Brain Plasticity Based Training for Focal Dystonia

DESCRIPTION (provided by applicant): This phase 1 SBIR proposal supports the development of a practical rehabilitative strategy to efficiently and inexpensively remediate focal dystonia of the hand (FHd), a professionally-devastating movement disorder with no currently effective treatments. An early prototype of a brain plasticity-based training strategy has been successfully implemented at the UCSF Department of Physical Therapy and Rehabilitative Science where it has been shown to be effective in restoring sensory and motor hand function. However, this clinic-based treatment strategy is cumbersome, expensive, and inherently repetitious and boring. Because re-normalization of hand control in FHd demands intensive daily exercise over a period of several weeks, there are significant problems with patient non-compliance. These problems are effectively addressed by the product model that will be created with the support of this SBIR. It will support the development of three simple training devices that shall be used in a multidimensional training program designed to rapidly, efficiently and completely restore normal sensory and hand motor control abilities. Exercises are controlled in an adaptive 'computer game' format, and are designed to optimize learning rates, closely control attentional focus, and strongly reward the trainee. By its nature, these training programs are designed to be engaging and delightful. They provide extensive feedback to the patient to assure their compliance. The software fully documents the patients compliance and progress, and (optionally) automatically sends relevant data to a supervising professional therapist. Our specific aims are as follows: Specific Aims 1 and 2: Construct prototypes of 1) three sensory stimulation devices and 2) the software programs to control these devices in progressive, adaptive, and enjoyable training tasks. Specific Aim 3: In a pilot effect size study, evaluate the extent to which this training approach will renormalize patients' sensorimotor function and restore their ability to work and function independently. This novel therapeutic strategy is directly relevant to human health because it offers the opportunity to radically change the therapeutic landscape for FHd by providing a practical and affordable treatment for this common and costly human malady.