WILL TEST WHICH COGNITIVE FUNCTIONS BEST PREDICT UPPER LIMB MOTOR GAINS AFTER REHABILITATION. AIM 3 WILL USE LESION SYMPTOM AND NETWORK MAPPING TO DETERMINE WHETHER STRUCTURAL DAMAGE OR DISCONNECTION IN ATTENTION-RELATED BRAIN REGIONS PREDICTS MOTOR OUTCOMES. TOGETHER, THESE APPROACHES WILL CLARIFY HOW SPECIFIC COGNITIVE FUNCTIONS CONTRIBUTE TO RECOVERY AND PROVIDE MECHANISTIC TARGETS FOR FUTURE INTERVENTIONS. THIS WORK ALIGNS WITH THE NIH MISSION TO REDUCE DISABILITY AND ENHANCE QUALITY OF LIFE THROUGH IMPROVED UNDERSTANDING OF BRAIN BEHAVIOR RELATIONSHIPS AND MORE PERSONALIZED REHABILITATION STRATEGIES.