Overview

Impairment based mechanisms underlie physical disability in neurodegenerative disease.

One aim of my research involves quantifying physical dysfunction so that we can understand what aspects of movement control are deficient. We utilize a unique set of quantitative tools and outcome measures to quantify impairments such as strength, sensation and balance and monitor functional limitations as they progress over time. We have discovered that strength is a primary impairment in stroke as well as in neurodegenerative diseases such as MS and Adrenomyeloneuropathy. The use of these quantitative tools and longitudinal testing helps to establish efficacy in drug trials, and rehabilitation interventions, as well as assisting with individualized treatment.

An examiner conducts a break test against the hip flexion muscle of a participant using a hand-held dynanometer
Our force plates allow us to assess subtleties in postural sway and balance
Our force plates allow us to assess subtleties in postural sway and balance
Dynamic sway in the anterior-posterior direction, measured using the force plate.
Dynamic sway in the anterior-posterior direction, measured using the force plate.
vibratron
Sensory impairment is measured using the Vibratron
Using our zeno mat, we can collect quantitative and sensitive data on the gait of our subjects
Using our zeno mat, we can collect quantitative and sensitive data on the gait of our subjects

Understanding the neuroanatomic basis for structure-function relationships in neurodegenerative disease defines disability.

We examine the neuroanatomy of the brain and spinal cord using advanced magnetic resonance imaging (MRI) techniques such as magnetization transfer and diffusion tensor imaging. These techniques are highly sensitive to white-matter architecture and thus provide a sensitive way of precisely localizing injury to specific pathways in the brain and spinal cord. Our work shows that damage to the corticospinal tract in the brain and spinal cord is fundamental for defining disability in MS.

dtiMAP
A DTI image shows the corticospinal tract
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An MRI image of the spinal cord shows a lesion in the patient (right) vs a healthy control.
dtiMAP3
A cross sectional DTI image of the spinal cord shows damage to the white matter tract in the patient (right)

Advancing rehabilitation for individuals with neurodegenerative disease.

We use tools in the lab to assess the effectiveness of rehabilitation interventions for MS. We have shown that a basic strength resistance training program can produce results in adults with MS in as little as eight weeks.  Another aspect of advancing rehabilitation is to ensure that clinicians and researchers who treat individuals with MS have an avenue to learn new information from their peers. It is with that objective that the annual International Symposium on Gait and Balance in MS was developed. This yearly symposium was founded in 2011 by Dr. Zackowski and two colleagues (Dr. Michelle Cameron and Dr. Joanne Wagner), and continues to date. The symposium is designed to highlight the importance of gait and balance measures in MS, explore the measurement of deficits, discuss the impact of specific abnormalities that affect gait and balance (e.g., falls, ataxia, cognitive function), and share current research about interventions that can be used in clinical and research settings with people with MS. Each year the symposium objectives target the perceived needs of the MS community within the context of gait and balance dysfunction. This symposium allows Dr. Zackowski the opportunity to mentor junior researchers from all over the country, foster research collaborations, and establish herself as a leader in the study of gait and balance in MS.

gaitsymppreview