Investigation of Clinical, Blood, and Neuroimaging Biomarkers as Predictors of Independent Walking Post-stroke

More than half of stroke survivors experience difficulty with walking, contributing to disability, loss of independence, and increased caregiver burden. The long-term repercussions of loss of independent walking, along with limited rehabilitation time and resources, demonstrates an urgent need for advancing prediction of early walking recovery to improve patient-centered care and support discharge planning. The proposed research seeks to elucidate prognostic biomarkers in persons who have had a stroke for predicting walking recovery at 3 months after stroke. Measures will be obtained within the first week after stroke including clinical tests of strength and balance, MRI scans to assess the structural integrity and connectivity of brain pathways important for movement, and blood draws to examine blood markers related to recovery and repair. Early identification of patients with the potential to recover independent walking can allow for tailored interventions to assist recovery and positively effect quality of life.

 

Image of gait analysis image with two women walking side by side          Side by side brain images

 

Project Director:

Photo of Project Director Denise Peters, PT, D.P.T., Ph.D.

Denise Peters, PT, D.P.T., Ph.D.

Associate Professor and DPT Program Director
Department of Rehabilitation and Movement Science
Doctor of Physical Therapy Program

MAIN Lab



Project Director: 

Photo of Project Director Nicholas Klug, PhD.

Nicholas Klug, Ph.D.

Assistant Professor  
Department of Pharmacology

Klug Lab website


Role of brain capillary KATP Channels in Physiological Deep Brain Hypoxia Sensing and Deficient Blood Flow Regulation in Ischemic Small Vessel Disease 

The main objectives of this proposal are to determine if blood flow responses mediated by capillaries in deep brain structures are altered during chronic hypoxia and whether deep brain hypoxia-sensing is disrupted in an animal model of cerebral small vessel disease. These questions will be addressed using sophisticated deep brain ultrasound imaging in well-characterized mouse models of cerebral small vessel disease. 

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Vascular Mechanisms of Cognitive Impairment in Chronic Kidney Disease

Research Summary: Chronic kidney disease (CKD) affects 30 million people in the U.S. and is independently associated with a 2-fold increased risk of cognitive impairment, especially vascular-mediated cognitive impairment. CKD causes disturbances in the vascular compartment including higher levels of inflammation, hemostatic and endothelial activation biomarkers. We hypothesize that the pathophysiological processes that these biomarkers represent are implicated in the development of vascular cognitive impairment via reduction in cerebral blood flow, and altered permeability of the blood brain barrier, leading to tissue damage. The proposed research will study participants in the REGARDS Study, a nationally representative biracial cohort of 30,239 individuals followed for over 10 years with repeated cognitive assessments. Dr. Cheung will harness these rich longitudinal data to determine the trajectories of cognitive decline and to study the mechanisms of cognitive impairment in those with CKD. She will study biomarkers of inflammation, hemostasis, and endothelial activation as mediators of cognitive impairment in CKD.

Image of Incidence and Trajectory of Cognitive function in CKD Chart

Project Director: 

Photo of Project Director Katharine Cheung, M.D., Ph.D.

Katharine Cheung, M.D., Ph.D.

Assistant Professor  
Department of Medicine- Nephrology, Tenure-track