2016 — 2017 |
Christou, Evangelos Lodha, Neha |
R21Activity Code Description: To encourage the development of new research activities in categorical program areas. (Support generally is restricted in level of support and in time.) |
Motor Control Deficits Following Transient Ischemic Attack
PROJECT SUMMARY A transient ischemic attack (TIA) is a brief episode of neurologic dysfunction. The conventional viewpoint is that there are no residual motor deficits following a TIA. However, recent evidence suggests that individuals who have a TIA have impairments in activities of daily living and driving. These activities require robust motor control. Our preliminary data suggest that compared with healthy adults, individuals with TIA exhibit greater movement variability during isolated ankle dorsiflexion, greater stride length variability during over ground walking, greater lane maintenance variability during a simulated road driving task, and greater brake force variability during a reactive driving task. In addition, individuals with a TIA exhibit greater variability of the neural activation and greater co-activation of the agonist and antagonist muscles. Based on these findings, we test the central hypothesis that TIA impairs motor control, over ground walking, driving, and the neural activation of muscle. To address this hypothesis we propose the following two specific aims. In Aim 1, we will determine whether individuals who had a TIA exhibit deficits in motor control compared with healthy age-matched controls. To accomplish this aim, we will recruit 30 individuals 1-5 weeks post TIA and 30 age matched controls. We will quantify deficits in motor control during isolated ankle dorsiflexion, over ground walking, simulated road driving, and reactive driving. We hypothesize that individuals with a TIA will exhibit greater motor output variability during the isolated ankle dorsiflexion tasks, greater walking variability, and deficits in road driving and reactive driving performance. In Aim 2, we will determine whether individuals who had a TIA exhibit altered neural activation of muscle compared with healthy age-matched controls. To accomplish this aim, we will test the same individuals as in Aim 1. We will examine single- and multi-motor unit discharge rate and agonist and antagonist muscle activity. We hypothesize that individuals with TIA will exhibit greater single- and multi-motor unit discharge rate variability, greater agonist and antagonist muscle variability, and greater coactivation for the agonist and antagonist muscles than healthy controls. This proposal will be the first to identify whether individuals who had a TIA exhibit residual functional motor control deficits. It is essential because the incidence of TIA is expected to increase dramatically leading to increased number of falls and driving accidents, and contribute significantly to health-related expenses.
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1 |
2021 |
Lodha, Neha |
K01Activity Code Description: For support of a scientist, committed to research, in need of both advanced research training and additional experience. |
Investigating Cognitive-Motor Variability to Predict Driving Performance in Stroke Survivors With McI @ Colorado State University
PROJECT SUMMARY/ABSTRACT Dr. Neha Lodha is an Assistant Professor in the Department of Health and Exercise Science at Colorado State University (CSU). Dr. Lodha's long-term career goal is to become an independent investigator advancing the science of functional mobility to improve the quality of life in aging and age-related neurological disorders and dementias. Up to this point, Dr. Lodha has acquired strong scientific background in neurophysiology and motor control. To accomplish her career goal, a key additional element required is the training in cognitive sciences. Understanding how cognitive and motor systems interact to enable independent mobility is important for identifying the precise mechanisms and developing interventions to promote functional mobility. The short-term training goals of the current K01 application are to train in 1) conducting cognitive assessments with specific emphasis on the intra-individual variability (IIV) approach, 2) clinical trials design and analysis, 3) multivariate statistics, 4) driving technology, and 5) transition to independence. To achieve these goals, Dr. Lodha has assembled a mentoring team that consists of 1) an eminent gerontologist, Dr. Manfred Diehl (primary mentor) with expertise in aging, IIV and cognitive development across the lifespan, 2) an experimental psychologist, Dr. Karlene Ball (co-mentor) who is internationally renowned for her work in cognitive correlates of driving mobility in aging and dementia, 3) a vascular neurologist, Dr. Sharon Poisson (advisor) with extensive experience in clinical trials in stroke survivors, and 4) a renowned biostatistician, Dr. Haonan Wang (co-advisor) with experience in statistical inference and modeling for clinical data. The proposed research plan focuses on identifying the motor and cognitive impairments underlying driving deficits in older stroke survivors with mild cognitive impairment as they are most likely to resume on-road driving after stroke. Conventionally, driving impairments are shown to be independently influenced by mean-level performance in specific motor and cognitive domains. However, this mean-level approach neglects the well-established fact that performance becomes highly variable and unstable in older adults with neurological disorders, such as those at preclinical stages of Alzheimer's disease and mild cognitive imapirment. The proposed research will apply the novel intra- individual variability (IIV) approach to investigate driving mobility in older stroke survivors. The goal of the research plan is to identify the impact of stroke on IIV in motor and cognitive performance (Aim 1); determine the contribution of IIV measures to predict driving performance (Aim 2); and use IIV measures to predict change in driving performance over a two-year period (Aim 3). The training plan will accelerate Dr. Lodha's career to pursue a unique and independent line of research that combines cognitive and motor processes to promote the functional mobility of older adults and is directly aligned with NIA's AD/ADRD goal to identify sensitive behavioral measures for earliest manifestations of functional impairments in older adults.
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0.943 |