K01AG075180

Cortical mechanisms and modulation of somatosensation in older adults with foot sole somatosensory impairments - proposal summary.

My career goals are to 1) understand the supraspinal sensorimotor pathways through which age- and age-related conditions diminish the functionality of the locomotor control system, and 2) use this information to develop new therapies to improve gait and balance in older adults. I hope to achieve this goal by transitioning into an independent scientist and leading a research program in the fields of aging and balance control.

In older adults, diminished lower-extremity somatosensation is highly prevalent and a primary contributor to poor balance, reduced mobility, and increased risk of falling. The vast majority of research and clinical efforts to date have attempted to improve somatosensation by restoring the function of peripheral elements of the somatosensory system. However, somatosensation is also dependent upon the capacity to activate the appropriate cortical networks in response to a given stimulus, which is also altered in older adults.

Therapeutic strategies aimed at enhancing the excitability of the somatosensory cortical network thus offer untapped potential to improve foot-sole somatosensation in this population. Our preliminary studies suggest that a single session of traditional transcranial direct current stimulation (tDCS), which produces a diffuse electric field over the primary somatosensory cortex, improves foot-sole somatosensation in older adults.

In this K01 award, we will first work to identify the specific cortical network that is responsive to walking-related foot-sole stimulation in older adults with and without foot-sole somatosensation impairments (Aim 1). We will use a block-design functional MRI paradigm with a custom-designed, MRI-compatible foot sole stimulation system to apply individualized pressures to the participant's foot soles that mimic those experienced when they walk, yet while they lay motionless in the scanner.

Based upon this knowledge obtained from Aim 1, we will develop a novel multi-target tDCS intervention targeting the identified cortical network and test the effects of a single session of this intervention on foot-sole somatosensation, balance, and mobility in older adults with mild-to-moderate foot-sole somatosensory impairments (Aim 2). We will then use participant brain MRIs and electric field modeling to establish the "dose-response" relationship between on-target current intensity induced by tDCS and its acute effect on the cortical response to foot sole stimulation (Aim 3).

Through this work, we will learn about how chronic lower-extremity somatosensory impairments influence the cortical processing of sensory feedback involved in the control of balance and mobility, demonstrate that such processing can be modulated by tDCS, and thus, obtain critical information needed to design a larger more definitive trial to test the potential for tDCS to improve foot sole sensation, balance, and mobility in this population.

This career development award will provide me with unique training experiences in neurophysiology of somatosensation in aging, the clinical care of these older adults, and increase my expertise in advanced neuroimaging and brain stimulation techniques, which, taken together, will greatly facilitate my efforts to transition into an independent academic scientist.

Hebrew Rehabilitation Center

TO ENCOURAGE BIOMEDICAL, SOCIAL, AND BEHAVIORAL RESEARCH AND RESEARCH TRAINING DIRECTED TOWARD GREATER UNDERSTANDING OF THE AGING PROCESS AND THE DISEASES, SPECIAL PROBLEMS, AND NEEDS OF PEOPLE AS THEY AGE. THE NATIONAL INSTITUTE ON AGING HAS ESTABLISHED PROGRAMS TO PURSUE THESE GOALS. THE DIVISION OF AGING BIOLOGY EMPHASIZES UNDERSTANDING THE BASIC BIOLOGICAL PROCESSES OF AGING. THE DIVISION OF GERIATRICS AND CLINICAL GERONTOLOGY SUPPORTS RESEARCH TO IMPROVE THE ABILITIES OF HEALTH CARE PRACTITIONERS TO RESPOND TO THE DISEASES AND OTHER CLINICAL PROBLEMS OF OLDER PEOPLE. THE DIVISION OF BEHAVIORAL AND SOCIAL RESEARCH SUPPORTS RESEARCH THAT WILL LEAD TO GREATER UNDERSTANDING OF THE SOCIAL, CULTURAL, ECONOMIC AND PSYCHOLOGICAL FACTORS THAT AFFECT BOTH THE PROCESS OF GROWING OLD AND THE PLACE OF OLDER PEOPLE IN SOCIETY. THE DIVISION OF NEUROSCIENCE FOSTERS RESEARCH CONCERNED WITH THE AGE-RELATED CHANGES IN THE NERVOUS SYSTEM AS WELL AS THE RELATED SENSORY, PERCEPTUAL, AND COGNITIVE PROCESSES ASSOCIATED WITH AGING AND HAS A SPECIAL EMPHASIS ON ALZHEIMER'S DISEASE. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.866 - Aging Research

National Institute on Aging (NIA) [HHS - NIH]

Roslindale, Massachusetts 021311000 United States

Single Zip Code

Mentored Research Scientist Development Award (Parent K01 - Independent Clinical Trial Required) (PA-20-176)

Amendment Since initial award the total obligations have increased 400% from $124,874 to $624,370.