Principal Investigator: Bradley Schlaggar (WUSTL Neurology)
Co-Investigators: Nico Dosenbach (WUSTL Neurology), Catherine Lang (WUSTL Physical Therapy), Steve Petersen (WUSTL Neurology)
Brain injury is the main cause of disability in children. Following brain injury, children often compensate remarkably well. It is thought that the developing human brain compensates for injuries through use-driven reorganization of the remaining intact brain structures, but the mechanisms remain unknown. Understanding these mechanisms is important for designing neurorehabilitative treatments that enhance recovery. Constraint-induced movement therapy (CIMT) is a treatment for one-sided weakness that requires restraining the stronger upper extremity while undergoing intense therapy for the weaker side. CIMT provides an elegant model-system for studying the neural mechanisms of use-driven brain reorganization. Advances in magnetic resonance imaging (MRI) of the brain (“multi-modal brain MRI”) now allow us to track changes in the brain’s functional organization. To identify brain changes most important for improved motor behavior we also need to acquire accurate, unbiased data about real-world behavior. This project will pioneer the use of wearable movement biosensors in children to provide continuous measures of three-dimensional extremity movement, from which we can derive the accurate outcome measures needed for clinically useful brain-behavior correlations. Merging advanced multi-modal MRI and biosensor technologies will identify functional links between brain regions most important for improving real-world movement in children. Such critical brain links can then be targeted with medications, therapies, brain stimulation and neurofeedback.