A5053659607- Multiple Sclerosis Research Studies
- Stroke Rehabilitation and Recovery
- Botulinum Toxin and Related Neurological Disorders
- Peripheral Neuropathies and Disorders
- Ion channel regulation and function
- Cerebral Palsy and Movement Disorders
- Acute Ischemic Stroke Management
- Neuroinflammation and Neurodegeneration Mechanisms
- Neurogenesis and neuroplasticity mechanisms
- Health Systems, Economic Evaluations, Quality of Life
- Immune Response and Inflammation
- Protease and Inhibitor Mechanisms
- Cytokine Signaling Pathways and Interactions
- Immunotherapy and Immune Responses
- Neuroscience and Neuropharmacology Research
- Immune Cell Function and Interaction
- Mesenchymal stem cell research
- Healthcare cost, quality, practices
- Systemic Lupus Erythematosus Research
- Polyomavirus and related diseases
- Clinical practice guidelines implementation
- Fibromyalgia and Chronic Fatigue Syndrome Research
- Nerve injury and regeneration
- Sirtuins and Resveratrol in Medicine
- Cardiac electrophysiology and arrhythmias
VA Office of Research and Development
2019-2023
VA Maryland Health Care System
2012-2021
Veterans Health Administration
1990-2021
University of Maryland, Baltimore
2011-2020
Baltimore VA Medical Center
1989-2019
United States Department of Veterans Affairs
2011-2019
Multiple Sclerosis Center of Atlanta
2008-2019
Providence VA Medical Center
2017
Case Western Reserve University
2017
Mount Sinai Rehabilitation Hospital
2017
Effective rehabilitative therapies are needed for patients with long-term deficits after stroke.In this multicenter, randomized, controlled trial involving 127 moderate-to-severe upper-limb impairment 6 months or more a stroke, we randomly assigned 49 to receive intensive robot-assisted therapy, 50 comparison and 28 usual care. Therapy consisted of 36 1-hour sessions over period 12 weeks. The primary outcome was change in motor function, as measured on the Fugl-Meyer Assessment Sensorimotor...
In this paper, we present the design and characterization of a novel ankle robot developed at Massachusetts institute technology (MIT). This robotic module is being tested with stroke patients Baltimore Veterans administration medical center. The purpose on-going study to train survivors overcome common foot drop balance problems in order improve their ambulatory performance. Its follows same guidelines our upper extremity designs, i.e., it low friction, backdriveable device intrinsically...
To provide evidence-based recommendations on the treatment of nervous system Lyme disease and post-Lyme syndrome. Three questions were addressed: 1) Which antimicrobial agents are effective? 2) Are different regimens preferred for manifestations disease? 3) What duration therapy is needed?The authors analyzed published studies (1983-2003) using a structured review process to classify evidence related posed.The panel reviewed 353 abstracts which yielded 112 potentially relevant articles that...
To make evidence-based recommendations for screening, diagnosing, and treating psychiatric disorders in individuals with multiple sclerosis (MS).We reviewed the literature (1950 to August 2011) evaluated available evidence.Clinicians may consider using Center Neurologic Study Emotional Lability Scale screen pseudobulbar affect (Level C). Clinicians Beck Depression Inventory a 2-question tool depressive General Health Questionnaire broadly defined emotional disturbances Evidence is...
Synergies are thought to be the building blocks of vertebrate movements. The inability execute synergies in properly timed and graded fashion precludes adequate functional motor performance. In humans with stroke, abnormal a sign persistent neurological deficit result loss independent joint control, which disrupts kinematics voluntary This study aimed at characterizing training-related changes apparent from movement and, specifically, assessing: 1) extent they characterize recovery 2)...
Abstract A retrospective study of 108 patients with myasthenia gravis who had solely ocular symptoms and signs at onset was carried out to identify factors influencing prognosis. Increasing duration pure associated a decreasing risk late generalized symptoms; only 9 (15%) the observed generalizations occurred after more than 2 years symptoms. age greater respiratory crisis or death caused by myasthenia, whereas younger chance benign outcome. Neither systemic curare tests nor responses...
Measuring the quality of health care is a fundamental step toward improving and increasingly used in pay-for-performance initiatives maintenance certification requirements. Measure development to date has focused on primary common conditions such as diabetes; thus, number measures that apply neurologic limited. The American Academy Neurology (AAN) identified need for neurologists develop establish process accomplish this.To adapt test feasibility independent by AAN national measurement...
Stroke is a leading cause of disability. Rehabilitation robotics have been developed to aid in recovery after stroke. This study determined the additional cost robot-assisted therapy and tested its cost-effectiveness.We estimated intervention costs tracked participants' healthcare costs. We collected quality life using Impact Scale Health Utilities Index. analyzed data at 36 weeks postrandomization multivariate regression models controlling for site, presence prior stroke, Veterans Affairs...
Abstract Treatment of experimental autoimmune encephalomyelitis (EAE) with resveratrol, an activator sirtuin 1 (SIRT1), reduces disease severity. This suggested that activators SIRT1, a highly conserved NAD-dependent protein deacetylase, might have immune-modulating or neuroprotective therapeutic effects in EAE. Previously, we showed SIRT1 expression increases EAE, suggesting it is adaptive response. In this study, investigated the potential function regulating EAE using SIRT1-overexpressing...
Bone marrow, or cells selected from bone were reported recently to give rise with a neural phenotype after in vitro treatment neural-inducing factors delivery into the brain. However, we showed previously that untreated marrow express products of myelin basic protein gene, and demonstrate here subset ex vivo expresses neurogenic transcription factor Pax-6 as well neuronal genes encoding neurofilament H, NeuN (neuronal nuclear protein), HuC/HuD (Hu-antigen C/Hu-antigen D), GAD65 (glutamic...
Chronic upper extremity impairment due to stroke has significant medical, psychosocial, and financial consequences, but few studies have examined the effectiveness of rehabilitation therapy during chronic period.. To test safety efficacy MIT-Manus robotic device for following stroke.. The VA Cooperative Studies Program initiated a multicenter, randomized, controlled trial in November 2006 (VA ROBOTICS). Participants with >/=6 months poststroke were randomized robot-assisted (RT), intensive...
Both the American Heart Association and VA/DoD endorse upper-extremity robot-mediated rehabilitation therapy for stroke care. However, we do not know yet how to optimize a particular patient's needs. Here, explore whether must train patients each functional task that they perform during their activities of daily living or alternatively capacitate class tasks have therapists assist them later in translating observed gains into living. The former implies motor adaptation is better model...
Chronic motor deficits in the upper limb (UL) are a major contributor to disability following stroke. This study investigated effect of short-duration robot-assisted therapy on impairment, as measured by clinical scales and robot-derived performance measures patients with chronic, severe UL impairments after As part larger study, 15 individuals paresis (Fugl-Meyer < 15) stroke (minimum 6 mo postonset) performed 18 sessions rehabilitation that consisted goal-directed planar reaching tasks...
Our objective in this study was to assess passive mechanical stiffness the ankle of chronic hemiparetic stroke survivors and compare it with those healthy young older (age-matched) individuals. Given importance during locomotion, an accurate estimate would be valuable for locomotor rehabilitation, potentially providing a measure recovery quantitative basis design treatment protocols. Using novel robot, we characterized both sagittal frontal planes by applying perturbations joint over entire...
In experimental autoimmune encephalomyelitis (EAE), deletion of transient receptor potential melastatin 4 (Trpm4) and administration glibenclamide were found to ameliorate disease progression, prompting speculation that acts by directly inhibiting Trpm4. We hypothesized in EAE, Trpm4 upregulation is accompanied sulfonylurea 1 (Sur1) form Sur1-Trpm4 channels, which are highly sensitive glibenclamide, channels required for EAE progression. was induced wild-type (WT) Abcc8−/− mice using myelin...
Background: Evidence-based clinical practice guidelines (CPGs) are statements that provide recommendations to optimize patient care for a specific problem or question. Merely reading guideline rarely leads implementation of recommendations. The American Academy Neurology (AAN) has formal process development and dissemination. last few years have seen burgeoning social media such as Facebook, Twitter, LinkedIn, newer methods dissemination podcasts webinars. role these in not been studied....
Background. Robot-assisted therapy provides high-intensity arm rehabilitation that can significantly reduce stroke-related upper extremity (UE) deficits. Motor improvement has been shown at the joints trained, but generalization to real-world function not profound. Objective. To investigate efficacy of robot-assisted combined with therapist-assisted task training versus alone on motor outcomes and use in participants moderate severe chronic disability. Methods. This was a single-blind...