"Neuroplasticity in Motion: Exploring Neural Oscillatory Activity and P" by Morgan T. Busboom-Matulka

Graduation Date

Spring 5-10-2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Medical Sciences Interdepartmental Area

First Advisor

Max J. Kurz

Second Advisor

Elizabeth Wellsandt

Abstract

Cerebral palsy (CP) results from a perinatal brain injury and is one of the most prevalent and costly developmental disabilities in the United States. As persons with CP transition from adolescence into adulthood they continue to be faced with prominent mobility challenges. Despite the increased recognition of the mobility deteriorations, NIH funding related to transition aged persons with CP is remarkably low. Thus, research focused on enhancing the mobility of persons with CP during this critical transition period is sorely needed to help narrow the gap and eliminate this disparity. Additionally, a better understanding of the neurophysiology surrounding physical therapy interventions is needed to develop neuroscience-informed treatment approaches for beneficial neuroplasticity. We sought to address these knowledge gaps by using state-of-the-art brain imaging technology (i.e., magnetoencephalography (MEG)), novel therapeutic paradigms, and clinical assessment outcomes. Overall, we observed decreased functional mobility and aberrant cortical activity in adolescents and adults with CP compared to neurotypical controls pre-therapy and observed beneficial clinical and neuroplastic changes post-therapy. Specifically in chapter 1, we identified that therapeutic power training appears to optimize the sensorimotor cortical oscillations of persons with CP, and these neuroplastic changes partly contribute to improvements in the leg peak power production of these individuals. In chapter 2, a gait training protocol was shown to enhance clinical outcomes and sensorimotor cortical oscillatory activity during an adaptive motor control MEG paradigm. Additionally, changes in the beta event-related desynchronization during the planning period were associated with improvements in the Timed Up and Go test in persons with CP. In chapter 3, we demonstrated that following a gait training paradigm focused on enhancing sensorimotor integration, no changes were observed in the somatosensory cortex when a paired-pulse stimulation paradigm was utilized. However, whole-brain analysis revealed increased activity in the anterior cingulate post-therapy in persons with CP. Lastly, chapter 4 highlighted the beneficial gait adaptation and overall functional mobility changes associated with a novel robotic exoskeleton gait training paradigm that focused on principles of motor learning to enhance the clinical outcomes. Taken together, these findings support the use of physical therapy treatments that incorporate key ingredients derived from neuroscience principles to promote beneficial neuroplastic and clinical changes for persons with CP.

Comments

2025 Copyright, the authors

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Available for download on Wednesday, March 10, 2027

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