Paralyzed Veterans of America's Research Foundation Board of Directors met on November 9, 2021, to decide which candidates would be the best deserving of the Foundation's annual awards.

 The Foundation received 55 total applications nation-wide. Out of the 55, the Foundation awarded nine grants to recipients whose work excelled in the areas of spinal cord injury/disease, including respiratory issues within SCI, pressure injury risk, and determining driving capability in persons living with SCI, as well as other topic areas. 

 The grants are awarded for a two-year period; the grant cycle beginning on January 1, 2022.

 This year, the Foundation awarded a total of $1,149,223 in grants.

 The grants for FY2022 are funded in three categories: basic science, clinical applications, and fellowship. 

Dr. Edmund Hollis, Winifred Masterson Burke Medical Research Institute

“Enhancing Nerve Transfer Treatment for Chronic Spinal Cord Injury”

$150,000

Project Summary:

Recovery of hand and arm function is the highest priority for tetraplegic individuals living with chronic SCI as it is critical for increasing quality of life and decreasing long-term care costs. The objective of this proposal is to determine the effects of a clinically relevant electrical stimulation procedure on outcomes following nerve transfer surgery to treat chronic cervical SCI. The proposed studies will determine the dose and duration of electrical stimulation required for enhancing nerve regeneration. The findings will be directly translatable and substantially impact current clinical care. The research proposed is innovative, because it addresses a key limitation of a state-of-the-art clinical intervention for ameliorating hand and arm paralysis in individuals with chronic SCI. It is significant because it is expected to provide a clinical approach to improving surgical outcomes in chronic SCI. The findings will lay the groundwork for optimization of this state-of-the-art intervention for treating chronic SCI.

Dr. Charles Tator, University Health Network

“Targeting Inhibition after Spinal Cord Injury to Promote Locomotor and Bladder Recovery”

$149,904

Project Summary:

Major spinal cord injury (SCI) causes paralysis, sensory loss, and loss of bladder and bowel function. Cell death, loss of axonal connections between the brain and spinal cord, and production of inhibitory proteins limit repair. In previous studies, we blocked the neurite growth inhibitor Repulsive Guidance Molecule A (RGMa) with human monoclonal antibodies, and demonstrated increased growth of motor axons, sparing of neurons around the lesion, and improvements in function. We also found earlier recovery of bladder emptying and reduced thickness of bladder tissue in a clinically relevant rat SCI model. Our team will use clinically relevant tests of bladder function and locomotion, and axonal tracing and tissue analysis to determine the neuroanatomical basis of locomotor and bladder recovery in anti-RGMa antibody treated rats. RGMa antibodies are currently in clinical trials and this study should inform their application for SCI patients.

Dr. James Yuh-Luen Hong, University Health Network

“Remote Ischemic Preconditioning Enhances Outcomes in the Surgical Management of Degenerative Cervical Myelopathy”

$100,000

Project Summary:

Degenerative cervical myelopathy (DCM) is the most common form of spinal cord injury. This progressive injury occurs when the bones and supporting tissues of the spine begin to break down in the neck. In DCM, these degenerative spinal structures compress the spinal cord and cause the onset of neurological symptoms. At present, the only treatment option for DCM is the surgical decompression of the spinal cord. However, this procedure is associated with ongoing neurological decline in a subset of severe DCM patients. My laboratory has previously shown this continued neurological decline is due to an increase in blood flow at the injury site during surgical decompression. This study aims to assess the efficacy of a technique whereby brief episodes of decreased blood flow in the hindlimb of animals can serve to prime and protect its body against the damage occurring remotely at the spinal cord during decompression

Dr. Yuming Lei, Texas A&M University

“Sensorimotor Interactions Following Spinal Cord Injury”

$149,580

Project Summary:

Spinal cord injuries dramatically alter motor and sensory systems, which affect sensorimotor integration and motor skill acquisition and performance. The induction of neuroplasticity in the interactions between the motor and sensory areas is the key to the recovery of sensorimotor function. The proposed work will study reciprocal sensorimotor interactions during voluntary movements in individuals with spinal cord injuries and test a novel intervention paradigm modulating sensorimotor integration following spinal cord injuries. The findings of this study may be important for developing novel therapies for inducing sensorimotor integration plasticity and improving the quality of life and independence in persons with spinal cord injuries.

Dr. Matthias Krenn, University of Mississippi

“Transcutaneous Spinal Stimulation for Reducing Lower Limb Spasticity in Chronic Spinal Cord Injury: A Cross-Over Study of Immediate Effects and Outcomes of Home-Based Therapy Trials”

$149,997

Project Summary:

Muscle stiffness and spasms develop soon after spinal cord injury and often interfere with hygiene, transfers, and locomotion, and may cause pain. New developments in electrical neuromodulation with transcutaneous spinal stimulation showed promise to control muscle stiffness and spasms in the lower limbs of individuals with SCI but the evidence about the best ways to provide this intervention is still missing. Therefore, in this project, we aim to examine the effects of different frequencies and intensities of transcutaneous spinal stimulation after a single application and after a week-long home-based therapy. We will also examine the participants’ experience and their perspective about the value, challenges, and acceptability of this intervention as we translate research findings into clinical practice. At the conclusion, we will provide information on whether this novel, low-cost and non-pharmacological approach is effective to control muscle stiffness and spasms after spinal cord injury.

Dr. Ann Van de Winckel, University of Minnesota

“A Clinical Trial of Cognitive Multisensory Rehabilitation for Sensory and Motor Recovery in Adults with Spinal Cord Injury”

$150,000

Project Summary:

About 296,000 Americans have a spinal cord injury/disorder (SCI/D), leading to reduced or complete loss of sensation, body awareness, and movement below the injury level. Current therapies insufficiently help recover sensation and movement. We found that specific brain connections were weaker in adults with SCI/D vs healthy adults and that a physical therapy termed “Cognitive Multisensory Rehabilitation” (CMR) restored these brain connections. After 6 weeks of CMR, adults with SCI/D-related neuropathic pain experienced significant pain reduction and improvement in sensation and movement, and maintained these improvements in the 6-week follow-up. Here, we will investigate whether 8 weeks of CMR vs an adaptive fitness program improves sensation and movement in adults with SCI/D (Aim 1) and whether CMR restores brain activity/connectivity related to sensorimotor function in adults with SCI/D (Aim 2). This work may result in an effective physical therapy approach that can easily be implemented within our healthcare system.

Dr. Shancheng Bao, Texas A&M University

“Cerebellar Contributions to Corticospinal Excitability and Skilled Movement Following Human Spinal Cord Injury”

$99,742

Project Summary:

This project aims to promote motor performance for individuals suffering from spinal cord injury. Specifically, we attempt to enhance the function of the motor cortex and the cerebellum during manual activities since these networks tend to atrophy after the injuries. We will manipulate the brain's plasticity through non-invasive brain stimulation in the study to determine if the participants benefit from the operation. In addition, we will investigate the effect of stimulation combined with robot-assisted training in a longitudinal study. We anticipate that the stimulation and robotic-assisted training protocol will lead to long-term benefits on the brain and improve manual function permanently (e.g., reaching and grasping). We also expect that findings from this study will contribute to developing optimal rehabilitation strategies in the future.

Dr. Claire Shackleton, University of British Columbia

“Motor and Autonomic Concomitant Health Improvements with Neuromodulation and Exoskeleton (MACHINE) Training: A Randomized Controlled Trail in Individuals with SCI”

$100,000

Project Summary:

Spinal cord injury (SCI) disrupts many aspects of life, including the loss of voluntary movement and involuntary control of bodily functions. Mobility impairments and body function complications limit health and quality of life following SCI. This trial will investigate whether activity-based therapy (ABT), using a robotic exoskeleton, can change the strength of signals from the brain that control voluntary movement (standing, muscle strength and seated balance) as well as other important involuntary bodily (i.e. cardiovascular, bladder, bowel and sexual) functions. We aim to determine whether these improvements can be enhanced with the addition of non-invasive (does not enter the body) spinal cord stimulation. This therapy has been shown to re-awaken inactive spinal circuits. We anticipate that in combination with ABT, spinal cord stimulation may maximize recovery and greatly improve health-related quality of life for individuals with SCI.

Dr. Soshi Samejima, University of British Columbia

“Transcutaneous Spinal Cord Stimulation for Bowel and Sexual Dysfunction Following Spinal Cord Injury”

$100,000

Project Summary

Our goal is to improve bowel and sexual function in individuals with spinal cord injury (SCI). After neck or upper back SCI, majority of people experience prolonged bowel management time and incontinence as well as sexual dysfunctions. Unlike a loss of movement, bowel and sexual dysfunction is “invisible” to the general public, but is rated among highest priorities for quality of life for people with SCI. During the last decade, spinal cord stimulation demonstrated remarkable recovery of motor and autonomic function. I propose a pilot clinical trial to test the effect of noninvasive spinal cord stimulation on recovery of bowel and sexual function following SCI. Noninvasive stimulation is low cost, non-significant risk and allows to reposition the electrode location. Based on our promising initial data and our expertise, I am confident that the proposed innovative therapy will improve bowel and sexual function that determine the quality of life following SCI.