Abstract Details

Title Individualized fMRI-Neuromodulation to Strengthen Swallowing Networks Targeted Towards Head and Neck Cancer Survivors, ALS, and Anterior Cervical Discectomy and Fusion Surgery Patients

Topic Neuro-rehabilitation

Presentation(s) P7 - Poster Session 7 (5:00 PM-6:00 PM)

Poster/Presentation
Number 4-004

Objective By decoding motor and sensory control network selectivity involved in swallow function, we aim to deliver precise rehabilitation via individualized neuromodulation tailored for patients with head and neck cancers (HNC), amyotrophic lateral sclerosis (ALS), and anterior cervical discectomy and fusion surgery (ACDFS).

Background

The Papageorgiou lab developed an individualized real-time fMRI closed-loop neuromodulation (iNM) to strengthen swallowing following surgery- and/or radiation-induced cranial neuropathy in HNC survivors, early phase ALS, or post-ACDFS by targeting swallow motor and sensory control (SwMSC) cortical networks. As a prelude to treating patients with iNM, we conducted a feasibility study in 30 healthy participants.

Design/Methods

On study-day one, we decoded cortical magnitude and spatial patterns (n=30) during swallowing and tongue movement. On study-day two, participants underwent both iNM and control-NO-iNM scans. Linear support vector machines (SVMs) were trained to distinguish between swallowing and tongue movement under iNM and control conditions, by iteratively training on one participant and testing on the other 29.

Results iNM improved the spatial precision of SwMSC networks (80.6%) compared to the control condition (73%). SwMSC via iNM showed statistically significant increases in blood-oxygen-level-dependent signal magnitude: a 34% rise in the sensory network’s area under the curve and a 22% increase in the motor network. Spatiotemporal causal modeling identified two brain states during SwMSC iNM trials: (1) a dominant state present in 78% of iNM trials (45% of control trials); and (2) a non-dominant, noise state in 22% of iNM trials (55% of control trials). Enhanced activity was noted for motor and sensory cerebellum and basal ganglia under iNM.

Conclusions Our study demonstrates that iNM increases the signal-to-noise ratio in regions regulating SwMSC networks. These findings suggest that iNM could be a valuable intervention by identifying targets for optimal neurorehabilitation in patients with HNC, ALS or ACDFS treatment sequelae, as well as other neurological disorders.

Authors/Disclosures
T. Dorina Papageorgiou, PhD, FAAN (Baylor College of Medicine) PRESENTER	The institution of Dr. Papageorgiou has received research support from McNair Foundation. The institution of Dr. Papageorgiou has received research support from TIRR - Mission Connect. The institution of Dr. Papageorgiou has received research support from McNair Medical Institute. The institution of Dr. Papageorgiou has received research support from Center for Alzheimer's and Neurodegenerative Disease. The institution of Dr. Papageorgiou has received research support from Naman Basic Science Faculty Award .
Sandesh Reddy	Sandesh Reddy has nothing to disclose.
Rohan Vemu, MSE	Mr. Vemu has nothing to disclose.
Cameron Noorbakhsh, BA	Mr. Noorbakhsh has nothing to disclose.
Anthony Kaspa Allam	Mr. Allam has nothing to disclose.
Peyton Presto, PhD	Dr. Presto has nothing to disclose.
erich M. sturgis, MD	The institution of Dr. sturgis has received research support from Cancer Prevention Research Institute of Texas. The institution of Dr. sturgis has received research support from NIH/NCI. The institution of Dr. sturgis has received research support from NIH/NIDCR.
Katherine Hutcheson, PhD	Prof. Hutcheson has nothing to disclose.
James P. Orengo, MD, PhD (Baylor College of Medicine)	Dr. Orengo has nothing to disclose.
Sarah Heilbronner, PhD	Dr. Heilbronner has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Society for Neuroscience. The institution of Dr. Heilbronner has received research support from National Institutes of Health.
Kelly R. Bijanki, PhD	The institution of Dr. Bijanki has received research support from National Institutes of Health. Dr. Bijanki has received intellectual property interests from a discovery or technology relating to health care. Dr. Bijanki has received intellectual property interests from a discovery or technology relating to health care.
Emmanouil Froudarakis	Emmanouil Froudarakis has nothing to disclose.
susan hilsenbeck, PhD	Dr. hilsenbeck has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AACR. Dr. hilsenbeck has stock in Genetex. The institution of Dr. hilsenbeck has received research support from NIH, CPRIT.

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