March 20 through 22, 2019
All Workshop Applicants Must Be Members of the NC NM4R Community.
Once you have joined our community, apply to attend the Level 2 Workshop.
This workshop is free of charge to all accepted applicants. Due to our funding by United States Department of Health and Human Services, National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health & Human Development under award number P2CHD086844, we must restrict admission to the workshops to those applicants who are affiliated with US-based institutions and who are eligible to receive NIH funding.
Operant conditioning is a powerful method to induce behavioral learning. Through operant conditioning, modification of a behavior is brought about by the consequence of that behavior. Since the first time Wolpaw and his colleagues demonstrated that the spinal stretch reflex can be changed through operant conditioning more than 30 years ago, variations of operant conditioning protocols have been applied to the stretch reflex or its electrical analog, the H-reflex, in monkeys, rats, mice, and humans, and repeatedly confirmed that a specific change (i.e., up- or down-regulation) can be induced in the activity of a targeted reflex pathway. Because a spinal reflex pathway serves many different movements and skills, the plasticity induced through operant conditioning can affect many motor skills in which the conditioned pathway participates. In fact, appropriate reflex conditioning can improve walking in rats and people with partial spinal cord injuries. Thus, it should be possible to facilitate/improve function recovery in other movement disorders and in other populations through operant conditioning.
Human operant conditioning protocols are completely non-invasive (although it is possible to include invasive procedures should there be a need for them) and can be applied to many different spinal reflexes and EMG evoked potentials (e.g., motor evoked potential to transcranial magnetic stimulation). Because these protocols can change the function of specific neural pathways, they can be designed to address the specific functional deficits of an individual with CNS disorder. Operant conditioning protocols may be combined with other rehabilitation methods, in order to enhance functional recovery. Successful applications require appropriate designing of a protocol and close adherence to designed procedures, as well as close attention to accommodating and engaging the individual subject in the conditioning process. The goal of this workshop is to provide participants with hands-on opportunities to learn and practice the fundamentals of human operant conditioning protocols. In hope to inspire different directions of conditioning applications, participants will be exposed to several different variations of conditioning protocols.
- Acquire the essential knowledge about operant conditioning of EMG evoked potentials in people.
- Become familiar with the H-reflex testing procedures.
- Learn how to obtain an H-reflex and M-wave recruitment curve.
- Understand the different H-reflex recruitment curves in different muscles.
- Learn what influence the H-reflex size (e.g., background EMG, antagonist activity, posture, and tasks).
- Learn the standard protocol for operant conditioning of the soleus H-reflex in people.
- Practice the soleus H-reflex operant conditioning session protocol.
- Learn non-invasive methods to study spinal inhibition.
- Learn different variations of EMG evoked potential operant conditioning protocols.
- Practice the soleus H-reflex operant conditioning session protocol (realize the importance of reproducibility of the H-reflex testing procedure).
- Learn and practice TMS-MEP operant conditioning session protocol.
- Learn and practice different variations of operant conditioning session protocols.
- Operant conditioning of EMG evoked potentials – essential knowledge (interactive lecture).
- H-reflex testing and nerve stimulation (demonstration, hands-on experiment)
- Modulation of the H-reflex experiments (demonstration, hands-on experiment).
- Effects of background EMG activity levels on the soleus H-reflex amplitude.
- Effects of the antagonist muscle activity on the soleus H-reflex amplitude.
- Task-dependent and phase-dependent modulation of the soleus H-reflex during walking.
- H-reflex and M-wave recruitment curve measurement (incl., which part of the recruitment curve should be studied in a plasticity study, and meaning of measuring the maximum M- wave).
- H-reflex and M-wave recruitment curves in different muscles.
- Learning to run the soleus H-reflex operant conditioning session (demonstration, hands-on experiment).
- Learning the conditioning-test stimulation paradigms for studying spinal pre- and post-synaptic inhibition (demonstration).
- Learning to run the soleus stretch reflex operant conditioning session, the reciprocal inhibition conditioning session, and/or the flexor carpi radialis H-reflex operant conditioning session (demonstration, hands-on experiment).
- Reproducing the soleus H-reflex operant conditioning session (hands-on experiment).
- Learning to run the MEP operant conditioning session (operant conditioning of the tibialis anterior motor evoked potential to transcranial magnetic stimulation) (demonstration, hands-on experiment).
- Learning to use an operant conditioning paradigm for conditioning other EMG evoked potential (i.e., flexor carpi radialis H-reflex, soleus stretch reflex, or reciprocal inhibition of the soleus) (hands-on experiment).
Advanced Operant Conditioning of EMG Evoked Potential Workshop
Wednesday, March 20, 2019
Introduction to Operant Conditioning of EMG Evoked Potentials
8:00-8:30 am Breakfast and registration
8:30-8:40 am Introduction and Overview of the Operant Conditioning Level 2 workshop (Rick Segal, PT Ph.D., FAPTA)
8:40-10:00 am Operant Conditioning of Spinal Reflexes (Jonathan Wolpaw)
10:00-10:15 am Coffee Break
Discussion of Early Stage Operant Conditioning Studies
10:15 am-1:45 pm Panel Discussion (Segal, Thompson, Wittenberg, Wolpaw)
Applications of Operant Conditioning
1:45-2:15 pm Operant Conditioning of EEG Sensorimotor Rhythm (Jonathan Wolpaw)
2:15-2:45 pm Operant Conditioning of EMG Evoked Potentials in Humans: Operant Conditioning Programs at the MUSC EPOC Lab (Aiko Thompson)
2:45-3:15 pm Introduction and Overview on H-reflex testing method (Aiko Thompson)
3:15-3:30 pm Coffee Break
Roll up Your Sleeves
3:30-4:00 pm Demonstration (EMG Recording, H-reflex and M-wave recruitment curve measurement)
Hands-On experiment (electrode placement, soleus H-reflex and M-wave recruitment curve measurement, gastrocnemius recruitment curve measurements)
4:00-4:30 pm Demonstration (Effect of Background EMG on H-reflex size)
Hands on Experiment (Effect of Background EMG on H-reflex size)
4:30-5:30 pm Hands on experiment (Operant conditioning of the soleus H-reflex)
6:00pm Optional unsponsored dinner gathering, location to be determined
Thursday March 21, 2019
8:00-8:30 am Breakfast and announcements
8:30-9:30 am Research on Lower Extremity Rehabilitation (Mark Bowden)
9:30-10:30 am Research on Upper Extremity Rehabilitation (Michelle Woodbury)
10:30-10:45 am Coffee Break
10:45-11:45 am Demonstration (Operant conditioning of MEP in the wrist extensor) with MEP004
12:00-1:00 pm Keynote Lecture (George Wittenberg) / bag lunch
1:15-2:00 pm Demonstration (Operant conditioning of MEP in the ankle dorsiflexor)
2:00-3:30 pm Hands on experiment (Operant conditioning of MEP to TMS)
3:30-3:45 pm Coffee Break
3:45-4:00 pm Demonstration (Measuring the Soleus H-reflex during Walking)
4:00-5:30 pm Hands on experiment (Operant conditioning of reciprocal inhibition)
5:30-7:00 pm Networking Social-CHP A, Atrium
Friday March 22, 2019
8:00-9:00 am Breakfast and announcements
9:00-10:30 am Hands-on experiments (parallel breakout sessions: tibialis anterior MEP conditioning, extensor carpi radialis MEP conditioning, flexor carpi radialis H-reflex conditioning, or soleus stretch reflex conditioning)
10:30-10:45 am Coffee Break
10:45-12:30 pm Hands-on experiments (parallel breakout sessions: experimental experiments, reflex conditioning and electrical nerve stimulation, conditioning during dynamic motion)
12:30-1:30 pm Lunch
1:30-3:30 pm Hands-on Experiment (soleus H-reflex conditioning skill evaluation)
3:30-3:45 pm Coffee Break
3:45-5:15 pm Presentation and discussion of potential operant conditioning project ideas (each participant presents his/her potential project idea in 1-2 slides up to 5 minutes) (Segal, Thompson)
5:15-5:30 pm Wrap Up/Discussion
The National Center for Neuromodulation for Rehabilitation (NC NM4R) is supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under award number P2CHD086844. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.