xt795x25f66j https://exploreuk.uky.edu/dips/xt795x25f66j/data/mets.xml University of Kentucky. Office of the Vice President for Research and Graduate Studies Kentucky University of Kentucky. Office of the Vice President for Research and Graduate Studies 2009 volumes. Call Number: LD2762.9 .K38c. Accession Number: 2018ua049 journals LD2762.9 .K38c English Office of the Vice President for Research and Graduate Studies  Contact the Special Collections Research Center for information regarding rights and use of this collection University of Kentucky Odyssey Magazine Research -- Kentucky -- Periodicals Education -- Research -- Periodicals Research -- Kentucky Odyssey: The Magazine of University of Kentucky Research and Graduate Studies, Summer 2009 text images Odyssey: The Magazine of University of Kentucky Research and Graduate Studies, Summer 2009 2009 2009 2026 true xt795x25f66j section xt795x25f66j  

   

University of Kentucky Research
Summer 2009

Can Fat Mice
Teach Us How
Ob sity Kills?

 

    
  
 
 
 
 
 
 
 
   
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
  
  
  
  
  
  
 
  
  
 
  
  
 
  
  
 

Lee T. Todd Jr,, Pressdent
Kumble Subbaswamy. Provost

James W Tracy,
Vice President for Research

Agriculture
M. Scott Smith. Dean

Arts and Sciences
Mark Kornbluh, Dean

BusinessandEconomics Umiverslty of Kentucky Research
3::inathan Sudharshan, Summer 2 O O 9
Communications

and Information Studies

H. Dan O'Hair, Dean

Dentistry

Sharon P. Turner, Dean ,

Design

Michael A Speaks, Dean , ’

Education ‘

Mary John O‘Hair, Dean "

Engineering
Thomas W. Lester, Dean

Fine Arts
Robert Shay» Dean

Graduate School

Jeannine Blackwell, Dean

Health Sciences

Lori Gonzalez, Dean

Law .
Dawd Al Brennen‘ Dean l
Medicine "
Jay A Perman. Dean

Nursing

Jane Kirschling, Dean

Pharmacy
Patrick McNamara,
interim Dean

Public Health

Stephen W, Wyatt, Dean
Social Work

Kay Hoffman, Dean

 

Odyssey COVER STORY \

Editor p

M Wor‘ey-’W0"ey@“ky'e"“ Can Fat Mice Teach Us How Obesrty Kills? 3 l

Associate Editor, Art Director . y ,

&Web Designer What started as a landmark dlSCOVCl‘V 1n l988—lat makes the precursor

Alicia P. Gregory, apgreg@uky.edu . , ' . s , i

D . to a protein that drn'es up blood pressure—has led Lisa (lassis, who chairs
eSigner

Shear & Shear

the UK Graduate Center for Nutritional Sciences. to 25 years of research

Photographer i . . H , . . a . .
LeePThomas Photography Oll [llC l‘lOl‘IDOllC-baSCCl I‘CIllll~élllgl()[CI]Slll SYSICIU. USlllg léll l‘lllCC, (138518 lS
Printer

learning how obesitv kills and finding mechanisms to stop it.
Gateway Press k '

IN BRIEF ‘

Odyssey is published twice a year
by the Office of the Vice Pres:dent for
Research and covers the latest research

advances. innovative scholarship, and research in Lexington ' Norman named poet laureate 0 Raitz appointed
outstanding people that are part of the

University ofKentucky's $336-mil'lon‘ state geographer ' Herring publishes foreign relations epic 1

Imaging live cells on a nanoscale ° reducing 0urcarbon footprint ' battery

a-year research enterprise.

 
 
  

To receive a free subscription, contact
UK Research Communications/Odyssey
213 Bowman Hall

University of Kentucky
Lexington, KY 40506-0059
859/257—8297

     
 
     
   
 
  

 
 

Member of the Unwersrty
Research Magazrne Association
wwwurma org ‘

      

  

An Equal Opportunity UniverSity \ ,I

(92009 Universmy of Kentucky

  

 wwwa‘esearchtikyedu/ odyssey

E E AT U R E 5
Taking Good Care (7
Based on the latest research about the brain‘s ability to

form new neural connections. UK‘s Lumy Sawaki is help— ll.

ing patients regain the Lise of stroke—damaged hands. legs

   
   

or arms. Her approach. which combines therapy with the
latest technology. is central to the research program in physical
medicine and rehabilitation at UK and Cardinal Hill Rehabilita—

tion Hospital.

A Walk across Uneven Ground l2

L'K history professor Ron l‘iller was a consultant for Diane Sawyer‘s

GROUND
lgADDALACHIA
ESSINCE 1945

 
 

20/20 program “A Hidden America: 'nie Children of Appalachia."

 
 

He talks abottt that experience. stereotyping. his new book. and the

 

consequences of “modernizing" Appalachia.

Kentucky Speeds into the Future with Internet 2 16
A federal appropriation will equip UK to install a stzite—ot—tlie—ai‘t
network connection to lnternet 2. Ten times faster than the current
I gigabit access. this network will benefit doctors. patients. medical

students. teachers. and scientists across Kentucky.

UK Attracts 33 New Cancer-Fighters 18

“Shining star" B. Mark liters, an accomplished surgeon from the
UniVersity ot'liexas Medical Branch in (ialVeston. and 32 other
recruits are helping to shape the future of the UK Markey Cancer
Center. Erers‘ goals: achie\'e national cancer center designation and
attract more top scientists to target Kentucky's deadliest cancers:
lung and colorectal cancer.

Burgers Make Me Happy 31

Three l7K professors have recently conducted research on emotional

 

intelligence the ability to understand and manage our emotions
when making decisions—and its role in consumer decision making.
'lheir obiectite: to help people learn to make better decisions about

what to eat and drink.

RESEARCH OUTREACH

Math and Science Partnership Scoring High Grades 33
An Appalachian program is helping students in 56 school districts
boost their math and science IQ. and supporting teachers with the

latest technology.

 

  

 

Hopping Probe to Study Nanostructures at the Surface of Live Cells

An international team of scientists. co—led by Uni—
versity of Kentucky physiologist Gregory Frolenkov.
has developed a technique for imaging nanostruc—
tures on the surface ofliving cells. The tea in developed
“hopping probe ion conductance microscopy." in
which a nanoscale probe “hops" over the surface of
acelllhishoppingprobe,similarto a sewingmachine
needlet never touches the surface of the cell. unlike
previous “sliding" probes that can damage cells.

The technique. which was published in the journal
Nature Methods in April. allows researchers to get
high—resolution. threc—dimensional images of the
surface of complex living cells.

“Until now, we had no idea what the surface of
most live cells looked like at nanoscale resolution.v
says Frolenkov, who came to UK in 2005 from the
XlH‘s National Institute on Deahtess and Other
Communication Disorders.

Frolenkov and his research team are studying the
mechanosensation——the conversion of mechanical
stimuli into neuronal signals——in the inner ear and

needed a tool to visualize nanoscale

obiects on the surlace ot live inner ear cells. “.\1anv
diseases affect the cell surface. and abnormal mechv
anosensitivitv ol’the cell is involved in dealness. pain.
cardiac arrhythmia. and e\ en cancer.

“Now we can see nanostructures such as individ—
ual protein or protein complexes in a living cell and
probe their function. \Ve expect that our technique.
together with emerging high—resolution imaging
techniques looking inside the cell. will clarify the
mechanisms of a number ol‘diseases. iust as optical
microscopes revolutioni/ecl medicine centuries ago."
liolenkov savs.

(to—principal imestigators on the proiec t \\ ere Yuri
Kcu‘chm ol‘the lniperial( ollegc‘ l onclon l)i\ ision ot
.\leclic inc' and David lxlenerman of (iantbriclgc
l'ni\ersitv‘s Department ol ( hemistrv. Ruben Stcv
pattvan ot the [le Department ol‘ l’hvsiologv \\‘as

also part ol‘ the research tcatn.—‘l\\'

 

Ret
lhc'
Rest
mer
ni/a
mat
plat

part

 

 Reducing Our Carbon Footprint
The University of Kentucky (Ienter for Applied Energy
Research (CA ER) has created a consortium with govern—
ment agencies, electric utilities and their research orga—
nixat ions to seek cost—effective technologies to reduce and
manage carbon dioxide emissions from coal—fired power
plants. Kentucky state government and the industrial
partners will provide 524 million over 10 years to support
the research.
The consortium will pursue three major carbon man—
agement research proiects:
l. l’ostecombustioncarbondioxidecapture,usingapilot
plant at CARR that was funded by LON US;
7. largoscale carbon dioxide capture. in a portable unit
to be constructed and operated at the power plants of
consortium industry members: and

Development ofa new combustion technology process

Lu

for solid fuels like coal and biomass that could provide
a more efficient power production technology for
next—generation power plants.

The consortium is designed to split the cost of research
on large—scale carbon dioxide capture systems. work
which has often been too expensive and risky for a
single utility or government agency to undertake.

“This consortium is an ideal example of the public
and private sector partnering to solve one of Ken—

tucky‘s—and the nation‘s—major problems," says UK

 
 
 
 
 
  
  
  
 
 
  
  
  
 
 
  
 
 
 
  
  
  
 
 
  
  
  
  
 
 
  
  
  
    

President Lee T. Todd _]r. “In creating this partnership,
Kentucky is asserting itselfas a national leader in develop-
ing technologies that will help reduce America‘s carbon
footprint. This is an important step for the future of

Kentucky‘s energy industry.“

New Partnership to Build

Battery Industry in Kentucky

The UniversityofKentucky and the Universityofl,ouisville
are partnering with Argonne National Laboratory and
the Commonwealth of Kentucky to establish a national
Battery Manufacturing Research and Development
Center to advance battery technology. This partnership
is a move toward securing US. energy independence,
reducinggreenhouse gas emissions and strengtheningthe
economy. The battery center will be built at Spindletop
Park next door to U K‘s Center forApplied Energy Research
on Ironworks l’ike.

“This center has the potential to transform Kentucky‘s
economy.“ says UK President Lee T. Toddjr. “With UK‘s
Coldstream Campus just two miles from the center and
with the nation‘s automobile manufacturing base located
in Kentucky and surrounding states. there will be great
potential to attract and develop new companies. With this
center in Kentucky. our state is uniquely positioned to
become a national leader in next—generation automobile

technology.“

   

 Gurney Norman Named
Kentucky Poet Laureate
Gurney Norman. director of tlte University of Kentucky
Creative W’riting Program. has been natned Kentucky
Poet Laureate for a two—year term.

For over 30 years. Norman has been a driving lorc e in
the literature of Appalachia and the South. He was in»
strumental in the founding of the Appalachian l’oett'y
Project and the Southern Appalachian W'riters Coopera-
tive. He is also known as a stellar attd lite—changing
teacher. and his students include Kentucky writers Frank
X \Walker. Chris Holbrook and Rebecca Howell.

His first novel. Dt'rt'ne Rig/it’s Trip. was originally pub-
lished in the margins of the lust W'ltole Fart/t Catalog.
which sold two million copies worldwide. Norman has
also published Boo/e One From (ftuzv Quilt: A Novel in
Progress and [vitae/ks: The W't/gus Stories. Norman‘s short
story “Fat Monroe" was made into a Ftlm starring Ned
Beatty in 1990. and the film was shown at the New York
Film Festival.

Norman was born in Grundy. Virginia. in 1937 attd
attended the University of Kentucky From 1955 to 1960.
majoring in journalism and anlish. He then studied
writing at Stanford University as a Stegner Creative \Vrit—
ing Fellow. Norman will soon complete his 30th year
teaching at UK.

The word “poet" in the positions title is interpreted in
its broadest sense to include writers whose accomplish—

ments are in any literary form. including the novel and

     
 
  
   
    
    
    
  
 
   
 
    
   
  
 
 
 
 
 
    

t.:Ltt"‘t’:,

Heft a t t"'t'tetket Ariel;

{new - «j'IJ'V‘iL totWeCt

 

short liction. Norman succeeds IMF—JUN“) Kentucky
l’oet laureatelane ( ientry \anc e. w lto is also a professor

in the [K Department ot l ngltsh.

Karl Raitz Appointed

State Geographer

Karl Rait/. a professor oli geography at l'K. has been
ttatned the new Kentucky state geographer. In this post
appointed by the governor. Rait/ will assist state and
local olt'icials with boundary studies. mapping.
cartographic programs. planning attd zoning. and land
usestudies.ser\ e asa resourcetorteachersand publishers
of geography textbooks. and work with geographers itt
other states to analy/e and disseminate geographic
information.

“Along with these other activ ities. l have a partic ulat‘
interest in working with researchers \\ ho are de\ elopittg
digital data sets for use itt Geographic lnlorntation
Systems analysis of mapping and en\ ironmental prob—
lems.‘~ adds Raitz. who will serv e a one—year term begttr
ninglanuary I.

A formerchait'ol‘his department at L' K attd a long—time
student of culture and its material artifacts. Rait/ has
spent the past 35 years examining American landscapes.
an interest which began during his undergraduate days.
As a student traveling through Kentucky on the way back
to his native Minnesota. Raitz says he was swept off his
feet by the Bluegrass. He took a visiting professorship in
geography at the University of Kentucky itt 1‘70 and

never left.

 .‘Il

id

(I
D‘

His early interest in this region focused on how the
most extensive collection of quarried rock fences still
standing in the United States came to be built. His in—
vestigation traced the origins of the fences to the work
of Irish stonemasons who came to the Bluegrass in the
mid—19th century. We detective work of Raitz and his
co—researcher, Carolyn Murray-Wooley, an architec-
tural historian, led to the publication of Roe/e Fences oftlie
Bluegrass.

Raitz says he is particularly proud of another publica—
tion, Wit’Al/ds ofKentuc/er ( University Press ofKentucky),
which he co—authored with UK colleagues Richard Ulack
and Gyula Pauer. “This was a major undertaking. More
than 20 researchers working in collaboration over a
period of eight years contributed to this effort," Raitz
says.

Currently, he is working on several projects relating to
the role of roads as a shaping influence on landscapes.
His research in this area has led to publication of two
books: We National Road and A Guide to the National
ROLHl—JW

Former Head of UK History
Department Publishes an Epic

on Foreign Relations

George Herring, UK alumni professor emeritus of his—
tory, retired from the university in 2005 after a 36—year
teaching career, but he continues to be an influential and
respected scholar of US. history. Herring recently pub—
lished From Colony to Superpower: U.S. I‘tn‘elgn Relations
Since 1776 (Oxford University Press, 2008), a thousand—
page volume that is part of the Oxford History of. the
United States series.

A November signing at the Washington, DC, book
store Politics and Prose—part of Herring‘s nationwide
book tour—was televised by C—SPAN. and the book has
been named an “Editor‘s Choice" by We New York Times
Boole Ret'iett’. Kudos for Herring‘s book have kept coming:
From Colour to Superpower was one of five finalists for
the 2008 National Book Critics Circle award in the
nonfiction category and received the 2008 Robert Fer—

rell l’rize given by the Society for Historians of American
Foreign Relations for the best book in the field.

How long does it take a scholar to write a 1,035—page,
scholarly book?

“I began serious work in the summer of 1997 and tin—
ished in early 2008,” says Herring. “Of course, I was
doing other things, too, during most of those years. Only
after I retired was I able to devote full attention to the
book."

Herring rates two US. diplomats as standouts: John
Quincy Adams and Franklin D. Roosevelt. “Both had an
instinctive understanding of how the world works, what
diplomats is all about. and what could and could not be
done in dealings with other nations. “ieir appreciation of
the limits ofpower sets them apart from many diplomats
and helps explain their success.“

The worst U.S. diplomat of all time?

Herring laughs. “Oh, he’s easy to identify, and, I am
sorry to say, was a Kentuckian—Edward Rumsey Wing
of Muhlenberg County. As Minister to Ecuador in the
18603, he tried, first, to annex that country to the United
States and then to assassinate the
British ambassador.
Fortunately, he
drank himself GE
to death before
he could further
damage US.

interests."

[A [minim IUIMIoNs \IN\ I lilo

I“! am” n”
.1011 a, y,”
UNIV“; 5””
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By Jeff Worley

Hi-tech Approach Helps Stroke Patients
Regain Their Lives

avid Rader knew something was very wrong. He suddenly
felt dizzy and weak. He’d been working for more than an
hour in his sweltering attic in late August 2007, putting in an
air-conditioning system, and thought he was suffering from heat _. ,_ ,
exhaustion.Hiswife,]ean,drovehimto the VA hospital,10 miles " "' i f j
away in Lexington, where he was examined and released. But iiiii 7 i: 7‘ J U
the next day he felt worse. He went back to the VA, where he ‘ >
had a massive stroke. I . _.
“His doctor told us he wasn’t going to make it," Jean recalls. 7
“They said to call our daughter in Florida and call the chaplain.
But I know my husband—he’s tough—so I told the doctor, ”Not
so fast,” she says, spacing out the three words for emphasis.
Jean knew David, 75, was a fighter and that with proper rehab
care he could make a comeback. She did call her daughter, Kate,
in Florida, because she remembered that Kate knew someone at
Cardinal Hill Rehabilitation Hospital in Lexington and that the
hospital had a good reputation. So she took David there. This

     
 
 
 
  
 
 
  
 
 
 
 
  
 
  
 
 
 
 
 
 

VII:
ale
:ie

311".

(at

    

turned out, Jean says, to be an excellent choice. The re-
habilitation programs at Cardinal Hill have played a
pivotal role in ongoing clinical studies originating from
the University of Kentucky.

At Cardinal Hill, David (who we‘ll return to shortly)
was put into the care of Lumy Sawaki, an associate pro—
fessor in the Department of Physical Medicine and Re—
habilitation at the University of Kentucky, who
immediately strikes you as a confident, affable and ap-
proachable woman. She included David in one ofher four
ongoing research projects that she brought with her from
Wake Forest University when she came to UK last year
as the Cardinal Hill Endowed Research Scholar in Stroke
and Spinal Cord Injury Rehabilitation.

“The common ground of all these studies is measuring
the effects of intensive, task-oriented therapy that uses
the latest technology to help stroke patients, some ofwhom
have suffered major, life-changingdamage,” says Sawaki,
her English tinged with the flavor of her native lan-
guage—Portuguese. (She was born and grew up in Brazil.)
The titles of three of her projects include the word “neu-
roplasticity,” which refers to the brain’s ability to reorga—
nize itself by forming new neural connections to

compensate for injury and disease.

The Brain Can Find a Way

In conventional stroke treatment, therapists frequently
focus on teaching patients how to compensate for loss of
function on one side of the body by making greater use
of the unaffected side. However, this compensatory ap—
proach does not address the potential for the affected side
to recover some function.

During the last two decades, scientists have learned
that the brain is able to relearn and redirect more activ—
ity after a stroke injury than previously thought possible.
Neuroimaging techniques, like fMRI, which shows the
functional activity of the brain, have revealed that remark—
able changes can occurafterconstraint-inducedmovement
therapy (CIMT). This approach involves constraining the
use of a stroke patients non—affected arm with a mitten
for 90 percent of his waking hours for two weeks so that
the weaker arm will have to do more of the work in daily
activities. In this way, use of the weaker arm triggers new
neuronal brain activity. The really good news is, brain
rewiring can occur even for patients who had a stroke 10
or 20 years ago.

 

Sawaki was the lead author on a CIMT study published
last year in the journal Neili'oreliabi/ifarion and Neural
Repair. In this multicenter study, 30 subjects between
three and nine months after their stroke were randomly
assigned to the experimental group (who received CIMT
immediately after initial evaluation) or the control group
(receiving CIMT after four months). Each subject was
evaluated using transcranial magnetic stimulation
(TMS), a noninvasive method to excite neurons in the
primary motor cortex, located toward the back of the
frontal lobe. The job of the motor cortex is to plan and
execute movements.

Here‘s how TMS works. By positioning a handheld,
wand-like device on a patient’s head, a therapist induces
weak electric currents in the patient’s brain tissue to trig-
ger brain activity. When TMS is used to stimulate an area
of the brain that controls movement of a particular
muscle, that muscle will move. By stimulating multiple
brain areas and monitoring muscle response, the therapist
can map the brain area that controls a particular muscle
and compare this map to previous patterns of activity. As
the patient’s ability to perform a certain movement im—
proves, these brain maps confirm the reorganization of
the associated area of the brain.

“Both groups in this study demonstrated improved
hand—motor function two weeks after baseline,” says
Sawaki, “but the experimental group showed signifi-
cantly greater improvement in grip force after the inter—
vention and at follow-up.” In the experimental group,
CIMT produced significant improvements in damaged
arm motor function, she explains as she demonstrates,
moving her right arm side-to—side. This group also had an
increase in the TMS motor map area compared with the
control group over a four-month period, which provided
evidence that the constraint-induced approach led to new
and functionally significant neuronal reorganization.

In discussing the importance ofTMS in mapping areas
of new neuron activity, Sawaki cites a breakthrough study
by Harvard neuroscientist Alvaro Pascual—Leone. Volun—
teers with no neurological disorders were brought into a
Harvard lab to learn a five-finger exercise on a piano
keyboard connected to a computer. The subjects did a
two-hour practice session for five consecutive days, and
each day’s practice was followed by a test that measured
their progress. Before the first practice session and every
day afterwards, Pascual—Leone and his team used TMS

   
  

  

to map the motor cortical areas that target finger tlexor
and extensor muscles. As the subjects” performance im—
proved, the size ofthe cortical representation in the brain
for both muscle groups increased significantly.

“But he didn’t stop there,“ Sawaki continues. “He had
a second group of subjects merely thin/e about practicing
the piano exercise.” They played the simple piece ofmusic
in their head, holding their hands still while imagining
how they would move their fingers. Then the volunteers
sat beneath the TMS coil. Pascual-Leone saw that the
cortex region that controls the piano—playing fingers also
expanded in the brains ofvolunteers who simply imagined
playing the music—just as it had in those who actually
played it. This discovery did nothing less than show that
mental training had the power to change the physical
structure of the brain. That finding is the basis for
Sawaki’s work with severely affected patients like David
Rader to guide them to move stroke—affected areas that
previous therapists had given up for dead.

Reading a Patient’s Brain Map

Scientists have long known which parts of the brain con-
trol which parts of the body. Humans spend a lot of time
talking and manipulating objects with their hands, so we
have large amounts of cortex devoted to mouth, tongue
and hands. (Differentspecies have differentpatterns. Rats
get a lot of information from their whiskers, so a large

amount of sensory cortex is devoted to the whiskers.)

 
 
 
 
 
 
  

 

“It‘s this ‘cortical priority” that, early on, inspired some
therapies for brain—damaged patients," Sawaki notes. “and
it‘s the basis for our CIMT work.“

In one of Sawaki‘s current studies, she is pinpointing
clusters ofnew neurons and, through some trial and error,
figuring out which parts ofa patients damaged tissue are
triggered by activating these neurons. lhis work is made
possible through the development ofa futuristic offshoot
of TMS called transcranial direct current stimulation
(tDCS), which involves applying weak electrical currents
to the head to generate an electromagnetic field to excite
and fire neurons. Sawaki uses this technology in conjunc—
tion with TMS.

In several of her studies, she is also using peripheral
nerve stimulation (l’NS) to increase the brain‘s ability to
reorganize. “In each l’NS session, three nerves in the
subject‘s affected arm are stimulated by mild electrical
pulses,” Sawaki explains. “'lhese pulses travel to the brain
and excite areas in the motor cortex." Each session lasts
two hours and is followed by intense, task—oriented oc—
cupational therapy.

lhe new technology is wonderful, Sawaki says, exuber—
antly, but any success—movement in the damaged area
of the body

 

is highly dependent on the patience and
perseverance of the stroke victim. “I think of myself as a
guide in this process. Once I find the area of the brain
where I believe new neurons are taking over a movement

function, I tell the patient to eni'isioii moving that area."

Theseimagesshowast‘roke patients brainbetore
(A) and after (B) therapy The dots represent
muscle activation, the iighter the dot, the
more activation in that area of the brain
It the motor cortex (highlighted yeiiow
area) is damaged by a stroke. neuron
regeneration often happens next door in
the sensory cortex (highlighted white
area) Brain maszhovvs Significantim»

provement in muscle activation in the

motor and sensory cortex on both the

strokeedamaged and non—stroke sides
of the brain. These 3D renderings were
created uSing sottvvarecalled Brainsight,

     
 
 
 
 
  

Th is is analogous to the work ofl’asqua l—leone. who asked
volunteers to envision practicing a piano exercise.

But how can sotneone imagine moving. say. a stroke—
damaged linger} How can we think abottt something the
body has always done automatically?

“This is actually very common.“ Sawaki says. “In
people who have lost a litnb. for example. there is still the
perception of sensations. usually inclttding pain. in the
missing artn or leg. The brain still gets messages fTom the
nerves that originally carried impulses from that litnb.
Amputees often talk abottt being able to ‘move‘ their
missing limb.“ And more to the point. Sawaki knows that
when patients envision the process of movement. this

mental picture facilitates the brain‘s rewiring.

Two Recent Successes

\‘y'hen David Rader became Sawaki‘s patient. he wasn‘t
optimistic about his chances of recovering any movement
in his damaged arm or leg. His wife._lean. placing a hand
on her husband‘s shoulder (David is still unable to speak).
sadly states that his whole left side was still withottt feel—
ing a year and a half after the stroke. After he completed
traditional therapy through home health and outpatient
services. his dattghter. Kate. convinced him to try work—
ing with the UK nettrorehabilitation research team at
Cardinal Hill. TTtere. Sawaki placed David in one of her
studies. which lasted two weeks.

“Two weeks might seem like a short time.“ Sawaki says.
anticipating the question of the study‘s brevity. “but this
is very intense work."

She used TMS to determine which parts of David’s
brain controlled his arm and hand. Based on that evalu—
ation. Sawaki gave him experimental treatment for two
hottrs a day. followed by fottr hours of intensive. task—
oriented occupational therapy.TT1is trainingoften involved
work with a robotic a rm (see p. 10). H is progress was slow.
bttt then came the breakthrough.

“Toward the end of the second week." Sawaki says.
“we were continuing to focus on Mr. Rader‘s damaged
arm in daily I’NS sessions. After stimulation during one
of these sessions. I told him to envision moving the
muscle in his arm that we had targeted; and suddenly his
arm moved."

Joe Springer. a professor of anatomy and neurobiology. is
heading JD the research program in ohySical mediCine and
rehabil taboo at UK and Cardinal Hill Rehabilitation Hospital
n LeXington Springer. who also serves as a research assocv
ate in UK‘s Spinal Cord and Brain lniury Research Center, is
one of severa bK faculty members located at Cardinal Hill.

“David was both surprised and thrilled.” his wife ex-
claims. recalling the moment. “Now he can move his arm.
which he thought he would never do. And because he
knows now he can move it. he‘s more motivated to work
at home to move it even more. It’s wonderful.“

In October 2004. stroke attacked Wendall Trent. 33. in
his sleep. When he went to bed. he felt fine. he said.
maybe just a bit sore {Tom a tough workout instructing
his martial arts class. He‘d been thrown by another in—
structor and “landed wrong." But he didn‘t think much
about it until he woke up at 2:30 a.m. next to his bed on
the floor. the whole left side of his body without feeling.
H is wife drove him to St. Claire Regional Medical Center
in Morehead. Kentucky. close to where they live. and the
prognosis was bleak: “The doctors said my carotid artery
had been torn. that I‘d never be able to use my arm or
hand again. or walk again." Wendall states. solemnly.
He was taken by helicopter to the UK Hospital. where
a stent was put in his neck. After four days in critical care.
W’endall was taken to Cardinal Hill. where he had inpa-
tient therapy for two months. By February 2005. he was
able to stand up and take a few steps. but his left arm and
hand failed to respond to traditional rehab exercises.
Four years passed. and still he had no feeling in his
disabled arm and hand. Then he decided to return to
Cardinal Hill and see if he could be helped through the
new rehabilitation research program he‘d heard about
there. “I was paired up with Lumy and was impressed

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with her from the beginning. She has a great
can—do attitude—no negativity is allowed in.
The therapy was strenuous, but I stuck with
it.“

In March of this year. working with
Sawaki‘s team and their neurorehabilitation
techniques,WendaIlenvisionedhisleftpinkie

 

finger moving and it moved. “I thought,
‘Wow! There‘s some progress!” Her expertise
on this high-tech equipment has given me new
hope. The whole process reminds me of hot—
wiring a car,” he laughs. “It’s another step on
the road to recovery."

Sawaki is pleased by the progress these two

 

patients—and others have made, but she
re—directs any praise aimed at her to the pa—
tients themselves. “Yes, I have the tools here
to ‘facilitate’ the rewiring process, but it’s the
effort and desire of the patient that tilti-
mately determines the outcome. I’m simply
helping these people help themselves.

“Everybody who comes here improves. My
mission here is beyond that,” Sawaki says. “I
want every patient to be able to go back to
their jobs or their lives and be physically able
to do things again. That’s the big goal.”

“Lumy’s work is the perfect match for the
type of research program we are building
here,” states her colleague joe Springer, pro-
fessor of physical medicine and rehabilita—
tion at UK and research associate in UK‘s
Spinal Cord and Brain Injury Research Cen‘
ter. Springer is one of several UK faculty
members IocatedatCardinalHill.“Following
our growing understanding of the brain’s
potential for neuroplasticity, her focus on
identifying novel neurorehabilitation strate—
gies is moving us into important, uncharted
territory.”

1O

Rehab Robots—Partners in Recovery

The latest robotic technology is helping patients like David
Rader and Wendall Trent regain movement and balance. In
january 2008 the Lokomat robotic system debuted at Cardinal
Hill Rehabilitation Hospital in Lexington, which has a close af—
filiationwith the UK College ofMedicine. The Lokomat’s harness
and lift system raises patients from a wheelchair and places them
in a standing position on the treadmill. Robotic devices attached
at the patient’s thighs and knees provide support to properly
“unweight” the patient. The Lokomat then operates at an ap-
propriate speed, creating a walking rhythm.

Cardinal Hill is the only facility in the state to offer Lokomat
treatment to the public and one of only 25 in the country used for
therapy, says Kara Lee, a doctor ofphysical therapy and coordina—
tor of the Lokomat program in the Center for Outpatient Ser—
vices at Cardinal Hill.