Childhood stroke predictors of motor recovery - my career goal is to become an independent physician scientist with a research program focused on neurorecovery in acquired pediatric brain injury

The National Institute of Child Health and Human Development awarded The Spaulding Rehabilitation Hospital Corporation $170,640 on July 15, 2026, under the Child Health and Human Development Extramural Research program (CFDA 93.865) to support a K23 career development award investigating childhood stroke predictors of motor recovery.

The award funds a physician-scientist's career development and research program centered on neurorecovery mechanisms in pediatric acquired brain injury, with emphasis on understanding variability in neurologic impairment and motor recovery following childhood stroke. The research plan includes subject-specific coursework and didactics, training in transcranial Doppler and kinematic measures, and a mentoring structure designed to transition the investigator to an independent research position. The project will examine bilateral brain activation patterns and their evolution toward unilateral motor network organization in the context of childhood stroke injury, neural restoration, and rehabilitation, drawing on functional and hemodynamic neuroimaging methodologies to identify factors associated with better motor outcomes.

Performance occurs in Charlestown, Massachusetts, with a period of performance from July 15, 2026, through June 30, 2031.

The proposed project will provide me with critical experience, and experimental skills to achieve competence in pediatric brain injury, neuroimaging methodologies, and clinical research to successfully transition to an independent position. To reach this goal, i have put together a career development training plan, which includes subject-specific coursework and didactics, training in transcranial doppler and kinematic measures, and a highly successful mentoring team to ensure my short- and long-term scientific success. This proposal seeks to investigate the mechanisms underlying variability in neurologic impairment and neurorecovery in children affected with stroke. Childhood stroke results in many decades living with functional impairment and disability. Early rehabilitation is critical for decreasing impairment and maximizing long-term outcomes, however there is limited understanding of the mechanisms that underlie variability across individuals. Neural development is characterized by structural and functional processes of pruning in which redundant and inefficient synapses are eliminated. As a result, the brain's motor system proceeds from generalized and bilateral networks to specialized, unilateral organization. When considering the effects of injury, neural restoration, and rehabilitation in the context of childhood stroke, IT is imperative to examine bilateral activation in the context of its evolution towards unilateral organization. In adult stroke, functional and hemodynamics neuroimaging measures of brain state provide insights into the mechanisms underlying motor impairment and recovery. Overall, adult stroke studies find that greater restoration of lateralized motor networks, both with spontaneous recovery and in response to treatment, is associated with better outcomes. However, given the greater reliance on bilateral networks in the immature brain, the effects of childhood stroke likely do not parallel those in adult stroke. In this proposed project, we will use multimodal neuroimaging methods in childhood stroke to 1) characterize variability in motor impairment in a childhood stroke cohort, 2) identify functional and hemodynamic neuroimaging biomarkers of motor impairment, and 3) evaluate the effect of time on biomarkers of motor impairment and neurorecovery. The proposed research will examine the mechanisms underlying impairment and functional recovery in childhood stroke and help identify the critical circuits for restoring developmental trajectories, maximizing neural restoration, and decreasing disability. The exceptional environment at spaulding rehabilitation hospital and harvard medical school will provide me with all the resources to complete the proposed research and to develop the necessary skills for a successful independent career.