Elucidating the Role of the Contralesional Corticoreticulospinal Tract for Lower Limb Function After Stroke

Elucidating the Role of the Contralesional Corticoreticulospinal Tract for Lower Limb Function After Stroke is sponsored by National Institute of Neurological Disorders and Stroke (NINDS). This opportunity supports mission-aligned projects and measurable outcomes.

Elucidating the role of the contralesional corticoreticulospinal tract for lower limb function after stroke. Project Number 5R21NS126808-02 Former Number 1R21NS126808-01 Project Summary/Abstract Chronic walking impairments such as decreased walking speed, endurance, and independence are common after stroke and limit physical activity, quality of life, and community involvement.

These walking impairments contribute to high healthcare costs and the development of secondary disabilities. Walking impairments tend to persist despite gait rehabilitation, partly because we lack a comprehensive understanding of which brain pathways contribute to lower limb and walking recovery after stroke.

Emerging evidence suggests that ipsilaterally-descending motor pathways from the non-lesioned hemisphere to the stroke-affected limb, specifically the corticoreticulospinal tract, may be enhanced. However, the measurement tools used in prior work, when considered in isolation, provide limited insight into whether this pathway is functional enhanced and contributes to improved lower limb function.

The primary objective of this proposal is to address this question with the long-term goal of improving gait rehabilitation after stroke by identifying recovery-related motor pathways that can be targeted. Our central hypothesis is that the corticoreticulospinal tract from the non-lesioned brain hemisphere to the more affected limb will be enhanced after stroke.

The secondary objective of this proposal is to determine whether the strength of the corticoreticulospinal tract from the non-lesioned brain hemisphere influences lower limb motor control. To achieve the objectives of this proposal, two specific aims will be tested in individuals with chronic stroke with a range of impairment.

In Aim 1, we will develop a multi-dimensional estimate of whether the corticoreticulospinal tract is enhanced after stroke by combining three measures used in prior research: functional magnetic resonance imaging (non-lesioned brain activation), diffusion tensor imaging (structural integrity), and transcranial magnetic stimulation (functional excitability).

In Aim 2, the association between the strength of the corticoreticulospinal tract from the non-lesioned hemisphere and lower limb motor control will be assessed. This analysis will account for measures of stroke severity (lesion load and lower limb impairment).

The proposed work would be the first to use a multifaceted approach to comprehensively and rigorously assess whether brain pathways from the non-lesioned hemisphere to the stroke-affected lower limb are enhanced after stroke. Results from this work will improve our understanding of the brain pathways that contribute to walking recovery after stroke, essential information for improving walking rehabilitation.

The proposed work will also provide insight into how stroke impairment influences the mechanisms of recovery and the optimal rehabilitative strategy. Support for the central hypothesis will be a major breakthrough that supports the potential for neuromodulation applied to non-lesioned brain pathways pathways to lead to improvements in walking recovery after stroke.

Improvements in walking rehabilitation that result from the proposed work could lead to substantial reductions in chronic walking impairment, disability, and societal cost of stroke.

Public Health Relevance Statement Project Narrative Individuals with stroke often have chronic walking impairments that limit physical activity, quality of life, and community involvement and lead to increased healthcare burden and the development of secondary disabilities.

The proposed work seeks to understand whether neural pathways from the non-lesioned side of the brain have enhanced use and contribute to the recovery of walking after stroke. Results from this work will provide insight into the role of novel neural pathways and may lead to a paradigm shift in lower limb rehabilitative strategy after stroke that reduces chronic walking impairment and healthcare burden.

Aging Bioengineering Biomedical Imaging Brain Disorders Cerebrovascular Clinical Research Disability Research Neurosciences Physical Activity Physical Rehabilitation Rehabilitation Stroke Address Affect Ankle Area Bilateral Brain Cerebral hemisphere Chronic Corticospinal Tracts Data Development Diffusion Magnetic Resonance Imaging Dimensions Fiber Functional Magnetic Resonance Imaging Gait abnormality Goals Health Care Costs Impairment Individual Ipsilateral Knowledge Lesion Limb structure Lower Extremity Measurement Measures Methodology Modeling Motor Motor Pathways Movement Neural Pathways Paresis Participant Pathway interactions Performance Phase Physical activity Quality of life Recovery Rehabilitation therapy Reporting Research Role Severities Side Stroke Testing Transcranial magnetic stimulation Walking Work blood oxygen level dependent brain pathway chronic stroke community involvement dimension reduction disability gait rehabilitation healthcare burden imaging study improved innovation insight motor control neuroregulation novel post stroke response reticulospinal tract societal costs stroke recovery stroke rehabilitation tool walking rehabilitation walking speed DOPERALSKI, ADELE ELIZABETH [Musculoskeletal Rehabilitation Sciences Study Section[MRS]](https://public.

csr. nih.

gov/StudySections/StandingStudySections) Administering Institutes or Centers National Institute of Neurological Disorders and Stroke Assistance Listing Number Project Funding Information for 2024 NIH Categorical SpendingClick here for more information on NIH Categorical Spending No Sub Projects information available for 5R21NS126808-02 Publications are associated with projects, but cannot be identified with any particular year of the project or fiscal year of funding.

This is due to the continuous and cumulative nature of knowledge generation across the life of a project and the sometimes long and variable publishing timeline. Similarly, for multi-component projects, publications are associated with the parent core project and not with individual sub-projects.

No Publications available for 5R21NS126808-02 No Patents information available for 5R21NS126808-02 The Project Outcomes shown here are displayed verbatim as submitted by the Principal Investigator (PI) for this award. Any opinions, findings, and conclusions or recommendations expressed are those of the PI and do not necessarily reflect the views of the National Institutes of Health. NIH has not endorsed the content below.

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