UF researchers attract federal funding for brain rehabilitation program

After years of believing that brain damage from strokes and other injuries was irreversible, researchers are growing optimistic that with the right combination of medicine and rehabilitation, they can inspire the brain to form new pathways to regain some lost functions.

With that goal in mind, a team of scientists from the University of Florida’s McKnight Brain Institute led by faculty from the neurology department has received a $5 million program project grant from the National Institutes of Health to test several provocative ideas for treating the stroke-induced communication problems referred to collectively as aphasia.

At the heart of the research is the emerging concept of neural plasticity—the idea that the brain is adaptable and under ideal conditions can create new ways to handle lost skills. However, after injury, these changes in the brain do not happen automatically. That’s why UF researchers are looking for the medicines, and mental and physical exercises that will enable the brain to develop new skills.

Their new grant, which the NIH will distribute during the next four years, comes just a year after the UF-affiliated Malcom Randall Veterans Affairs Medical Center in Gainesville was awarded $3.5 million to develop a center of excellence in brain rehabilitation research. With those funds from the Rehabilitation Research and Development Service of the U.S. Department of Veterans Affairs, these same UF and VA scientists are tackling additional cognitive and motor problems brought on by traumatic injury, stroke or degenerative diseases such as Alzheimer’s.

“Neurological diseases are among the most debilitating chronic conditions,” said Leslie Gonzalez-Rothi, a professor of neurology in UF’s College of Medicine who is the principal investigator on both grants. “Cognitive disorders isolate the person who is affected by them, and everyone who lives with them is seriously affected. So our goal is try to minimize these effects.”

For the rehabilitation efforts, UF specialists from the colleges of Medicine and Health Professions will work with their counterparts at the VA on a variety of projects. While much of the work will be done at the VA and Shands Rehab Hospital in Gainesville, researchers also will see patients at Brooks Rehabilitation Hospital in Jacksonville. Additionally, the team has collaborators at Old Dominion University in Norfolk, Va., Baylor University in Waco, Texas, and the University of Kentucky.

“One of the things we’re trying to do is make the brain more receptive to learning by trying certain medications in combination with speech or physical therapy,” said Gonzalez-Rothi, program director of the Gainesville VA’s Brain Rehabilitation Research Center.

The medications and another therapy involving transiently stimulating the brain with magnetic fields may encourage the creation of new nerve cell pathways, said Dr. Stephen Nadeau, a professor of neurology in UF’s College of Medicine and a staff neurologist at the Gainesville VA Medical Center. “The behavioral portion of our treatments, whether physical, speech or another kind of therapy, provides the learning content,” he said.

In one study, UF scientists are exploring whether people who have lost the ability to speak in sentences can relearn language skills—in part by associating colors with parts of speech. “We’re recruiting a different part of the brain to the task of language that never participated in it before,” Gonzalez-Rothi said.

In another communication-building effort, scientists are testing ways to help people with aphasia control how they pay attention to their surroundings.

“There is a phenomenon in which, if you approach a person with aphasia from one side of their body, as opposed to the other, you will get very different responses,” Gonzalez-Rothi said. “If you show patients pictures to identify, on one side they might name 25 percent of them correctly, but on the other, they might answer 60 percent right.”

Bruce Crosson, a professor of clinical and health psychology, and his colleagues are testing the effectiveness of directing patients to look to their left side as they try to name an object. In a related project, research participants who have difficulty initiating speech will be asked to perform a series of complex movements with their left hand as they try to name pictured objects.

Dr. Kenneth Heilman, the James E. Rooks Jr. distinguished professor of neurology at UF and chief of neurology for the regional VA system, is working with people who have suffered right hemisphere brain damage. Such damage can affect their ability to understand and express the emotional content of communication that is indicated by facial expressions, body language, and tone and volume of voice.

Heilman, co-principal investigator on both the UF and VA grants, said experimental therapies include medications and re-education strategies in which a person is explicitly told how to communicate emotions (such as to speak more loudly when angry), as well as encouraging patient and family to say, using words, what they are feeling.

In many of these studies, researchers plan to use functional magnetic resonance imaging, commonly referred to as fMRI, to map any detectable changes that may occur in the brain while a person undergoes rehabilitation. The imaging technique provides a view of which parts of the brain are activated to perform a specific function.

“We think this will allow us to develop much better treatments because we will be able to see if our ideas about what is happening in the brain are correct,” Crosson said. “We think it will help us predict which patients we can help and with what treatments.”