T. Dorina Papageorgiou
Dr. Papageorgiou obtained a BA in Psychology and Sociology (University of Georgia), a M.H.Sc. in Psychiatric Epidemiology (Johns Hopkins University), and a Ph.D. in the Biomedical Sciences with a focus on the neuroimaging of morphine (University of Texas - M.D. Anderson Cancer Center; MDACC). She continued with three postdoctoral fellowships: (i) neuroimaging of pain (MDACC); (ii) real-time fMRI neurofeedback of speech impairment (Baylor College of Medicine); and (ii) real-time fMRI neurofeedback of cortical blindness (BCM). As an Assistant Professor of Neurology her research focuses on cortical plasticity, and neuro-rehabilitation of cortical blindness, speech impairment and, chronic pain syndromes, as a result of neurological disorders, traumatic brain injury or, cancer-related symptoms using targeted/individualized real-time fMRI neurofeedback methods. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The T. Dorina Papageorgiou - Investigational Targeted Brain Neurotherapeutics Lab has developed a novel, targeted and individualized MRI-compatible brain computer interface (BCI) based on associative learning principles that can induce neuromodulation in patients with neurological sequelae following stroke (commonly a result of a posterior cerebral artery infarct, or a middle cerebral artery infarct), traumatic brain injury or tumor resection. We call our MRI-BCI, individualized real-time functional MRI neurofeedback (iRTfMRI nFb), which is based on promoting the reorganization of networks by bypassing lesioned pathways and capitalizing on redundant, intact but functionally associated pathways to the injured ones. This is achieved by modulating the magnitude and spatial extent of Blood-Oxygen-Level-Dependent (BOLD) signal with the goal to recover the brain function, as a result of a neurological insult. We apply this investigational treatment to patients with impairments of the following cortical systems: Retrochiasmal lesions downstream of the optic radiation, which result in cortical blindness. Supra- or infra-nuclear injury to the hypoglossal or glossopharyngeal nucleus, which result in upper motor neuron disease (lesions upstream of the medulla oblongata that can impact somatomotor, and somatosensory areas) or lower motor neuron disease (lesions downstream of the medulla oblongata). Pain matrix network areas, which result in impaired somatosensory and somatomotor pain matrix network activity as a result of CNS- or PNS-associated pain. Reorganization is possible by neuromodulating the spatial extent and intensity of the Blood-Oxygen-Level-Dependent (BOLD) signal to a patient's intact cortical area, which takes over in performing the function, as it has been impaired in the primary cortical areas following neurological injury. This investigational treatment engages associative learning mechanisms that modulate the activity of intact cortical areas with the goal to improve performance in patient populations with neurological sequelae as a result of stroke, traumatic brain injury or tumor resection. Patients undergo rneurofeedback in real time to upregulate or downregulate the activity of intact cortical and/or subcortical areas in conjunction with the continuous presentation of visual stimuli inside the MRI environment with the goal to restore or reorganize lesioned pathways associated with vision, speech, or pain. The modulation in the Blood-Oxygen-Level-Dependent (BOLD) signal intensity is achieved by feeding back to the patient the magnitude of mean BOLD signal intensity of his/her intact cortical area during the presentation of a stimulus in real-time. The hypothesis is that such training engages Hebbian mechanisms that modulate the activity of intact cortical areas with the goal to improve performance.