# Perinatal Brain Injury:  Identifying Cortical Excitability and Circuitry through Multi-Modal Assessment

> **NIH NIH R21** · UNIVERSITY OF MINNESOTA · 2020 · $184,538

## Abstract

PROJECT SUMMARY/ABSTRACT
Early brain injury, caused by stroke, is one of the primary causes of cerebral palsy. Individual lifetime costs of
care for an individual with cerebral palsy are estimated at over $1M. Understanding the manner in which the
brain recovers after early brain injury, and the impact on resultant motor function, will allow future development
of targeted and effective rehabilitation interventions in this uniquely neuroplastic infant population. The first
year of life post-injury represents a ‘window of opportunity’ to advance our knowledge of the changes in brain
organization and excitability that contribute to motor function. Non-invasive brain stimulation can assess brain
excitability and identify patterns of connectivity, or circuitry in the brain, especially as the brain both recovers
and develops after a perinatal injury. Brain stimulation can be used therefore to characterize the excitability
profiles of the cortical regions contributing to motor output and the circuitry of the descending corticospinal tract
originating from these regions. Stimulation can serve as a unique tool to investigate recovery from brain injury
complementing current neuroimaging and motor function assessments to predict outcomes.
We propose to use one form of non-invasive brain stimulation, transcranial magnetic stimulation (TMS), to
assess the excitability and circuitry of motor cortical areas in infants with early brain injury due to stroke. To
complement this assessment, we will create individualized computational models of the TMS-induced electric
field distribution in the infant brain using individual structural brain anatomy obtained through magnetic
resonance imaging. For both infants with perinatal brain injury and age-matched typically-developing controls,
we will create complementary computational models of TMS-induced electric fields in each hemisphere, based
on individual neuroanatomy obtained from MRI. This combined approach will provide critical information about
the structures and pathways activated by TMS, and offer insight into potential targets for future non-invasive
brain stimulation interventions. The results from this proposed in this R21 will advance our understanding of
infant brain development after perinatal injury by integrating TMS assessment and computational models to
predict not only the impact of the stroke on developing motor circuitry but also the response to brain
stimulation. We will integrate our findings in future studies comparing excitability and circuitry as variables that
may contribute to motor outcomes. By integrating validated computational models of TMS-induced electric
fields, we can use individualized anatomical targets for future neuromodulation studies in infants with defined
circuitry patterns and develop tailored interventions to improve motor function in infants with early brain injury.

## Key facts

- **NIH application ID:** 9988916
- **Project number:** 5R21HD097575-02
- **Recipient organization:** UNIVERSITY OF MINNESOTA
- **Principal Investigator:** Leslie R. Morse
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $184,538
- **Award type:** 5
- **Project period:** 2019-08-01 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9988916

## Citation

> US National Institutes of Health, RePORTER application 9988916, Perinatal Brain Injury:  Identifying Cortical Excitability and Circuitry through Multi-Modal Assessment (5R21HD097575-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9988916. Licensed CC0.

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