The primary focus of our research is to understand central nervous system and neuromuscular mechanisms underlying neurological disorders and processes of functional recovery resulting from medical rehabilitative interventions. Major research techniques performed in the laboratory are electrophysiology and functional imaging. Our laboratory also does research involving development of new technologies and therapies to aid patients with motor disabilities.
Current Projects and Funding
Motor recovery post stroke
Conventional motor rehabilitation post stroke is a process of usage-dependent motor skill relearning, during which patient actively repeats movements and daily activities under the help of the physical therapist to promote and reinforce neural reorganization and motor control. This approach focuses on interventions at the periphery of the body, specifically the upper and lower limbs, and requires patients having remaining movement ability post stroke or regaining some movement ability after spontaneous recovery or other surgical or pharmaceutical treatment. Conventional rehabilitation (except subacute passive exercise) might have the disadvantages that: 1) there might be a significant delay waiting for it to start, while early treatment is widely reported critical for stroke recovery; 2) it promotes the cortical reorganization through peripheral treatment and training, thus it might have a lower efficiency than the interventions that directly address CNS plasticity. This might partially explain why after being “rehabilitated” with conventional therapy, 30%-60% of stroke patients still suffer residual functional disability. Various methods related to direct cortical stimulation or training have been brought up to facilitate motor recovery and mobility post stroke, for example, mental-practice of motor tasks, direct cortical rTMS or TDCS stimulation, brain-computer interface, etc. These interventions not only directly train and guide CNS plasticity to improve motor function and mobility, but also can potentially be applied at an earlier stage for post-acute rehabilitation when a stroke patient with limited movement ability is clinically stable.
Management of chronic pain and relief of chronic fatigue
Patients with chronic fatigue syndrome/fibromyalgia experience debilitating fatigue lasting for at least six months that cannot be alleviated by bed rest, with concurrent occurrence of at least four of eight symptoms such as muscle and joint pain, headache, sleeping problems, abnormalities in memory and concentration, tender lymph nodes, sore throat, etc. The current body of research has suggested various treatments, such as immunological therapy (i.e., immunoglobulin, interferon), pharmacological therapy (hydrocortisone, antidepressants), psychological therapy, behavioral relaxation training, nutritional supplements, graded exercise therapy (GET), and cognitive behavioral therapy (CBT). These treatments, however, address only a single symptom or a single possible cause (e.g., antidepressants for depression, interferon for immune dysfunction), with limited effect and sometimes even adverse side effects (i.e., adrenal suppression from hydrocortisone). The most promising interventions thus far, GET and CBT, address only the patient’s overall well-being and physical and cognitive functions instead of symptomatic relief. CFS is heterogeneous in origin and is associated with a wide range of symptoms. Directly relieving these somatic and psychological symptoms is critically important to improving quality of life and helping CFS patients build up a positive belief and attitude toward their condition.
Acupuncture and Acupressure treatment in rehabilitation
Traditional Chinese medicine emphasizes on balance and harmony. Although the underlying mechanisms are still unknown yet, some distinct effects have been widely observed and documented in evidence-based medicine. Among them, acupuncture has been reported to serve as an effective complement to standard care of postoperative and chemotherapy nausea and vomiting, addiction, headache, myofascial pain, low-back pain, migraine, and stroke rehabilitation; and acupressure used to restore motor function and mobility at the chronic stage after injury and disability. Acupuncture stimulates anatomical points on the body by hair-thin needles (sometimes in combination with electrical stimulus or with heat). Acupressure is a noninvasive therapeutic massage during which anatomical points on the body are stimulated by fingers-pressing (sometimes in combination with massage along “meridians”). Both of them work on the same presumed network of energy channels in the body outlined in traditional Chinese medicine, which are not evidenced in Western medicine yet. Thus debate exists in the literature regarding their effectiveness and more rigorous clinical trials are needed before any convincing conclusion can be made.
- Scott Bea, PsyD
- Janis Daly, PT, PhD
- Mellar Davis, MD
- Juliet Hou, MD
- Shuyun Jiang, PhD (China)
- John Lee, MD
- Daniel Mazanec, MD
- Halle Moore, MD
- Erik Pioro, MD, PhD
- Rui Qi, PhD (China)
- Wlodzimierz Siemionow, PhD
- Jamie Starkey
- Margaret Tsai, MD
- Juntao Yan, PhD (China)
- Liu JZ, Brown RW, Yue GH. A dynamic model of muscle activation, fatigue and recovery. Biophysical Journal, 82: 2344-2359, 2002.
- Liu JZ, Shan ZY, Zhang LD, Sahgal V. Brown RW, Yue GH. Human brain activation during sustained and intermittent submaximal fatigue muscle contractions: an fMRI study. Journal of Neurophysiology, 90: 300-12, 2003.
- Ranganathan VK, Siemionow V, Liu JZ, Sahgal V, Yue GH. From mental power to muscle power – gaining strength by using the mind. Neuropsychologia 42: 944-56, 2004.
- Zhang LD, Dean D, Liu JZ, Sahgal V, Yue GH. Quantifying degeneration of white matter in normal aging using fractal dimension. Neurobiology of Aging, 28: 1543-1555, 2007.
- Liu JZ, Lewandowski B, Karakasis C, Yao B, Siemionow V, Sahgal V, Yue GH. Shifting of activation center in the brain during muscle fatigue: An explanation of minimal central fatigue? NeuroImage, 35: 299-307, 2007.
- Fang Y, Daly JJ, Hrovat K, Sahgal V, Yue GH. Functional corticomuscular connection during reaching is weakened following stroke. Clinical Neurophysiology, 120: 994-1002, 2009.
- Yavuzsen T, Davis MP, Ranganathan VK, Siemionow V, Walsh TD, Khoshknabi DS, Kirkova J, Lagman R, LeGrand S, Yue GH. Cancer related fatigue, central or peripheral? Journal of Pain and Symptom Management, 38: 587-596, 2009.
- Yang Q, Fang Y, Sun CK, Siemionow V, Ranganathan VK, Khoshknabi DS, Davis MP, Wash D, Sahgal V, Yue GH. Weakening of corticomuscular coupling during muscle fatigue. Brain Research, 1250: 101-112, 2009.
- Kisiel-Sajewicz K, Fang Y, Yue GH, Siemionow V, Daly JJ. Weakening of synergist muscle coupling during reaching movement in stroke patients. Neurorehabilitation and Neural Repair, in press.
- Fang Y, Hansley J, Daly JJ, Sun J, Yang Q, Hvorat K, Fredrickson E, Yue GH. Contralesional brain activation is greater during planning than execution phases for reaching in chronic stroke. Neurorehabilitation and Neural Repair, in revision.