ABOUT OUR PROGRAM
The Program in Rehabilitation Neuroscience Neuroscience is a cross-disciplinary
collaboration between clinicians and researchers at the VA Medical Centers in San Francisco and Martinez, with UC
Berkeley, UC San Francisco, and the California Pacific Regional Rehabilitation Center in San Francisco. The Program
was founded in 2007 on the premise that basic neuroscience and patient-oriented research must be brought together in
order to make clinically relevant advances in rehabilitation.
DIRECTIONS IN RESEARCH
Research projects in the Program are approached from three complementary directions:
- Basic research: Basic neuroscience with experimental models of learning and plasticity in healthy individuals in order to provide a foundation for translation to clinical work
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Translational research: Translation of basic neuroscience studies to patient studies in order to elucidate mechanisms of learning and plasticity in patients with brain injuries
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New Treatments: Development of neuroscience-based interventions for improving cognitive functioning for patients with brain injuries
LEARNING HOW THE BRAIN LEARNS
Learning through training is the foundation of rehabilitation interventions, and yet the neural mechanisms that underlie
the effects of training are poorly understood. One of the most common, debilitating, and yet under-recognized consequences
of brain injuries is dysfunction in the neural processes that support successful goal-directed behavior-processes
involved in attention, working memory, planning and problem-solving. Therefore, we are focusing on these higher level
cognitive functions. We are investigating the brain changes that occur with learning in health, as well as after injury.
IMPROVING SIGNALS, REDUCING NOISE
We are developing research interventions that are implemented by skilled therapists as well as via computer-assisted
training programs. These are organized around the themes of enhancing top-down signals (goal-directed, top-down guidance
of behavior such as for attention and memory) and reducing noise (suppressing non-relevant processing). These are basic
problems faced by many patients with brain injuries, and are processes that are important 'gateways' for effective
learning, organization and problem-solving.
MEASURING EFFECTS
The development of new methods to measure the effects of treatment is an important part of this work. Ongoing projects
involve the development of biomarkers using functional brain imaging as well as new methods for measuring how an individual
functions in the real world. By investigating the neural changes that underlie training effects, we hope to build a solid
theoretical foundation that will provide targets for biologic interventions.
CROSSING BRIDGES, CROSSING INSTITUTIONS
A parallel 'patient-oriented arm' of this program, based at the VA Medical Centers in Martinez and San Francisco, is
currently being developed. This is tentatively named the Northern California Center for Integrated NeuroHealth Treatment
and Research (CINHTR). CINHTR is designed to effectively cross the (often wide) bridges between research and patient care,
and will include a new building at the VA Martinez campus to house cutting edge treatment and research programs. Research
programs will span areas important for patients living with brain injury: basic mechanisms of neural injury, learning and
recovery; development of improved neuro-diagnostic tools; methods to improve health services; development of rehabilitation
training and novel biological therapies; tracking of patients across the lifespan. Clinical programs will include integrated,
multi-disciplinary outpatient and residential programs, with facilities for physical and cognitive training to facilitate a
return to healthy neurologic functioning. Many of the new facilities will be geared towards improving the lives of young,
active veterans. We envision this as a model system that will foster innovative clinical and research programs that will
lead to benefits for veterans as well as civilians living with brain injury.
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