Kevin Kilgore, PhD, staff scientist in the departments of Orthopaedics and Physical Medicine and Rehabilitation (PM&R), was awarded a $2.6M, 4-year grant from National Institutes of Health. The goal of the project is to develop an implanted device that can measure health status and predict disease states.
The proposed implanted device, called the "Lifeline", measures parameters such as body temperature, photoplethysmogram, electrocardiogram, audio, and acceleration. Taken together, these measures may be able to predict the early onset of autonomic dysreflexia (specific to spinal cord injury (SCI)), pneumonia, urinary tract infections, and pulmonary embolism. These comorbidities are among the top causes of death in SCI. Early treatment may prevent them from progressing to life-threatening conditions. The Lifeline device will be incorporated into an existing modular implant system that Dr. Kilgore's team has previously developed, called the "Networked Neuroprosthesis."
Dr. Kilgore is the P. Hunter Peckham and George J. Picha Professor of Biomedical Engineering in the Dept. of Orthopaedics and PM&R, Case Western Reserve University (CWRU). His co-investigators include Niloy Bhadra, MD, PhD, Associate Professor, Dept. PM&R, CWRU; Michael Fu, PhD, Assistant Professor, Dept. Electrical, Computer & Systems Engineering and PM&R, CWRU; Pedram Mohseni, PhD, Professor of Electrical, Computer, & Systems Engineering, CWRU; Laleh Najafizadeh, PhD, Associate Professor of Electrical & Computer Engineering, Rutgers University; and Brian Smith, BScHons, Director of Implant Development, Biomedical Engineering, CWRU.
Kevin Kilgore, PhD, staff scientist in the departments of Orthopedics and Physical Medicine and Rehabilitation (PM&R) and Megan Moynahan, MS, Executive Director of the Institute for Functional Restoration at Case Western Reserve University (CWRU) were awarded a two-year, $998,000 grant from the Ohio Department of Higher Education (ODHE) entitled: “Restoration of Grasp and Reach in Cervical Spinal Cord Injury (SCI) - Study Culmination.”
The proposed work involves the use of an implanted system, referred to as the Networked Neuroprosthesis (NNP), which utilizes low levels of electrical current to activate paralyzed muscles. The NNP System was developed by Dr. Kilgore and Dr. Hunter Peckham at MHS and CWRU. Early feasibility studies in individuals with SCI had already demonstrated that this implanted neuroprosthesis can enable people to regain grasping and reaching functions and provides increased independence in activities such as eating, drinking, writing, office tasks, and other activities of daily living.
The grant from the ODHE enables the purchase of implanted systems to complete an ongoing multi-center pivotal clinical trial that was initiated with funding from National Institutes of Health (NIH). MHS and CWRU are partnering with Synapse Biomedical of Oberlin, Ohio on the clinical study. This project will have a direct positive impact on Ohioans with SCI by providing them with increased independence and improved quality of life, and will also have a direct positive impact on the Ohio medical device industry, potentially leading to the only commercial product of an implanted neuroprosthesis for grasp and reach in SCI.
Dr. Kilgore is Professor of Orthopedics, PM&R and Biomedical Engineering at CWRU. Megan Moynahan, MS is Executive Director for the Institute for Functional Restoration (IFR), a non-profit organization based at CWRU that has the mission to restore function to people with SCI.
David Cunningham, PhD, post-doctoral fellow in the department of Physical Medicine and Rehabilitation (PM&R) received a $250,000 NIH K12 award entitled “Multimodal therapy to improve motor control in chronic stroke: Pairing non-invasive brain stimulation with Functional Electrical Stimulation.” The award is administered by the Neurorehabilitation and Restorative Training Network based at the Georgetown University Medical Center. The proposed project demonstrates Dr. Cunningham’s initiative and commitment to defining mechanisms underlying neural plasticity and recovery of function following central nervous system (CNS) injury, and to develop strategies that incorporate noninvasive brain stimulation to Functional Electrical Stimulation (FES) therapies in order to augment recovery.
Dr. Cunningham’s primary mentor will be Jayme Knutson, PhD, Director of Research for the Department of PM&R at the MetroHealth System (MHS) and Associate Professor of PM&R at Case Western Reserve University (CWRU). His other mentors include Richard Wilson, MD, Director of Neurological Rehabilitation at MHS and Vice Chair and Associate Professor of PM&R at CWRU; Ela Plow, PhD, Assistant Professor of Medicine at the Cleveland Clinic Lerner College of Medicine (CCLCM); and Ken Baker, Adjunct Assistant Professor of Biomedical Engineering and Molecular Medicine at CCLCM.
Dr. Cunningham joined the department of PM&R as a post-doctoral fellow in June of 2017. In July of 2018, he was awarded the NIH CWRU StrokeNet Fellowship. He is a faculty candidate for the department of PM&R with anticipated transition to faculty in July of 2020.
Kenneth Laurita, PhD, bioscientific staff in the Heart and Vascular Center and Lance Wilson, MD, attending physician in the Department of Emergency Medicine, were awarded a 5-year, $3,200,000 NIH grant to improve patient outcomes during resuscitation from sudden cardiac arrest.
Sudden cardiac arrest, due to an abnormal heart rhythm, is a major public health problem. Every year, over 300,000 people die from sudden cardiac arrest, which is particularly tragic because it is often the first manifestation of potentially treatable underlying heart disease. Despite significant efforts to improve resuscitation, patient survival remains poor.
In this project, Drs. Laurita and Wilson propose to investigate the causes of cardiac arrest and re-arrest during resuscitation, and to develop innovative biomarkers and new treatments to improve patient outcomes.
Drs. Laurita and Wilson serve as Co-Principal Investigators on this grant. Dr. Laurita is an Associate Professor of Medicine (Cardiology) and Biomedical Engineering and Dr. Wilson is a Professor of Emergency Medicine, Case Western Reserve University. Co-Investigators include Joseph Piktel, MD, Associate Professor of Emergency Medicine and Ohad Ziv, MD, Assistant Professor of Medicine (Cardiology).
Michael Fu, PhD, staff scientist in the department of Physical Medicine and Rehabilitation (PM&R) was awarded a five-year, $549,000 National Science Foundation (NSF) Early Career Award entitled “Maintaining Volitional Effort During Electrical Stimulation-assisted Stroke Rehabilitation.” The main goal of his proposed research is to tightly link brain activation or the intent to move a paralyzed limb with actual movement of the limb assisted by Functional Electrical Stimulation (FES). “The brain learns best after stroke when it actively tries to move the paretic limb – not when it is passively moved for the person,” explains Dr. Fu. Achieving this goal may enhance the ability of FES to accelerate the recovery of the paralyzed limb following stroke.
Another important goal of this award is to provide an innovative educational experience for students at the Lincoln-West School of Science and Health. Research results will be integrated into educational programs to participate in rehabilitation science and engineering, which are currently available primarily to graduate-level students. An example is the development of stroke rehabilitation video games, which will be incorporated into the ongoing science education program and train students to create video games for clinician clients.
Dr. Fu is Assistant Professor of Electrical, Computer and Systems Engineering at the Case School of Engineering (CSE), and Assistant Professor of PM&R at the Case Western Reserve University (CWRU) School of Medicine (SOM). After receiving his PhD in Electrical Engineering from CSE, Dr. Fu completed his KL2 training at MetroHealth under the mentorship of Jayme Knutson, PhD, Associate Professor of PM&R and John Chae, MD, Professor of PM&R and Biomedical Engineering. Dr. Fu’s present transdisciplinary staff scientist position at MHS and tenure track faculty position at CSE are the results of collaborative leadership between MHS, CSE and CWRU SOM.
P. Hunter Peckham, PhD, Co-Director of the MetroHealth Rehabilitation Institute and Research Faculty in the Departments of Orthopedics and Physical Medicine and Rehabilitation (PM&R), received the Lifetime Achievement Award at Annual Meeting of the North American Neuromodulation Society (NANS) in Las Vegas, NV. The NANS Lifetime Achievement Award recognizes an individual who has made significant and lasting contributions to the field of neuromodulation over the course of their career.
Dr. Peckham is a Member of the National Academy of Engineering, Fellow of the National Academy of Inventors, Fellow of the American Institute for Medical and Biological Engineering and Fellow of the International Academy of Medical and Biological Engineering. Dr. Peckham is Distinguished University Professor, Donnell Professor of Biomedical Engineering and Professor of Orthopedics and PM&R at Case Western Reserve University.
Tina Vrabec, PhD, research faculty in the department of Physical Medicine and Rehabilitation (PM&R) and the MetroHealth Rehabilitation Institute, in collaboration with the UCLA Neurocardiology Center for Excellence, was awarded a 5-year, $2.3 million NIH grant entitled, “Investigation of Partial Electrical Nerve Block for Autonomic Regulation.”
More than 600,000 people die of heart disease in the United States every year. Sudden cardiac death often occurs as a result of ventricular tachyarrhythmias (VT) in patients with coronary heart disease (CHD) and/or heart failure (HF). Conventional treatments lack efficacy in certain populations of patients and are accompanied by off-target side effects. Partial electrical nerve block, originally developed to block pain signals in chronic pain patients and unintentional muscle activation among neurologically impaired patients, is proposed to provide control of cardiac function that is targeted, rapid, reversible, and gradable. The addition of a biosensor to measure regional cardiac neurotransmitters is designed to generate feedback for the system to provide a customizable, adaptable, patient-specific intervention for cardiac dysfunction. The evaluation of this approach could lead to interventions that automatically adapt to a patient’s disease state over time.
Dr. Vrabec is Assistant Professor of PM&R at the Case Western Reserve University (CWRU) School of Medicine (SOM). Co-investigators and CWRU faculty based at The MetroHealth Rehabilitation Institute include Kevin Kilgore, PhD, Professor of Orthopedics, PM&R and Biomedical Engineering, and Niloy Bhadra, PhD, Associate Professor of PM&R. Other collaborators include Corey Smith, PhD, Professor of Physiology and Biophysics at the CWRU SOM and Jeff Ardell PhD, Professor of Medicine and Anesthesiology at UCLA and Director of the UCLA Neurocardiology Center for Excellence.