OVERVIEW
The National Capital
Area Rehabilitation Research Network (NCARRN) brings together outstanding
programs in basic neuroscience (at Georgetown University), biomedical
engineering (at National Rehabilitation Hospital, Catholic University,
and Georgetown University) and clinical research and care (at National
Rehabilitation Hospital) to establish a nationally recognized interdisciplinary
research program in spinal cord injury, based on both animal and human
studies. The goal of this program is to provide strong mentored, in-depth
research training opportunities and access to state-of-the-art core research
facilities for rehabilitation professionals. The program specifically
targets physicians with interests in neurorehabilitation (physiatrists,
neurologists and neurosurgeons) and Ph.D. trained individuals at the early
stages of their independent academic careers. In this way, we provide
a centralized research infrastructure which will enhance the capability
of medical rehabilitation investigators to identify and understand the
neural mechanisms underlying functional recovery, design and implement
therapeutic strategies to enhance these mechanisms and to improve the
quality of life for individuals with spinal cord and other CNS injuries.
This network will also enhance the visibility and highlight the importance
of clinical and basic science research directed towards neural recovery.
Barbara S. Bregman, Ph.D., PT and Joseph M. Hidler, Ph.D. serve as program
directors. This National Capital Area Rehabilitation Research Network
creates a unique national resource of research cores in activity based
CNS plasticity and recovery of function: basic neuroscience, biomedical
engineering, imaging (animal and human MRI and fMRI) and clinical research
and care in spinal cord injury. This NCARRN is comprised of four research
cores and an administrative core.
 Research
Cores
The Research
Cores for the NCARRN include: A) Rehabilitation Robotics: Activity-based
approaches to rehabilitation; B) Imaging Technologies: Visualizing
CNS Plasticity in Animals and Humans; C) Animal Models of Injury,
Plasticity and Recovery of Function; and D) Cellular and Molecular
Approaches of Plasticity. These four research cores play a complimentary
role in providing unique insight into neural plasticity and the
process of functional recovery.
A.
Rehabilitation Robotics: Activity-Based
Approaches to Rehabilitation
The principle
objective of this research core is to advance the diagnosis and
treatment of neurological injuries utilizing robotic devices. Robots
have been successfully integrated into neurorehabilitation programs
world-wide targeting both the upper and lower extremities; however
their potential for understanding and treating sensory-motor impairments
has not been fully realized. Rehabilitation robots are well suited
for promoting activity-dependent neural plasticity due to their
ability to foster repetitive practice. Furthermore, since these
devices are fully instrumented with kinematic and kinetic sensors,
they also lend themselves nicely to quantitatively diagnosing impairment
and tracking functional recovery. Utilizing robotic devices currently
residing in the Center for Applied
Biomechanics and Rehabilitation Research (CABRR) at the National
Rehabilitation Hospital as well as new technologies that will
be developed under this NCARRN, researchers can investigate new
treatment interventions, advance the diagnosis of impairment, and
promote these new interventions among the medical community and
to new clinical researchers. (see Rehab
Robotics section for more details)
B.
Imaging Technologies: Visualizing CNS Plasticity
in Animals and Humans
We believe
that imaging technologies will play a key role in the future of
rehabilitation medicine. One of the major obstacles, however, in
translating interventions in animal models of CNS injury to future
human applications is the inability to follow changes in the CNS
over time after injury and in response to interventions. These resources
are expensive in terms of both equipment and expertise. This NCARRN
provides core access to state-of-the-art imaging, including access
to expertise in designing, executing and analyzing imaging experiments
and will also provide technical assistance in gathering pilot data.
This core is designed to serve not only as a resource for the sabbatical
and pilot grants program associated with this NCARRN, but will also
serve as a national resource for rehabilitation professionals. Participants
will have access to the human 3 Tesla MRI (for anatomical, functional
and spectroscopy imaging) and to the 7T MRI for small animal imaging.
(see Imaging section for more details)
C. Animal
Models of Injury, Plasticity and Recovery of Function
Studies to define
the mechanisms underlying plasticity will require the use of specific
CNS injury models in rats or mice. In both instances, the expertise is
best provided by individuals through a shared resource, so that individual
investigators can make use of the techniques and approaches without having
to incur the expense of building the expertise and acquiring the equipment
in their individual laboratories. Through this NCARRN, these resources
are available to investigators participating in this program through sabbaticals,
through the pilot grants project, and will be available as a national
resource for individuals interested in studies to define the mechanisms
underlying CNS plasticity and recovery of function after spinal cord injury.
Junior faculty developing their independent research programs can utilize
these facilities to generate preliminary data in support of independent
grant applications. Each of these injury models and behavioral analysis
approaches is in current use in one or more of the participating laboratories.
In order to ensure the availability of these models to participants, we
will provide technical support and expertise through this NCARRN. Drs.
Barbara Bregman and Jean Wrathall will co-direct the injury models and
behavioral analysis components of this NCARRN. (see Animal
Models section for more details)
D. Cellular
and Molecular Approaches of Plasticity
The Department of
Neuroscience at Georgetown provides a unique resource for junior clinical
and Ph.D. level investigators to develop and explore new hypotheses related
to reorganization of CNS pathways. The Molecular and Cellular Approaches
to Neural Plasticity core provides resources and training in cellular
therapies (neural tissue transplantation, stem cell / neural progenitor
cells) and pharmacological approaches (neurotrophins, modulators of intraneuronal
cAMP, modulators of the inhibitory environment (chondroitinase, inhibitors
to myelin-associated inhibitors, ephrins and eph receptors) to increase
regeneration and recovery of function after spinal cord injury. This core
also provides expertise, resources and training in neuroanatomical tracing,
quantitative image analysis, and cellular and molecular approaches to
evaluate the nature and extent of plasticity associated with these interventions.
The Neuroscience laboratories at Georgetown have extensive research experience
using these approaches and extensive training experience in teaching collaborators,
students and fellows in these approaches. This core is designed to operate
in close association with the animal models core, above. The Department
of Neuroscience will make the core equipment in our Morphology and Imaging
shared resources available to all NCARRN participants. (see Cell
and Molecular section for more details)
Administrative
Core
The administrative
core coordinates the sabbatical and pilot-grants programs and provides
ongoing education and training to the rehabilitation community through
the organization of workshops and symposia. The administrative core also
coordinates a strong research design and grant writing development program.
The central location of this network in Washington, DC with its easy access
provides an excellent focus for collaborations beyond the immediate metropolitan
area. This NCARRN provides an outstanding research infrastructure in CNS
Injury and Recovery and brings together established investigators, core
resources and a sabbatical and pilot grants
program visiting rehabilitation research scholars who are poised to
become strong independent investigators contributing to rehabilitation.
We also have an established grant-writing / grant-review and mentorship
program to assist these individuals in securing independent, peer-reviewed
funding in medical rehabilitation research. By providing core resources,
strong mentorship and opportunities for broad interaction this program
will increase strong medical rehabilitation research and improve outcomes
for individuals with spinal cord injury and other neurological disorders.
(see Sabbatical and Pilot Grants section
for more details)
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