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Physical Medicine & Rehabilitation - Education

Houston, Texas

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PM&R Alliance Education Office
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Fellowships in Neuroplasticity and Neuroimaging and in Medical Rehabilitation and Clinical Trials

NIH-funded T-32 Postdoctoral Fellowships in Neuroplasticity and Neuroimaging and in Medical Rehabilitation and Clinical Trial

Fellowship positions for Ph.D. and M.D. are currently available in the areas of Neuroplasticity/Neuroimaging and Medical Rehabilitation/Clinical Trials. The goal of the program is to provide postdoctoral fellows with mentored research training to prepare them for careers as independent investigators in medical rehabilitation research.

Training Program

The goal of this two-year postdoctoral program in mentored research relevant to rehabilitation is to produce academicians who are capable of competing for federal grants and mentoring the next generation of investigators in rehabilitation research. A training-faculty representing externally-funded basic science and clinical investigators drawn from various departments of Baylor College of Medicine, The University of Texas Health Science Center at Houston, and Rice University, will mentor the fellows in conducting hypothesis-driven projects in two areas of concentration, including neuroplasticity and neuroimaging, and medical rehabilitation and clinical trials.

The program reflects:

  • Current models of illness, disablement, and rehabilitation and health
  • Trends in research emphasizing neuroplasticity as a mediator of recovery and response to therapy
  • Advances in brain imaging research that facilitate examination of neural mechanisms mediating recovery and reorganization of function
  • Interaction of the person with disability and the environment\
  • Development and evaluation of innovative interventions to mitigate complications of injury and improve health-related quality of life

The core of the training program includes courses in rehabilitation research and the ethical conduct of research with elective coursework in the trainee's selected area of concentration and other didactic activities. One-to-one mentoring will be emphasized in the trainee's acquisition of skills in methodology, project management, preparation of manuscripts, communication skills, good citizenship in science, and developing competitive grant applications.

Trainees will be selected from Ph.D.s and all professional areas of medical rehabilitation trained in fields such as neuroscience, bioengineering, neuropsychology, and health services research. The director and co-director will administer the program with oversight provided by a steering committee and an external advisory committee. Primary and secondary mentors evaluate trainees every three months. The evaluations will be reviewed in a meeting between the trainee and the program director or co-director. Trainees will evaluate their mentors and the program quarterly. Venues for recruitment will include notices in journals, national conferences, and the Department of Physical Medicine and Rehabilitation at Baylor College of Medicine. The department has established procedures for recruitment of qualified candidates who are underrepresented minorities and/or persons with disabilities. We believe that the proposed training-faculty, curriculum, and institutional environment will produce productive and ethical investigators who will advance medical rehabilitation research.

Current Mentor Research

Neuroplasticity and Neuroimaging

Michael S. Beauchamp, Ph.D. Functional Magnetic Resonance Imaging of Multisensory Integration. Dr. Beauchamp's research program uses fMRI to investigate the neural mechanisms for multisensory integration. Different sensory modalities are encoded by our brain in very different ways. The auditory system is most concerned with the frequency (high or low-pitched sounds), as is the tactile system (slow stroking vs. quick vibrations). In contrast, our visual system is organized by the spatial location of stimuli--a stroke may damage our ability to see objects on the left side of the room but not the right side. Although each sensory modality is organized fundamentally differently, our brain must integrate the information provided by the different modalities in order to make decisions. For instance, is our mobile phone ringing or not? We can make this decision by integrating auditory, visual and somatosensory information along with our prior knowledge about what our phone looks, feels and sounds like when it is ringing. Multisensory integration is likely to be particularly important in rehabilitation, in which patients with impairments in one sensory modality learn to use other sensory modalities to compensate.

Corwin Boake, Ph.D.

Stephanie Daniels, Ph.D.

Pramod Dash, Ph.D. Memory After TBI in a Rodent Model. Neurochemical mechanisms mediating recovery of working memory after brain injury in a rodent model. Dr. Dash's laboratory is studying dopaminergic modulation of memory deficit in an experimental model of TBI. He is also engaged in studies concerning the molecular biology of TBI and acute pharmacologic interventions in a rodent model.

James Grotta, M.D. Translational Research and Clinical Trials in Acute Stroke. Dr. Grotta's Specialized Program of Translational Research in Acute Stroke includes a clinical trial of constraint-induced movement therapy within two weeks after ischemic or hemorrhagic stroke using TMS to map associated changes in cortical representation of motor function. This NINDS program project also supports a genomics project and clinical trials of agents to treat acute ischemia, including pharmacologic agents and transcranial ultrasound. Dr. Grotta's laboratory investigates neuroprotective approaches to acute stroke therapy using rodent stroke models.

Harvey Levin, Ph.D. Neurobehavioral Outcome of Brain Injury and Reorganization of Function. Dr. Levin investigates the neurobehavioral outcome of TBI, including studies of children and adults. His laboratory is using fMRI at the MEDVAMC to investigate changes in the cortical representation of working memory following TBI related to blast injury in veterans. Dr. Levin is also PI of an NIH supported longitudinal investigation of recovery from TBI in children which investigates cognition, motivation, and social cognition in relation to changes in brain region volumes using MRI data.

Ponnada Narayana, Ph.D. Magnetic Resonance Imaging of Spinal Cord Injury and Brain Injury. Dr. Narayana's magnetic resonance imaging (MRI) research includes ongoing projects on MRI of SCI and TBI, diffusion tensor imaging (DTI), and automated segmentation of gray and white matter of the brain. His projects on MRI and DTI in the rat spinal cord and high field scanning of animals are relevant to translational SCI research. [Dr. Narayana is Director of a 3T research-dedicated MRI Center housed at the University of Texas Medical School building on the campus of the Texas Medical Center.]

Andrew C. Papanicolaou, Ph.D. Magnetic Source Imaging of Cognition and Language. Dr. Papanicolaou is utilizing magnetic source imaging to investigate cerebral reorganization of language, motor, visuospatial, and memory skills. He is currently applying these activation tasks to studying reorganization of function after stroke in an NINDS Program Project which he directs. Dr. Papanicolaou is Director of the Magnetic Source Imaging Laboratory, a research facility, based at TIRR Hospital.

Claudia Robertson, M.D. Translational Research on TBI. Dr. Robertson uses xenon-computed tomography to investigate regulation of cerebral blood flow after TBI, including a spectrum of disturbances ranging from frank ischemia to increased susceptibility to secondary insults. She has evaluated a management strategy to prevent ischemia by providing the brain with a higher perfusion pressure that would compensate for the impaired ability of the injured brain to pressure auto-regulate. The goals of this research include early identification of patients who are at greatest risk of secondary insults and to develop interventions to prevent secondary cerebral ischemia by correcting the underlying vascular abnormalities. Dr. Robertson also collaborates with Dr. Sander on a clinical trial of cognitive rehabilitation of patients with mild to moderate TBI.

Sean Savitz, M.D.

Gabriel Tan, M.D.

Medical Rehabilitation and Clinical Trials

Rabih O. Darouiche, M.D. Prevention of Secondary Complications of Spinal Cord Injury. Dr. Darouiche is conducting an NIH-supported multicenter clinical trial of active bacterial interference by using bladder inoculation with E. coli 83972, a non-pathogen which has reduced the frequency of catheter-related, urinary tract infections in a single center study of persons with SCI. He is Founder and Director of the Center for Prostheses Infection in the BCM Department of PM&R.

Daniel E. Graves, Ph.D. Outcome of Spinal Cord Injury and Measurement of Impairment. Dr. Graves provides statistical support to fellows and faculty in PM&R and investigates functional and neurologic outcomes of SCI as part of the NIDDR-funded Model Systems for SCI. He is especially interested in applying item response theory and structural equation modeling to studying impairment and recovery following SCI.

Baylor College of Medicine. Baylor is comprised of a College of Medicine and a Graduate School with degrees or certificates available through a M.D. program, ten department-based and three interdepartmental Ph.D. programs in the biomedical sciences, a combined M.D./Ph.D. program, M.S. programs in nurse anesthesia, nurse-midwifery, physician assistant, and both M.D./M.B.A. and Ph.D./M.B.A. programs with Rice University. Baylor conducts one of the largest graduate medical education training programs in Texas and in the nation.
Baylor consistently ranks among the nation's leading biomedical research institutions. The College's spending for research and development ranks first among medical schools in Texas. The College also ranks in the top 10 in the nation in the amount of support received from the National Institutes of Health.

Baylor Department of Physical Medicine and Rehabilitation. The Department of Physical Medicine and Rehabilitation provides excellent clinical care, education, and research in the field of Physical Medicine and Rehabilitation, leading to optimum quality of life for individuals with physical disabilities, while maintaining its status as one of the pre-eminent departments of Physical Medicine and Rehabilitation in the United States.

The University of Texas Health Science Center. The University of Texas Health Science Center at Houston is primarily a graduate education university focusing on the health sciences. Located in the Texas Medical Center, UTHSC is the most comprehensive academic health science institution in the UT-System offering programs in biomedical science, health information, medicine, nursing, and public health. Interdisciplinary studies are encouraged at the university with joint degree programs offered by all but one of the schools.

The University of Texas School of Public Health. The UTSPH has grown steadily in size and national reputation since its first class was admitted in 1969. Located in the TMC complex, the UTSPH offers graduate degrees (Masters and Ph.D.) in all public health disciplines. Formal cooperative agreements between Baylor and the UTSPH provide students and fellows in health services research, biometry and epidemiology with the opportunity to take formal courses at UTSPH and to complete their research projects with a Baylor faculty member. The mission of the school is to improve and sustain the health of people by providing the highest quality graduate education, research and community service for Texas, the nation and internationally.

Baylor College of Medicine-University of Texas Physical Medicine and Rehabilitation Alliance. The mission of the alliance is to be a pre-eminent academic unit by integrating a balanced program of state-of-the-art, cost effective, general and specialty clinical services; outstanding programs in medical student, graduate, post-graduate and continuing education; and an excellent biomedical, behavioral and rehabilitation outcomes research program.
The two departments at BCM and UT offer clinical, educational and research programs for medical and graduate students and postdoctoral fellows. Six major health care institutions form the core of the clinical activities of the BCM/UT PM&R Alliance.

These include the Harris Health System (Ben Taub, Quentin Mease Community and Lyndon B. Johnson General Hospitals), St. Luke's Medical Center, Texas Children's Hospital, Michael E. DeBakey Veterans Affairs Medical Center, The Institute for Rehabilitation and Research, and Memorial Hermann Hospital. Additional affiliated programs include the Kindred Hospital, TIRR-Human Performance Center, Work Ready Rehabilitation Centers, Kelsey-Seybold Clinic, Seven Acres Jewish Geriatric Center, and Neurobehavioral Resources Ranch Program (The Ranch).

Multiple personal computers, using DOS, Windows and/or Macintosh operating systems are available to trainees through their mentors. In addition, the BCM Department of PM&R has several personal computers that are made exclusively available to residents and fellows for their educational needs. All basic data management, word processing, graphics and statistical analysis software is readily available.

Office space is provided to each fellow by the corresponding mentor. The grant will supply funds for office supplies.

Clinical Resources

The Institute for Rehabilitation and Research. This private, nonprofit rehabilitation institute, located on the Texas Medical Center campus, is internationally recognized for restoration of adults and children with a wide range of disabilities, especially those with traumatic brain injury, spinal cord injury, and amputations. Daily outpatient clinics offer opportunities for managing patients along the full continuum of care and for treating a variety of diagnoses among children and adults. Commitment to research is a major aspect of TIRR's mission and reflected in grant awards, faculty involvement, and new developments in patient care.

All Alliance committees, including the Research Committee, meet at TIRR. The research office is directed by Dr. Harvey Levin, who also chairs the Physical Medicine & Rehabilitation Alliance Research Committee. Didactic activities for the proposed fellowship are based primarily at TIRR, including the Rehabilitation Research course and the Research, Education and Development Seminars. The alliance for PM&R Education Office, which is based at TIRR, would be a resource for the didactic activities in the proposed program.

Several training faculty including Drs. Graves, Maher, Papanicolaou (see Magnetoencephalography Laboratory below), Sander and Struchen have research activities based at TIRR hospital. The TIRR professionals include physicians, rehabilitation nurses, neuropsychologists, physical and occupational therapists, respiratory and recreational therapists, social workers, orthotists, vocational counselors, and speech-language pathologists. These professionals are dedicated to restoring each patient to an active and productive life as early and as cost-effectively as possible. TIRR has a Model System on Spinal Cord Injury and a Research and Training Center on Community Integration of Persons with Traumatic Brain Injury supported by the National Institute on Disability and Rehabilitation Research. Fellows will have access to a poster printer and computer resources at TIRR hospital.

The TIRR Challenge Program facilitates entry back into the community for adults who have sustained a serious brain injury. This outpatient day treatment program prepares the brain-injured survivor for return to work, school or home. Therapies teach strategies to compensate for deficits that affect learning, recall, reasoning, perception, communication, and decision-making.

Ben Taub Hospital. A Level 1 trauma center operated by the Harris Health System, Ben Taub Hospital offers extensive inpatient and outpatient services to eligible Harris County citizens of all ages.

Physical medicine and rehabilitation consultations and electromyographic tests are provided to eligible Harris County residents. A substantial patient population, with acute as well as chronic injuries, provides ample opportunity for clinical research activities.

In addition, the hospital provides computer terminals for general computer processing, email, Internet, access to medical records free of cost (with proper security authorization). The medical records departments and clinical databases are located within the building. Research and clinical collaborations across departments with Baylor Neurology, Neurosurgery, Trauma Surgery, and Medicine have already been well established. Dr. Claudia Robertson's program project on TBI is based at the Neurosurgical Intensive Care Unit of BTGH.

Quentin Mease Community Hospital. This hospital is part of Harris Health System along with Ben Taub Hospital and LBJ Hospitals. The Quentin Mease Hospital has an inpatient PM&R facility, an adult outpatient rehabilitation clinic, and an electrodiagnostic laboratory.

Michael E. DeBakey Veterans Affairs Medical Center. The MEDVAMC is a federally funded hospital and is the primary health care provider for more than 103,000 veterans in southeast Texas. The PM&R Service includes a general rehabilitation unit, an active consultation service, general and specialty outpatient clinics including a multi-disciplinary pain clinic and a regional prosthetics clinic. EMG testing is done for all Houston area veterans. The Spinal Cord Injury Center provides for early inpatient rehabilitation, readmissions for complications of spinal cord injury, and outpatient care within a primary care model.

Several training faculty are based at the MEDVAMC. They are also faculty members in the Department of Physical Medicine and Rehabilitation at Baylor College of Medicine and participate in the alliance. The primary target population for their research is veterans who have sustained a stroke, spinal cord injury, or amputation. The MEDVAMC houses a number of state-of-the-art laboratories for assessing and managing patients. There are more than three dozen contemporary, networked personal computers, high-speed printers, and data storage devices. The VAMC research is supported by a comprehensive Medical Media Service, which facilitates large format printing (posters, etc).

Finally, a multifaceted cooperative research program has been put into place, currently linking the Houston VAMC Rehabilitation Research with centers at Stanford/Palo Alto VA, University of Pittsburgh/Pittsburgh VA, Case-Western Reserve/Cleveland VA, and the University of Florida/Gainesville VA. Joint research projects range from speech therapy to robot-assisted physical therapy, to assessment of altered motor control after SCI.

Texas Children's Hospital, located in the Texas Medical Center, founded in 1954, has grown to become the largest pediatric hospital in the United States. Texas Children's is nationally ranked in the top four among children's hospitals by both Child magazine and U.S. News and World Report. It is Baylor's primary pediatric teaching hospital. It provides full-care pediatric inpatient and outpatient facilities and support for more than 40 specialties and subspecialties.

The Department of Physical Medicine & Rehabilitation treats children and adolescents with disabilities and with acute or chronic neuromuscular problems, including cerebral palsy, brain and spinal cord injury, and nerve and muscle problems. Outpatient services include bracing, wheelchairs and other equipment needs; positioning; feeding; antispasticity management; therapy prescriptions; and EMG and nerve conduction studies.

Memorial-Hermann Hospital. As the major teaching hospital for UT, Memorial/Hermann Hospital is an acute medical-surgical referral center with an active regional Level 1 trauma center located at the Texas Medical Center. An inpatient rehabilitation unit is available for patients. An active consultation service evaluates patients and provides rehabilitation services on medical and surgical floors and intensive care units. A comprehensive outpatient rehabilitation facility and day hospital staffed by physiatrists in the alliance for PM&R serve the needs of patients who require ongoing rehabilitation treatment after discharge. Ongoing research by several training faculty involves Memorial-Hermann Hospital.

General Clinical Research Center. The GCRC at Baylor College of Medicine has been open and supported through the National Center for Research Resources at the NIH for 40 years. The goal of the GCRC Program is to provide clinical research infrastructure for medical scientists who conduct patient-oriented research. The center is primarily used by investigators supported by individual NIH research project grants. However, investigators who are supported by funds provided by other federal, state and local agencies, and the private sector, are also eligible for GCRC support.

The GCRC provides the resources for a variety of patient investigations and its mission is in part to provide educational opportunities for students, house staff, fellows, and junior and senior faculty.

The GCRC offers use of its facilities and resources for clinical studies, which have been approved through the BCM IRB and the GCRC Scientific Advisory Committee. These resources include: Inpatient and outpatient facilities; financial support for selected ancillary laboratory costs associated with inpatient stays or outpatient visits; research nursing services; bionutritionist services; biostatistician services; a cell and gene therapies core laboratory.

The GCRC is structured to accommodate patient-oriented research activities at appropriate sites throughout the patient care facilities utilized by BCM. A single administrative structure supports both the pediatric and adult units of the GCRC.

Pediatric Unit. The pediatric unit at Texas Children's Hospital is located in the West Tower of Texas Children's, 10th floor. This discrete inpatient unit consists of six inpatient rooms, an infusion room which can serve as an additional private room, an outpatient clinic, and a specialized neonatal research satellite unit located within the neonatal intensive care unit. In addition, a mock MRI scanner is located in the Pediatric Unit, which is used to prepare children for undergoing MRI and fMRI for research project.

Adult Unit. The adult unit consists of per diem beds within The Methodist Hospital as well as adult outpatient facilities located on the 9th floor of the Jones Neurosensory building. Most of the inpatient admissions for the adult unit are admitted on a per diem basis to the 10th floor nursing unit on the Jones Neurosensory building. The adult GCRC lab is utilized for specimen processing and storage and is located conveniently to both inpatient and outpatient areas on the 9th floor of the Jones Neurosensory building.

St. Luke's Medical Center. This BCM-affiliated acute-care facility operates a 24-bed inpatient rehabilitation unit and a large consultation service. This hospital is a community teaching hospital delivering primary care and a tertiary referral center serving both the greater Houston area and the global community.

A team of rehabilitation specialists consisting of physicians, nurses, therapists (physical, occupational and speech), case managers, dietitians, psychologists and neuropsychologists work together to design and implement individualized treatment programs for each patient. The most common types of patient conditions seen by the rehabilitation team are total joint replacement, stroke, cardiovascular surgery, amputation and various neurological conditions. Outpatient care is delivered in a private clinic setting.

Scientific Resources

Mission Connect and The Institute for Rehabilitation and Research. In 1997, The Institute for Rehabilitation and Research Foundation established Mission Connect, a consortium of basic and clinical neuroscientists including BCM, UT, and other local institutions that is dedicated to improving outcomes of SCI and TBI by affecting the injured nervous system. The scope of Mission Connect has since been expanded to include stroke research. Training scientists to pursue research related to neurotrauma and stroke is a major commitment of Mission Connect.

Resources - Neuroplasticity and Neuroimaging

Human Neuroimaging Laboratory. This core resource for BCM is located on the ground floor of the Smith Research Building, adjacent to TIRR Hospital. Opened in February 2003, HNL operates two 3T head only Siemens Allegra fMRI scanners that are dedicated to research. The center currently supports projects in neuroscience, psychology, and sociology including hyperscanning of social interactions.

Specialized Program of Translational Research in Acute Stroke (Dr. Grotta). The Stroke Program is located on the 7th floor of the UT Medical School building, adjacent to and connected directly with Memorial-Hermann Hospital. Memorial-Hermann Hospital is one of the city's two Level 1 trauma centers, which receives 38 percent of acute stroke patients carried by city paramedics.

The Statistical Coordinating Center for SPOTRIAS is housed on the 8th floor of the Reuel A. Stallones Building, The UT School of Public Health.

MRI Research Center-UT Medical School Building (Dr. Narayana). A Philips, 3T whole body scanner is located on the ground floor of the Medical School in a 2400-square-foot office. The MRI suite houses, besides the scanner and electronics, a mock scanner. Waiting areas, patient examination room, and a small conference room are part of the MRI suite. All the computers, including a Sun Blade 100 (2), SGI Octane 2 (1), Dell PCs (6), and the scanner computers, are on network. The animal MR laboratory is also located on the ground floor of the medical school. This 2,400 square-foot facility houses the 7T Bruker, 30 cm bore USR scanner, an animal holding area, surgical suite, a biochemistry lab, and an electronics lab, cubicles for graduate students, post-doctoral fellows, and technicians.

Magnetoencephalography Laboratory (Dr. Papanicolaou). This facility was established at TIRR Hospital in 2002. It includes the MEG laboratory and two acoustically insulated chambers for neuropsychological testing sessions. The MEG laboratory includes a whole-head neuromagnetometer system equipped with 248 magnetic flux sensors (Magnes WH3600, 4D Neuroimaging, Inc.). The instrument is housed in a magnetically shielded chamber designed for reducing environmental magnetic noise that interferes with the recordings of physiological signals. In addition to the neuromagnetometer, there are five SUN workstations with Ethernet connections that allow for the transfer of MRI and MEG data between the laboratory and the UT-Houston (or other) MRI facility. A second MEG laboratory is located at Memorial-Hermann Hospital, in the UT-Houston Medical School campus. The current MEG system at Memorial-Hermann Hospital is identical to the neuromagnetometer at TIRR.

Cognitive Neuroscience Laboratory (Dr. Levin). The Cognitive Neuroscience Laboratory is engaged in research concerning neurobehavioral sequelae of traumatic brain injury in children and adults and in clinical intervention studies. Ongoing NIH-supported projects include the cognitive and behavioral sequelae of TBI in children in relation to prefrontal lesions and a multi-center clinical trial of hypothermia for severe TBI in adults. In addition, the laboratory is engaged in a CDC funded study of case management after mild to moderate TBI.

The Cognitive Neuroscience Laboratory occupies nine offices, one testing room, a library, and a computer lab and has computer resources for data management, statistical data analysis, file transfer, manuscript preparation, and communication (e.g., Internet access and email). The laboratory's computer resources include 11 Dell desktop computers, two Compaq desktop computers, and six laptop computers. Four computers are equipped with the SAS statistical analysis software, and three are also equipped with the SPSS statistical software. All computers (including laptops) have email and Internet access. All investigators and personnel have adequate office space.

Postdoctoral fellows have well-equipped offices including Internet access and personal computers. Laboratory meetings are held monthly. Testing rooms are designed for studies of children and adults. The laboratory is located in Scurlock Tower, a building that houses academic and clinical units of several Baylor College of Medicine departments including the department of Neurosurgery. The building is located across the street from Rice University and within walking distance of TIRR.

The Laboratory for Brain and Behavior Imaging, which is staffed primarily by faculty and staff of the Cognitive Neuroscience Laboratory, is located at the MEDVAMC. This laboratory has computer image processing and analysis capabilities consisting of three Dell Dimension 330 workstations using Red Hat Enterprise Linux (1.8 GHz processor, 2.0 G RAM, 2 x 80 G HD), one HP xw6000 workstation using Red Hat Enterprise Linux (2 x 3.0 GHz processors, 2.5 G RAM, 3 x 146 G HD), two Dell Dimension 330 workstations using Windows 2000 (1.8 GHz processor, 1.0 G RAM, 2 x 40 G HD), one Sun Ultra 10 workstation using Solaris 9 (2 x 440 MHz processors, 1.0 G RAM, 2 x 20 G HDs), and a Dell 4400 PowerEdge server (2 x 1.0 GHz processors, 1.5 G RAM, 6 x 72 G HDs RAID 1 and RAID 5) with PowerVault 221S external storage (8 x 146 G HDs RAID 5).

All computers are part of a local area network (LAN) and have Internet access so that data can be downloaded directly to the lab from MR console systems and other laboratories. Data transfer can be accomplished using file transfer protocol (ftp) or the secure file transfer protocol (sftp) that is part of the secure shell (ssh) software package. Automated data backups are accomplished over the LAN using a Hewlett-Packard 1/9 Ultrium tape autoloader (9 tape slots, 200 G per tape) using Hewlett-Packard OpenView data protector software. There are two network laser printers, including a color printer (HP 4600dn). Software packages available in the laboratory for image processing and analysis include MEDx, Matlab, SPM, AFNI, and MRIcro.

Transcranial Magnetic Stimulation Laboratory at Rice University (Dr. Ro). Located across Main Street from the Texas Medical Center, this laboratory includes two Cadwell Laboratories MES10 transcranial magnetic stimulation units for non-invasive stimulation of cortex, four Grass-Astromed IP511 amplifiers for recording EMG responses, one Grass-Astromed IP122 AC/DC strain amplifier for recording skin conductance responses, two Grass-Astromed SD9 electrical stimulators for delivery tactile pulses, one Applied Science Laboratories Model 210 infrared eye tracker for tracking eye position and spatiotemporal dynamics of eye movements, one Applied Science Laboratories Model 504 remote video eye tracker for tracking eye position and spatiotemporal dynamics of eye movements in an MRI scanner, two ELO touchscreens to measure endpoint accuracy of hand movements to different spatial locations, and one Polhemus FASTRAK magnetic digitizer for co-registration of MRI scans. The TMS unit is portable and is used to map motor representation in patients before and after constraint induced movement therapy as part of Dr. Grotta's program project on acute stroke. Dr. Ro's laboratory includes five Pentium III testing computers, four Pentium III analysis computers, two Pentium III IBM ThinkPad laptop computers, one Linux workstation and one Silicon Graphics Indigo2 UNIX workstation.

Neurotrauma Laboratory (Dr. Dash). The laboratory, which is located in the UT Medical School Building, is equipped with: three cortical impact devices to perform rat and mouse injury, three stereotaxic devices, infusion pumps, water maze set-up, training chamber for fear conditioning, cryostat for brain sectioning, a stereology setup for unbiased cell counting, a PhosphoImage and software for detection and quantification of western blots, low speed centrifuges, PCR machines, protein and DNA gel electrophoresis equipments, spectrophotometer and an imaging work station.

Spinal Cord Injury Research Laboratory (Dr. Davies). This laboratory occupies approximately 3000 square feet in the Neurosensory Center at Baylor College of Medicine. The laboratory has eight new PCs and the appropriate software for image processing, word processing, statistical analysis, graphics for presentations. All computers have network connections and Internet access is available throughout the laboratory and office areas. Baylor College of Medicine has several core facilities, including Flow Cytometry, Densotometry and Phosphoimaging, and a Microarray and DNA Sequencing core.

Dr. Davies' laboratory is fully equipped with extensive tissue culture facilities, including four incubators, two class 2 laminar flow cabinets, and a dissection hood and all the equipment necessary for protein extraction, electrophoresis, western blot analysis and real time PCR. An inverted 4 channel Leica TCS SP2 confocal microscope, with a dedicated computer and Leica image analysis software, is installed in a specially ventilated room. The laboratory houses several other microscopes which Dr. Davies has exclusive access to including two Zeiss operating microscopes, two Zeiss dissection microscopes, a Zeiss inverted microscope and an Olympus BX60 fluorescence microscope fitted with a new Olympus CAST design based stereology system. A Leica cryostat, a Vibratome and a sliding microtome are available for tissue sectioning. The Microsurgery suite includes three Kopf rat stereotaxic apparatus, an Infinite Horizons rat spinal cord contusion device and computer and two micro-injection units from Applied Scientific Instrumentation.

Rehabilitation Engineering Laboratory (Dr. Krouskop). This laboratory is equipped with a portable digital wound measurement system, a mechanical instrument shop with lathes, vertical milling machine, sanders, welding equipment, polishing equipment, saws, metal cutting shear, and hand tools; and a MacIntosh G4 Powerbook computer with Microsoft Office 2003 and Photoshop CS.

Neurosurgical Intensive Care Unit (NICU) and Neurotrauma Laboratory (Dr. Robertson). Dr. Robertson's clinical and translational human research is conducted in a 16-bed, dedicated NICU at Ben Taub Hospital, a Level 1 trauma center. The Neurosurgery Department at Ben Taub has a local network that houses the research database for ongoing projects. The network is managed by a Dell 4400 PowerEdge server and seven PCs connected to the network.

Equipment on the Ben Taub unit includes a DWL transcranial Doppler on the NICU, a Medsonics transcranial Dopler, a Licox pO2 monitor, a Flowtronics thermal diffusion CBF monitor, microdialysis pumps, microdialysis fraction collectors, and a Neurotrac EEG-evoked potential monitor. The NICU also has a Philips Tomoscan Mobile CT scanner to obtain Xenon CT scan images. For animal model research, Dr. Robertson has space at the Baylor Neurosensory Center, including areas for 2 rat and 1 mouse cortical impact injury stations, area for behavioral tests, area for a small analytical laboratory, and area for data management and analysis. The animal laboratory is supported by 3 computers.

Medical Rehabilitation and Clinical Trials

Model Spinal Cord Injury System (Dr. Graves). TIRR's Model Spinal Cord Injury System, funded by NIDRR, is engaged in the application of item response theory and structural equation modeling approaches to the investigation and testing of theoretical models of disability in SCI.

The Model SCI System at TIRR offers many research opportunities for fellows, including a National SCI Database that contains records for approximately 25,000 participants with SCI who-have been studied over a 30-year period. In addition, there over 100,000 follow-up records on these cases. The SCI Model system has two full-time data collection employees and a number of professionals who are partially supported by the grant. The center occupies 700 square feet of office space in two distinct areas of TIRR. A data collection area is adjacent to the outpatient clinic space with additional office space located on the second floor of the clinical building. Two Pentium laptops and seven desktop workstations with network and high- speed internet access are located in the SCI center. Peripheral equipment includes three scanners, three laser printers with one on network, a data projector and a large format (36'') color poster printer. Data collection stations include software and hardware for creating data forms for scanning. A large format high- resolution transparency scanner for MRI and CT films is available in the data collection area.

Center for Prostheses Infection (Dr. Darouiche). The Center for Prostheses Infection in the Department of PM&R at Baylor College of Medicine was established by Rabih O. Darouiche, M.D., in April 1999. The center is comprised of clinical and research faculty representing 18 different specialties. The principal mission is to improve the quality of life of persons who have medical prostheses by developing and implementing technologies to prevent or treat infection. Primary objectives of the Center for Prostheses Infection are to: (1) develop interdisciplinary approaches to prevent infections associated with indwelling medical prostheses; (2) investigate innovative means for managing prostheses infection; and, (3) develop educational collaborations that bring together academic institutions, scientific organizations, regulatory agencies and device manufacturing companies for the purpose of achieving these goals.

Rehabilitation and Research Training Center for Community Integration After Traumatic Brain Injury (Drs. Sander and Struchen). The RRTC is directly adjacent to the Challenge Program, TIRR's brain injury day-treatment program, and to TIRR Outpatient Therapy Services. The RRTC is located in the community and is about one mile from the main hospital. Researchers conduct clinical research within TIRR Hospital, Ben Taub Hospital, and the Quentin Mease Community Hospital.

The RRTC consists of 6 research projects and 8 training/demonstration projects. There are two clinical trials included among the research projects: a randomized study of the effectiveness of a brief substance abuse intervention (in collaboration with Ohio State University) and a randomized trial to study the effectiveness of a social peer mentor program to improve social integration. The other research projects include: an investigation of ethnic differences on community integration needs, attitudes toward disability, and barriers to integration; evaluation of a distance learning program to train family members in rural areas as paraprofessionals; an investigation of intimacy after TBI; and a study of the contribution of social communication abilities and environmental factors to social integration.

The RRTC is situated in the Brain Injury Research Center which has a total of 12 workspaces, each equipped with a computer hooked up to the main TIRR Hospital network via a dedicated LAN line. The center has a conference room, and five closed-door offices that can be used for testing, therapy, and small group meetings.

Mechatronics and Haptic Interfaces (Dr. O'Malley). The MAHI laboratory at Rice University houses several commercial and custom robots, both desktop devices and wearable devices, which are candidates for rehabilitation. Hardware includes:

  • PHANToM Desktop haptic interface from Sensable Technologies. 6 degrees of freedom of position sensing and 3 degrees of freedom of force feedback
  • Windows PC interface with graphics to accompany the haptic feedback
  • PHANToM Premium 1.0A haptic interface from Sensable Technologies. 6 degrees of freedom of position sensing and 3 degrees of freedom of force feedback. Windows PC interface with graphics to accompany the haptic feedback. Additionally, a 6-axis force/torque sensor is mounted at the endpoint for additional sensor feedback. Stylus or thimble interface.
  • CyberTouch FingerForcer haptic device with 3 translational and 3 rotational degrees of force feedback and position sensing to the wrist, plus individual finger position sensing and force feedback for grasp simulations
  • Impulse Engine 2000 haptic joystick from Immersion. 2 degrees of freedom of position sensing and force feedback. Windows PC interface with graphics.
  • Adept Cobra robot (4 degrees of freedom)
  • Custom robots including 1-, 2-, and 5-degree of freedom (DOF) devices
  • Knobs, pinch-grasp devices, planar pantograph, and a lower-arm exoskeleton

Access to this hardware, and the accompanying control computers, software, and electronics, would be available to the fellows in the program. The laboratory is equipped with networked computer systems, and the necessary diagnostic equipment is available. The university also has several machine shops and technicians who can assist with the design and fabrication of new robotic devices, or make modifications to existing devices. Rice University provides networked computer systems to all faculty, staff, and students. Classroom Technology Services and IT staff provide support.

Affiliated Institutions Supporting Postdoctoral Research

Rice University (Dr. O'Malley and Dr. Ro). This private, non-sectarian university, which has about 4,000 students enrolled in undergraduate and graduate programs in all major scientific areas, is located adjacent to the Texas Medical Center campus. Strong collaborative programs (e.g. Bioengineering, Cognitive Science) especially in the life and physical sciences areas, have been jointly developed by faculty at Rice University and the Texas Medical Center.

University of Houston (main campus) is located seven miles east of the Texas Medical Center campus and serves approximately 30,000 students through its 79 undergraduate and graduate programs. The University of Houston programs have significant impact on the training of scientists engaged in all disciplines of clinical research.

University of Houston Health Law and Policy Institute has become a well-respected health law program. Full-time faculty have expertise in bioethics, genetics, HIV, reproductive health law, brain injury, mental illness, occupational health law and disability discrimination law. In addition, adjunct faculty teach courses in health care finance, health care fraud and abuse, managed care, correctional health law and public health law. Courses in health law and in healthcare policy taught at the University of Houston Law Center are open to fellows who have a special interest in this area.

Current Mentor Research

Neuroplasticity and Neuroimaging

Pramod Dash, Ph.D. Memory After TBI in a Rodent Model. Neurochemical mechanisms mediating recovery of working memory after brain injury in a rodent model. Dr. Dash's laboratory is studying dopaminergic modulation of memory deficit in an experimental model of TBI. He is also engaged in studies concerning the molecular biology of TBI and acute pharmacologic interventions in a rodent model.

Stephen Davies, Ph.D. Axonal Regeneration After Spinal Cord Injury. Dr. Davies's laboratory is investigating the effects of experimental interventions on regeneration of sensory axons in rat spinal cord. This work is centered on agents that modify scar formation, block inflammatory growth factors, and promote axon regeneration.

James Grotta, M.D. Translational Research and Clinical Trials in Acute Stroke. Dr. Grotta's Specialized Program of Translational Research in Acute Stroke includes a clinical trial of constraint-induced movement therapy within two weeks after ischemic or hemorrhagic stroke using TMS to map associated changes in cortical representation of motor function. In collaboration with Dr. Ro and Dr. Levin, this study is examining the relation of motor recovery to reorganization of motor function. This NINDS program project also supports a genomics project and clinical trials of agents to treat acute ischemia, including pharmacologic agents and transcranial ultrasound. Dr. Grotta's laboratory investigates neuroprotective approaches to acute stroke therapy using rodent stroke models.

Harvey Levin, Ph.D. Neurobehavioral Outcome of Brain Injury and Reorganization of Function. Dr. Levin investigates the neurobehavioral outcome of TBI, including studies of children and adults. His laboratory is using fMRI to investigate changes in the cortical representation of working memory following TBI in relation to executive functioning as measured by cognitive tasks, clinical assessment, and everyday activities. This project also evaluates the effects of methylphenidate on changes in working memory and associated alterations in brain activation using fMRI. Dr. Levin is also PI of a longitudinal investigation of recovery from TBI in children which investigates cognition, motivation, and social cognition in relation to changes in brain region volumes using MRI data. His collaboration on a trial of CIMT is described above in the section on Dr. Grotta's research.

Lynn Maher, Ph.D. Intensive Speech Therapy and Reorganization of Language. Dr. Maher investigates theory driven speech therapy interventions for aphasia and related disorders and the impact these interventions have on functional communication and brain reorganization post-stroke. She is currently comparing the effects of an intensive speech-focused intervention for aphasia to traditional speech therapy representing the current standard of care in aphasia intervention. Dr. Maher and Dr. Papanicolaou collaborate in a program project utilizing MEG to study reorganization of language following stroke and the effects of speech therapy.

Dr. Stephen McCauley, a K-23 awardee in the BCM Department of PM&R, is currently conducting an fMRI study of prospective memory under Dr. Montague's mentorship. Dr. Michele York, who is also a K-23 awardee and a former fellow in the BCM T-32 program, is pursuing an fMRI project on Parkinson's disease with mentoring provided by Dr. Montague.

Ponnada Narayana, Ph.D. Magnetic Resonance Imaging of Spinal Cord Injury and Brain Injury. Dr. Narayana's magnetic resonance imaging (MRI) research includes ongoing projects on MRI of SCI and TBI, diffusion tensor imaging (DTI), and automated segmentation of gray and white matter of the brain. His projects on MRI and DTI in the rat spinal cord and high field scanning of animals are relevant to translational SCI research. [Dr. Narayana is Director of a 3T research-dedicated MRI Center housed at the University of Texas Medical School building on the campus of the Texas Medical Center.]

Andrew C. Papanicolaou, Ph.D. Magnetic Source Imaging of Cognition and Language. Dr. Papanicolaou is utilizing magnetic source imaging to investigate cerebral reorganization of language, motor, visuospatial, and memory skills. [He is currently applying these activation tasks to studying reorganization of function after stroke in an NINDS Program Project which he directs.] Dr. Papanicolaou is Director of the Magnetic Source Imaging Laboratory, a research facility, based at TIRR Hospital.

Tony Ro, Ph.D. Transcranial Magnetic Resonance Stimulation. Dr. Ro's TMS research is examining cerebral mechanisms of attention, perception, language, and interactions of these domains. He is also applying TMS to map cortical and subcortical motor reorganization in relation to constraint-induced movement therapy in acute stroke patients in the collaborative study that is part of Dr. Grotta's program project on acute stroke.

Claudia Robertson, M.D. Translational Research on TBI. Dr. Robertson uses xenon-computed tomography to investigate regulation of cerebral blood flow after TBI, including a spectrum of disturbances ranging from frank ischemia to increased susceptibility to secondary insults. She has evaluated a management strategy to prevent ischemia by providing the brain with a higher perfusion pressure that would compensate for the impaired ability of the injured brain to pressure auto-regulate. The goals of this research include early identification of patients who are at greatest risk of secondary insults and to develop interventions to prevent secondary cerebral ischemia by correcting the underlying vascular abnormalities. Dr. Robertson also collaborates with Dr. Sander and Dr. Struchen on a clinical trial of cognitive rehabilitation of patients with mild to moderate TBI.

Medical Rehabilitation and Clinical Trials

Rabih O. Darouiche, M.D. Prevention of Secondary Complications of Spinal Cord Injury. Dr. Darouiche is conducting an NIH-supported multicenter clinical trial of active bacterial interference by using bladder inoculation with E. coli 83972, a non-pathogen which has reduced the frequency of catheter-related, urinary tract infections in a single center study of persons with SCI. He is Founder and Director of the Center for Prostheses Infection in the BCM Department of PM&R.

Susan Garber, M.A., OTR. Interventions for Complications of Spinal Cord Injury. Ms. Garber is engaged in clinical trials to mitigate secondary conditions associated with SCI, including pressure ulcer prevention, treatment and education. Her other interests include outcome of stroke rehabilitation, wheelchair mobility, evaluation and utilization of assistive technology, technology transfer, and patient and family education.

Daniel E. Graves, Ph.D. Outcome of Spinal Cord Injury and Measurement of Impairment. Dr. Graves provides statistical support to fellows and faculty in PM&R and investigates functional and neurologic outcomes of SCI as part of the NIDDR-funded Model Systems for SCI. He is especially interested in applying item response theory and structural equation modeling to studying impairment and recovery following SCI.

Thomas A. Krouskop, Ph.D. Rehabilitation Engineering. Dr. Krouskop's research has explored the development of a sleep surface that promotes better quality sleep by adjusting its support characteristics as the user changes positions. Currently, Dr. Krouskop's research is characterizing the mechanical properties of breast and prostate tissue during compressive loading and examining changes associated with malignancy. He also has interests in preventing pressure ulcers, developing more effective means of securing wheelchairs in public transit vehicles, the interactions between the socket used by amputees and the tissues of the residual limb, and in expanding the possible uses of carbon-carbon composites as medical materials.

Marcia O'Malley, Ph.D. Dr. O'Malley is engaged in robotics research, including the use of haptic feedback and visual displays in human-robot interactions. She has recently collaborated with Susan Garber, M.A., OTR on robotic-assisted therapy for stroke patients and she is currently collaborating with Drs. Levin and Ro in developing a robotic-assisted protocol for sensorimotor training to increase the efficiency of constraint induced movement therapy.

Diana H. Rintala, Ph.D. Clinical Trials for Spinal Cord Injury Patients and Other Disabilities. Dr. Rintala is a Veterans Affairs Career Scientist investigating drug treatment of chronic pain and psychological stress in patients with SCI. She is also studying the efficacy of telerehabilitation for individuals with lower limb amputations or foot and leg ulcers. Dr. Rintala has a project investigating the effects of assistance dogs on mobility and hearing in disabled persons. She has also collaborated with Drs. Garber, Graves, Sander, and Struchen.

Angelle Sander, Ph.D. Clinical Trials to Enhance Community Integration of Persons After TBI. Dr. Sander is collaborating with Dr. Struchen in studying the efficacy of social interventions to enhance reintegration of persons following TBI and racial and ethnic differences in outcome of TBI. She is also investigating the role of social communication ability and environmental factors in community reintegration following TBI. Dr. Sander's other research interests include prediction of outcome after TBI including vocational, social, substance abuse, and family adjustment. She is also supervising a randomized trial investigating the efficacy of an extended case management service to improving job maintenance after brain injury. Dr. Sander is engaged in a pilot study of racial and ethnic differences in outcome of stroke, which is supported by a subcontract from RehabWest.

Margaret Struchen, Ph.D. Clinical Trials to Enhance Community Integration of Persons After TBI. Dr. Struchen is Co-PI with Dr. Sander in their NIDRR-supported center, which investigates community reintegration of persons with TBI, including social interactions and the role of environmental factors.

Application

To apply, send curriculum vitae, statement of career goals, unofficial transcript, and names of three references to:

Harvey S. Levin, Ph.D.
Cognitive Neuroscience Laboratory
Baylor College of Medicine
1709 Dryden Road, Suite 725
Houston, TX 77030
Phone: 713-798-4860
Fax: 713-798-6898
E-mail: hlevin@bcm.edu

Benefits

Starting salaries range from $37,000 to $52,000 and a benefit package is included.

This program is available to U.S. citizens and permanent residents only.

Institutional Resources

The program, “Mentored Research Training in Rehabilitation Science,” at Baylor College of Medicine is located in the setting of the Texas Medical Center, an extensive network of medical educational institutions and facilities and an array of other resources that can enrich the learning experiences of fellows in this program.

The Texas Medical Center. The Texas Medical Center was chartered in 1945 and is the largest medical and healthcare center of its kind in the world. Visit the TMC web site for details.

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