BOOST Project

FRRB Project 3438840 - Bottom-up and tOp-down neuromOdulation of motor plaSTicity in cerebral palsy

The Coordinator of the project is Associazione La Nostra Famiglia IRCCS. The Lead Principal Investigator of the project is Dr. Alessandra Finisguerra.

PROJECT SUMMARY 

While there is a general call for early and intensive interventions to alleviate the negative outcomes of cerebral palsy (CP), there is an unmet need for non-pharmacological strategies to optimize neurorehabilitation effects. Noninvasive brain stimulation (NIBS) has the potential to facilitate neural plasticity, particularly in chronic disease conditions. However, response to NIBS treatments has shown large variability across individuals and overall limited effect size in CP. BOOST aims to optimize and trial novel NIBS protocols tailored to the individual clinical profile of CP patients, namely transcutaneous vagus nerve stimulation (tVNS) and transcranial alternating current stimulation (tACS), which provide, respectively, a bottom-up and a top-down pathway to stimulation of neural plasticity. We first test the neurophysiological mechanisms of action in inducing neuroplastic changes of motor cortex in young adults with typical development, by using state-of-the-art neurophysiologic and electroencephalographic measures of cortico-spinal excitability and intracortical inhibition. Then, we translate this knowledge to a two-arm, randomized, double-blind, sham-controlled trial of the efficacy of tACS and tVNS combined with a gold-standard motor rehabilitation intensive training in 6-17 yo CP patients with mild-to-moderate upper-limb deficits. We expect that tACS and tVNS may potentiate the effects of functional training by promoting brain plasticity and boosting motor learning.