Research

  • Our research team (faculty, graduate students, and postdoctoral fellows) have contributed to science in three major areas: 1) Neuroimaging and rehabilitation, 2) Clinical trials and basic mechanisms of action in rehabilitation, and 3) Rehabilitation engineering research. 

     Neuroimaging and Rehabilitation


    a. To determine the brain-behavior mechanisms that support rehabilitation in brain-damaged conditions—primarily stroke. Our progress with implementing real-time fMRI at HSC has picked up since Andrew Hooyman joined my lab. At the end of December 2014, we succeeded in implementing real-time fMRI on the GE scanner at HSC using BrainVoyager. Our collaborators on this project include: Bosco Tjan, Dr. Meng Law, Daryl Huang (Imaging research staff) and the IT folks (Daniel Sierra) from Keck.


    b. In addition to rtfMRI, we are using standard block-design fMRI for Dorsa Berukheim-Kay’s dissertation project -The impact of intrinsic motivation on functional brain activity during motor learning. We are working very closely with Jason Kutch and John Monterossa from Psychology to design and test this novel protocol. We will be using a force-pressure motor learning task in the scanner. Dorsa has procured funds from the CTSI TL1 to cover the cost of the scans.


    c. DTI analysis of corticospinal tract using BrainSuite: A potential biomarker of upper extremity therapeutic response to neurorehabilitation in chronic stroke. This project uses our DOSE trial data (see below) in collaboration with Richard Leahy and Justin Haldar (Ming Hsieh Dept of Electrical Engineering; Brain and Creativity Inst) that includes my students, Bokkyu Kim (primary), Dorsa Berukheim-Kay (secondary), and Youngmin Oh (recent Neuroscience PhD).


    Clinical Trials and Basic Mechanisms of Action in Rehabilitation 


    a. The Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE, Phase III Multisite Rehabilitation RCT NCT00871715): This is a collaboration with our colleagues, Steve Wolf at Emory and Alex Dromerick, at Georgetown University and National Rehabilitation Hospital in Wash DC, the Data Management Center here at USC led by Christianne Lane, Co-Investigator, Rebecca Lewthwaite at Rancho and USC BKN, and project manager, Monica Nelsen. This project is funded by a U01 mechanism primarily from NINDS with a small portion from NICHD. Funding ends in July 2015, however a no-cost extension to use remaining carry-forward funds will allow us another year to ensure dissemination of the primary outcome paper and half a dozen secondary outcome papers.


    b. Optimizing Dosage of Rehabilitation After Stroke (DOSE, Phase I, single-site, RCT NCT01749358 ). This is in collaboration with Nicolas Schweighofer and his students and Clarisa Martinez (now a T32 Fellow). This is an NIH NICHD funded 5 yr RCT with computational model to determine prospectively the dose of therapy that maximizes the efficacy of treatment.


    c. On July 1st 2014 in connection with my sabbatical leave, Dr Winstein was appointed as Sir Walter Murdoch Distinguished Collaborator at Murdoch University’s School of Psychology and Exercise Science in Perth, Australia. We have one publication from our collaboration (Sugg et al., 2015). We are in discussion regarding the development of several grant proposals and a PhD dissertation proposal in development for Kita Sugg.


    Rehabilitation Engineering Research


    The 5 year NIDRR funded RERC on aging ended after a no-cost extension in Fall of 2014. We have several manuscripts in various stages from the later work conducted during the funded life of the center, 1 published last year (Proffitt et al. 2015 online). We continue to work in this exciting area to leverage advances in smart technologies including virtual reality applications (Kinect™ camera), and body worn sensors (APDM sensors), for rehabilitation purposes including diagnostics. Our current work is funded through one CTSI grant (POCM project, funding ended 6/30/13), and several Industry partners (i.e., Reach Bionics, MedHab). There are four projects that fall into this general area.


    a. Point-of-care monitoring in Parkinson’s disease - this is a continuing collaboration originally supported through a CTSI grant-with Cesar Blanco--Developing Point-of-Care Mobility (PoCM) Monitoring System Technologies. Our current team includes: Luciano Nocera (IMSC) and his team of students and engineering colleagues, Beth Fisher, Carolee Winstein and our team of students (Yu-Chen Chung, Yi-An Chen, Helen Bacon, Phan Chanthaphun). 


    b. Reach Bionics, Inc (NCT02358915). Peri-auricular muscles voluntary control training. This is a funded R&D project-The purpose of the study is to test the effectiveness of a 2-step training paradigm for improving voluntary control of the peri-auricular muscles. This is a collaboration with Lucinda Baker (PI), Yi Yu (BKN MS student) and Sandy Heck, the director of the small business, Reach Bionics, Inc. (Reach Bionics is supported by an NSF grant, Reach Bionics is funding our R&D work).


    c. Medhab clinical trial project (NCT02270684). StepRite Evaluation. This is a industry funded comparative effectiveness study of an activity-specific monitoring device (StepRite) on short-term outcomes in adults after total knee arthroplasty. Enrollment is expected to begin January 2015. Winstein is Co-PI on this project, Powers is PI and Helen Bacon is the project coordinator. We are working with our clinical colleagues (Maria Zibell, Amy Diaz, and Yas Kasuyuki as well as Dr. Daniel Oakes at Keck).


    d. The Impact of Social-Cognitive Factors on Paretic Hand Use in persons after stroke. This is Yi-An Chen's dissertation project in collaboration with her Guidance Committee (Carolee Winstein, Chair, Rebecca Lewthwaite, Nicolas Schweighofer, Beth Fisher and Phil Requejo). The specific aims of this research are: Aim 1: Demonstrate the feasibility of Ecological Momentary Assessments (EMA) to investigate social-cognitive factors and paretic hand use post-stroke in the natural environment. Aim 2: Demonstrate the validity of EMA to investigate social-cognitive factors and paretic hand use post-stroke in the natural environment. Aim 3: Determine the association of social-cognitive factors and paretic hand use post-stroke in the natural environment. We are currently seeking funding to support this research.