University of Kentucky
A. Personal Statement
Although more than 40% of individuals who experience a stroke are left with severe impairments, disproportionately few studies have focused on this population. The goal of our research program is to determine how to maximize motor function following stroke by combining neuromodulation with motor training. My primary role in our studies is to deliver the neuromodulatory interventions (i.e. peripheral nerve stimulation, transcranial magnetic stimulation) and map the motor cortex using transcranial magnetic stimulation. I am also responsible for organizing and maintaining all study data, and will perform interim analyses and assist with interpretation of functional and neurophysiological data. I also participate in disseminating the results of the study by preparing manuscripts for publication in peer-reviewed journals and presenting our results at local and international conferences.
My history of collaboration with Dr. Sawaki precedes my joining her lab in 2013. She served as a mentor for my master’s research which focused on increasing neuroplasticity to help facilitate recovery from neurological injury. My educational background in biomedical engineering, combined with my relevant research experience during graduate school and as a biomedical research associate in Dr. Sawaki’s lab, demonstrates I have the knowledge and experience necessary to perform my role in this study, and a genuine interest in neurorehabilitation.
B. Positions and Honors
Positions and Employment
2013- Biomedical Research Associate, Department of Physical Medicine and Rehabilitation, University of Kentucky, Lexington, KY
Other Experience and Professional Memberships
2011- Member, Biomedical Engineering Society
2011-2014 Member, Society for Neuroscience
2018 Best poster presentation (“Dose-response relationship of transcutaneous spinal direct current stimulation in healthy humans: a proof of concept study”): UK Department of Physical Medicine and Rehabilitation 30th Annual PM&R Research Day; May 2018; Lexington, KY.
2015 Best poster presentation (“Modulation of spinal excitability through transvertebral direct current stimulation in subjects with motor incomplete spinal cord injury”): UK Department of Physical Medicine and Rehabilitation 27th Annual PM&R Research Day; May 2015; Lexington, KY.
2014 Best poster presentation (“Enhancing upper extremity motor recovery with brain stimulation in spinal cord injury: pilot data”): UK Department of Physical Medicine and Rehabilitation 26th Annual PM&R Research Day; May 2014; Lexington, KY.
2013 Best poster presentation (“Discrimination of attempted movements from rest using an EEG brain-machine interface for rehabilitation from neural injury”): UK Department of Physical Medicine and Rehabilitation 25th Annual PM&R Research Day; May 2013; Lexington, KY.
2011 USEC Fellowship, College of Engineering, University of Kentucky, Lexington, KY. Awarded to engineering graduate students based on academic record and research productivity.
C. Contribution to Science
1. Combining interventional stimulation and therapy to improve outcomes in individuals with neurological impairment. As a member of our current research team, I have been involved in studies that combine experimental forms of stimulation with occupational or physical therapy in stroke and spinal cord injury subjects, in an effort to improve motor recovery beyond what is possible with therapy alone. My role in these projects is to deliver the different forms of interventional stimulation, such as transcranial direct current stimulation (tDCS), peripheral nerve stimulation (PNS), and transvertebral direct current stimulation (tvDCS). We have found that administering active stimulation results in greater recovery than sham stimulation when both are combined with therapy.
a. Carrico C, Chelette KC, Westgate PM, Powell ES, Nichols L, Fleischer A, Sawaki L. Nerve stimulation enhances task-oriented training in chronic, severe motor deficit after stroke: a randomized trial. Stroke. 2016 Jul; 47(7): 1879:84.
b. Carrico C, Chelette KC, Westgate PM, Powell ES, Nichols L, Sawaki L. Randomized Trial of Peripheral Nerve Stimulation to Enhance Modified Constraint-Induced Therapy After Stroke. Am J Phys Med Rehabil. 2016 Jun;95(6):397-406.
c. Carrico C, Westgate PM, Powell ES, Chelette KC, Nichols L, Pettigrew LC, Sawaki L. Nerve Stimulation Enhances Task-Oriented Training for Moderate-to-Severe Hemiparesis 3-12 Months After Stroke: A Randomized Trial. Am J Phys Med Rehabil. 2018 Nov;97(11):808-815.
d. Powell ES, Carrico C, Raithatha R, Salyers E, Ward A, Sawaki L. Transvertebral direct current stimulation paired with locomotor training in chronic spinal cord injury: a case study. NeuroRehabilitation. 2016 Feb 10;38(1):27-35.
2. Optimizing neuromodulation to maximize motor recovery in individuals with neurological impairment and neuroplasticity in healthy volunteers. Several studies by our research team have investigated how varying parameters of neuromodulatory techniques affects recovery of motor function when paired with motor therapy in individuals with neurological impairment as well as indices of neuroplasticity in healthy volunteers. My role in these studies has been to deliver the neuromodulatory stimulation, including tDCS, PNS, and tvDCS, and to measure the indices of neuroplasticity with transcranial magnetic stimulation. We have found that varying the timing of stimulation, electrode configuration, and dose of stimulation all affect the observed results. In cases of stroke, the effects of these variables depend greatly on the severity of the stroke.
a. Powell ES, Carrico C, Westgate PM, Chelette KC, Nichols L, Reddy L, Salyers E, Ward A, Sawaki L. Time configuration of combined neuromodulation and motor training after stroke: A proof-of-concept study. NeuroRehabilitation. 2016 Jul 15;39(3):439-49.
b. Powell ES, Carrico C, Chelette KC, Nichols N, Sawaki L. Optimal polarity of transcranial direct current stimulation for severe hemiparesis after stroke. Poster presented at: Neuromodec NYC. January 2017, New York City, NY.
c. Powell ES, Carrico C, Salyers E, Westgate PM, Sawaki L. The effect of transcutaneous spinal direct current stimulation on corticospinal excitability in chronic incomplete spinal cord injury. NeuroRehabilitation. 2018;43(2):125-134.
d. Powell ES, Korupolu R, Westgate PM, Carrico C, Reddy L, Sawaki L. Dose-response relationship of transcutaneous spinal direct current stimulation in healthy humans: A proof of concept study. NeuroRehabilitation. 2018;43(4):369-376.
3. Delivery of closed-loop stimulation to motor incomplete spinal cord injury individuals. I have been part of a collaboration with a group from the University of Kentucky’s Department of Biomedical Engineering that is developing a brain machine interface (BMI). This system detects an individual’s intent to move using features of EEG and triggers PNS prior to initiation of movement. This stimulation is designed to mimic sensory input associated with movement as experienced by unimpaired individuals, thus providing positive feedback to the subject and enhancing neuroplasticity. My role in the study began while in graduate school, during which time I developed the BMI and tested it on healthy volunteers without stimulation. The project is now in a pilot study with spinal cord subjects receiving stimulation. My current role is to measure neuroplastic change via TMS, set up subjects for PNS, and assist with data collection as needed.
a. Schildt CJ, Thomas SH, Powell ES, Sawaki L, Sunderam S. Closed-loop afferent electrical stimulation for recovery of hand function in individuals with motor incomplete spinal injury: early clinical results. Accepted for publication in Proceedings of 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society; August 2016; Orlando, FL
b. Salmon E, Chelette K, Sawaki L, Sunderam S. Development of an EEG brain-machine interface to facilitate motor recovery from incomplete spinal cord injury: a feasibility study. Proceedings of 2012 Neural Interfaces Conference; June 2012; Salt Lake City, UT
c. Thomas SH; Schildt CJ; Rajamanickam Y; Powell ES; Salles S; Sawaki L; Sunderam S. Brain-Machine Interface-Drive Afferent Peripheral Nerve Stimulation for Motor Rehabilitation after Spinal Cord Injury. 2017 Biomedical Engineering Society Annual Meeting, October 2017, Phoenix, AZ
Complete List of Published Work in MyBibliography:
D. Research Support
Ongoing Research Support
StrokeNET 2U01NS086872~06 Feng & Schlaug (PIs) 08/15/18 – 07/31/21
Transcranial Direct Current Stimulation for Post-stroke Motor Recovery – a Phase II Study (TRANSPORT-II)
This is a phase II multi-center transcranial direct current stimulation (tDCS) dosing selection study to evaluate the efficacy, safety, tolerability and feasibility of 2 different tDCS doses and compared to sham tDCS.
Role: Biomedical Engineer
1R21HD079747-01 Sunderam (PI) 07/08/15 – 06/30/19
A brain-machine interface to facilitate motor recovery from incomplete spinal cord injury
This project tests whether PNS in subjects with incomplete spinal cord injury can accelerate motor recovery when PNS is delivered in closed-loop (in response to subject’s volition). PNS is triggered by a brain-machine interface (BMI) that detects intent-to-move from suppression of the electroencephalogram (EEG) sensorimotor (“mu”) rhythm, which can occur with actual or imagined movement effort.
Role: Biomedical Engineer
Completed Research Support
NIDRR USED Grant H133G120086 Sawaki (PI) 10/01/12 – 09/31/15
Combining brain stimulation and peripheral nerve stimulation to improve upper extremity function after severe stroke
This project will determine whether the combination of tDCS and PNS enhances post-stroke motor recovery when applied before intensive upper extremity motor training on a robot-assisted device (InMotion2). We will use TMS to measure cortical reorganization, as well as standardized tests of motor performance to measure upper extremity motor function, before and after intervention.
Role: biomedical engineer
UK CCTS 2013 Pilot Research Program Sunderam (PI) 01/01/14 – 06/30/15
Development of a brain-machine interface to facilitate motor recovery from incomplete spinal cord injury
This project tests whether PNS in subjects with incomplete spinal cord injury can accelerate motor recovery when PNS is delivered in closed-loop (in response to subject’s volition). PNS is triggered by a
brain-machine interface (BMI) that detects intent-to-move from suppression of the electroencephalogram (EEG) sensorimotor (“mu”) rhythm, which can occur with actual or imagined movement effort.
Role: biomedical engineer
UK CCTS 2013 Pilot Research Program Sawaki (PI) 08/08/13 – 06/30/15
Effects of transvertebral direct current stimulation in humans
This proposal will be the first-ever investigation of transvertebral direct current stimulation (tvDCS) to promote functional recovery and neuroplastic change in chronic spinal cord injury (SCI). Our exploratory, developmental project will systematically evaluate the effects of tvDCS on motor function and on a marker of neuroplasticity (ie, corticospinal excitability).
Role: biomedical engineer
R01 NIH HD056002 Sawaki (PI) 07/01/08 – 06/30/14 Sensory-driven motor recovery in poorly recovered subacute stroke patients The major goal of this project is to evaluate the effectiveness of sustained PNS coupled with intensive task-oriented therapy to promote functional motor recovery in subacute stroke patients with severe motor deficits. Role: biomedical engineer