The Neural Effects of Balance Versus Aerobic Training in Individuals with Degenerative Cerebellar Diseases

PROJECT SUMMARY/ABSTRACT Degenerative cerebellar diseases are a group of disorders that cause severe disability and can be fatal. There are currently no known disease-modifying treatments available for use, and there is a critical need to find treatments that slow disease progression and allow affected individuals to live more functional lives. Balance and aerobic training show promise as treatments for degenerative cerebellar diseases, but the neural effects of both training methods have not been thoroughly investigated. It is crucial to understand how the training impacts the brain, and particularly the cerebellum, in order to determine if one training method is better at slowing disease progression than the other. The goal of this proposal is to compare the neural effects of balance versus aerobic training in individuals with degenerative cerebellar diseases. We hypothesize that aerobic training causes neuroplastic changes within the cerebellum whereas balance training causes improvements for people with cerebellar degeneration by impacting brain structures outside the cerebellum. If our hypothesis is true, aerobic training may have more influence on disease progression than balance training as it directly impacts the cerebellum. To investigate our hypothesis, various neuroimaging techniques will be used, which will allow the candidate to gain invaluable expertise in processing and analyzing brain scans. In AIM 1, we will compare cerebellar volume before and after the participants perform either 6-months of balance or aerobic training. In AIM 2, we will investigate whether neural changes have clinical significance by correlating cerebellar volume changes with clinical measures of ataxia. Finally, for AIM 3, we will use diffusion tensor imaging and resting state fMRI scans to examine how both training methods impact cerebellar microstructure and functional cerebellar connections. We hope that a detailed understanding of how each training method impacts the cerebellum will lead to more targeted training regimens with the goal of slowing disease progression of these devastating diseases. The candidate has a clinical background in Physical Medicine and Rehabilitation with an emphasis on movement disorders. He has a PhD in immunology and will be completing a master?s degree in clinical research design and statistical analysis. He is committed to a career in ataxia research focusing on the effects of exercise training on disease progression and plans to use the additional training he receives through this NIH Career Development Award to support his future work in this field. The candidate has assembled a multidisciplinary mentoring team to accomplish three training goals: 1) to learn and master neuroimaging techniques; 2) to become proficient in longitudinal statistical methods; 3) to improve grantsmanship skills to facilitate ongoing research support. In addition, the candidate will receive further training in career development and the responsible conduct of research.