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Graduation Medical Education (GME): Neurorehabilitation

Fellowship Program Director: Leonardo Cohen, MD

The goal of our research is to understand the mechanisms underlying plastic changes in the human central nervous system and develop novel therapeutic approaches for recovery of function based on these advances. Most of our work has focused in plasticity of the human motor system. More recently, we became interested in the study of plastic changes across sensory modalities (blindness). We have studied plastic changes in patients with lesions in the central nervous system like hemispherectomy, stroke, and spinal cord injury and in the peripheral nervous system like amputations. In healthy volunteers, we studied plastic changes associated with transient deafferentation.

The main technique employed is transcranial magnetic stimulation. In this respect we are interested in the development of this technique as a tool to help us to understand mechanisms of human plasticity and to modulate plastic changes in humans. A multimodality approach is applied to the understanding of mechanisms of plasticity including PET scanning, fMRI, MEG and EEG when appropriate. Our research protocols are focused in the evaluation of patients with stroke, amputations, and blindness and to the study of plasticity in healthy volunteers (see NIH Clinical Center home page).

Our work in the last few years has focused on the assessment of plastic changes in human motor function after a variety of interventions and injuries. We have advanced in the understanding of the mechanisms, time-profile and site where plasticity takes place after a variety of disorders and in particular in relation to motor learning. Our future goals are to improve our understanding of the mechanisms underlying plasticity of function in humans and its functional relevance. On the basis of these mechanisms, we are starting to design and test interventions to improve motor disability after human diseases, for example stroke.

Program Structure
This is a two-year fellowship program designed for physicians planning a career in academic neurology with a focus on the clinical neurophysiology and neuroimaging of recovery of function after stroke and other cortical injuries. Additional features of this program include the development of Clinical expertise in diagnosis and treatment of movement disorders. Trainees will develop expertise in at least one branch of clinical neurophysiology (for example transcranial magnetic stimulation) or neuroimaging (functional MRI or PET). Research will focus on the physiology and pathophysiology of recovery of function after injury including mastering the technique of transcranial magnetic stimulation, EEG analysis or functional neuroimaging. By the end of the first year, an original research protocol should be written that would be executed in the second year. Fellows are expected to attend the weekly journal club and the weekly unit meeting where they are exposed to the different protocols and techniques utilized in the unit. They are also expected to attend the meetings of the NIH integrative neuroscience interest group. Written evaluation of performance will be at 6 month intervals. Fellows should take the NIH Clinical Center course in clinical research (Introduction to the Principles and Practice of Clinical Research) in their first year. At least one additional course should be taken in biostatistics. Fellows attend the Branch's outpatient clinic each Monday afternoon which focuses on movement disorders and also the Stroke Neurorehabilitation Clinic.

Application Information
Apply to this program through the NIH Graduate Medical Education Application System.

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This page last updated on 05/21/2021

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