# Plasticity in the Spinal Cord to Enhance Motor Retraining after Stroke

> **NIH VA IK2** · VETERANS HEALTH ADMINISTRATION · 2020 · —

## Abstract

Approximately 6000 VA admissions for stroke occur each year. Current rates of functional recovery
from movement-related deficits after stroke are largely unsatisfying. Economic burdens continue to
place limits on the length of rehabilitation, emphasizing a need for new strategies that increase the
efficacy and efficiency of rehabilitation programs. Neuromodulatory strategies involving cortical
stimulation have been examined as adjunctive therapies to enhance rehabilitation outcomes after
stroke. It has been proposed that targeting other neural structures may offer new avenues to enhance
the effects of rehabilitation.
The broad objective of the proposed research is to strengthen corticospinal transmission to hemiparetic
intrinsic hand muscles in veterans with stroke by targeting corticomotoneuronal synapses in the spinal
cord based on principles of spike timing-dependent plasticity. There are two major goals for satisfying
this objective: 1) examine functional and structural neurophysiological mechanisms underlying the
response to this neuromodulatory strategy, and 2) explore how corticomotoneuronal synaptic plasticity
after stroke can enhance voluntary motor output and drive progression during motor retraining.
Presynaptic and postsynaptic action potentials will be timed to arrive at the corticomotoneuronal
synapse in a particular sequence and within a specific temporal window based on conduction times
calculated from individual response latencies. In Aim 1, repeated pre- and postsynaptic action
potentials will be delivered and various neurophysiological responses will be measured to evaluate
changes in corticospinal transmission. In Aim 2, the triple stimulation technique will be used to measure
failures in central conduction, and diffusion spectrum imaging fractional anisotropy will be used to
estimate corticospinal spinal tract integrity. These functional and structural characteristics will be used
to evaluate the response to neuromodulation targeting synapses in the spinal cord. Aim 3 experiments
will test how the change in corticospinal transmission alters the control of voluntary motor output during
visuomotor task performance. Building on the first three aims investigating mechanisms of plasticity,
Aim 4 will pilot a mechanism-driven intervention to enhance progression during motor retraining.
The research team is comprised of experts in the areas of neurophysiology, neural engineering,
neuroimaging, and stroke neurorehabilitation and, therefore, is well positioned to satisfy the proposed
project goals. This Career Development Award will also help establish Dr. Urbin as an independent
investigator within the VA RR&D service. Dr. Urbin is committed to pursuing a clinical research career
with the objective of developing a line of inquiry that promotes restored functional independence for
veterans living with disability. The training experiences that will take place as part of this award will
allow Dr. Urbin to acquire new skills in neuroimag...

## Key facts

- **NIH application ID:** 10053239
- **Project number:** 5IK2RX002837-03
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** Michael A. Urbin
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-11-01 → 2023-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10053239

## Citation

> US National Institutes of Health, RePORTER application 10053239, Plasticity in the Spinal Cord to Enhance Motor Retraining after Stroke (5IK2RX002837-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10053239. Licensed CC0.

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