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Program Announcements (PA)
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Mission:
The repair and plasticity (RP) program plans and directs research on interventions to restore function in the damaged nervous
system across a broad range of diseases and disorders and conducts basic research on neural plasticity, neural development,
and stem cells as they relate to repair and adaptation of the nervous system following degenerative diseases, injury, and
stroke.
Motivation:
Harnessing the capacity of the nervous system to adapt by activating repair mechanisms offers great hope for restoring function
in the injured or diseased brain and spinal cord. In contrast, our current inability to effect brain repair has major consequences
in both economic and human terms. Beyond possible interventions to treat disease, a more complete understanding of the capacity
of the nervous system to reorganize can contribute to methods for preserving function throughout life.
Implementation:
In carrying out this mission, the RP program supports a range of research activities from basic studies of cell communication
to neural rehabilitation. Acute as well as late interventions are of great interest. Scientific research topics that are of
particular relevance to this research include neuron-neuron communication; neuron-glia interaction; proliferation, migration,
and differentiation of cells in the mature nervous system; mechanisms of axonal elongation and dendritic arborization that
contribute to regeneration; cell injury and death or recovery; changes in neural circuits and connections resulting from injury;
stem cells; and replacement of lost structure and function. Clinical topics of particular interest are spinal cord injury
and traumatic brain injury. There is also significant interest in stroke, neurodegenerative disorders, and epilepsy.
In this area of research, our immediate goals are to:
The important new information about molecules that guide axon growth and formation of nerve cell connections in invertebrate species must be applied to understanding repair in higher vertebrates. Likewise, neurotrophic factors (natural chemical signals that promote growth and survival) important in development are also likely to influence synaptic plasticity in adults. Most importantly, these insights must be applied to encouraging regeneration in the human nervous system. An important challenge in coming years will be to identify new trophic factors and guidance molecules and to understand how they interact to orchestrate synapse formation and plasticity in the injured nervous system.
New knowledge about circuit function and formation must be brought to bear on the urgent need to repair the injured nervous system. This is particularly important for traumatic spinal cord and brain injury and stroke. We must harness the plasticity of the brain for recovery through a variety of means, including chemicals such as neurotrophic factors that stimulate and direct nerve fiber growth, chronic brain stimulation, behavioral techniques such as virtual environments, and novel training methods beyond traditional rehabilitation. Neural prostheses, electronic and mechanical devices that connect with the nervous system to restore lost function, will remain an important part of this effort.
Stem cells are immature cells that have the ability to multiply and specialize into almost any cell or tissue in the body. In no area of medicine is the potential for harnessing human stem cells greater than in diseases of the nervous system. Enormous scientific and ethical considerations must be addressed, but recent advances in stem cell biology offer great hope for repair and recovery of function for Parkinson's disease, multiple sclerosis, and many other neurological disorders.
Funding mechanisms beyond the traditional R01 grant exist but need to be proactively utilized to facilitate the early and late phases of research. In the early phase, small grants are needed to fund high risk research before extensive preliminary results are available. In the late phase, especially in translational research or research dependant on large scale resources, consortia and/or core facilities may be required to bring multiple disciplines into focus on a project. Training initiatives to support attendance at focused scientific meetings and clinical exposure to the course and treatment of neurological disorders in human subjects are needed to introduce students to the area of repair and plasticity and to foster multidisciplinary approaches. Communication and collaboration with voluntary, professional and commercial organizations provide opportunities for leveraged, coordinated efforts and will be pursued.
Workshops and Summaries
Neural Interfaces Workshop 2005 September 7-9, 2005
November 15-17, 2004
Translating Promising Strategies for Spinal Cord Injury Therapy February 3-4, 2003
2002 Deep Brain Stimulation Consortium Meeting June 3-4, 2002
NINDS Workshop on Re-establishing Connectivity in the Damaged Spinal Cord January 18-19, 2001
The Neural Prosthesis Program Workshop October 25-27, 2000
Functional and Dysfunctional Spinal Circuitry: Role for Rehabilitation and Neural Prostheses June 14-15, 2000
The First International Symposium for Hereditary Spastic Paraplegia May 25-27, 2000
Clinical Trials in Head Injury May 12-13, 2000
Role of the Immune System in Spinal Cord Injury April 5-6, 2000
Neural Stem Cells Workshop: Promoting Repair and Plasticity of the Nervous System July 20-21, 1999
Spinal Cord Injury: Emerging Concepts September 30 - October 1, 1996