Faculty

Pioneering Rehabilitation

Kathleen M. Friel, Ph.D.

Director, Clinical Laboratory for Early Brain Injury Recovery

Assistant Professor of Neurology and Neuroscience, Weill Cornell Medical College

Phone:

(914) 368-3116

Research Focus

NEW!  The Friel Lab 

Dr. Friel’s work at the Burke-Cornell Medical Research Institute aims to improve hand function in children with cerebral palsy (CP).  Her research focuses on the importance of motor activity in neurorehabilitation.  Her laboratory uses sophisticated techniques to non-invasively study the anatomy and function of the brain and spinal cord.  Her laboratory studies how brain structure and function change as children receive hand rehabilitative training.  By better understanding brain structure and function in children with CP, it is hoped that scientists will best be able to devise new therapies for these children.  Currently, her laboratory is also developing therapies for CP that utilize noninvasive brain stimulation. 

Using noninvasive brain stimulation, Dr. Friel and her colleagues are able to identify the parts of the brain that control hand movements.  This image demonstrates the effects of hand rehabilitative training on the part of the brain that controls movement of the impaired hand in a child with hemiplegic cerebral palsy.  After training (right), the size and strength of the part of the brain controlling the impaired hand is larger than before training (left).

The Burke-Cornell Early Brain Injury Recovery Program

This clinic is the first effort to actively pursue translation of basic science discoveries at the Burke Medical Research Institute into clinical trials at the Pediatric Neurology Department at Weill-Cornell Medical College.

The clinic will provide high-quality medical treatment for paralysis, vision loss and other neurological impairments in brain-injured children. Those who qualify will be enrolled in clinical trials to test newer treatment methods, such as high intensity training programs and non-invasive brain stimulation. Merging clinical care and scientific research will provide patients with access to promising treatments and assessment of long-term results.

For more information, visit the Eary Brain Injury Recovery Program page and the Burke-Blythedale Hemiplegia Center page

Biography

Dr. Friel received her B.A. in Biology at Rice University, an M.S. in Neuroscience at the University of Texas Health Sciences Center at Houston, and a Ph.D. in Neurophysiology from the University of Kansas Medical Center.  She completed a postdoctoral fellowship at Columbia University Medical Center.  She also received a M.S. in Biostatistics from Columbia University, with a focus on patient-oriented research.  Her research focuses on the importance of motor activity in neurorehabilitation. 

Selected Publications

Friel K.M., Kuo H-C, Carmel JB, Rowny S, Gordon AM. (2014) Improvements in hand function after intensive training are not associated with corticospinal tract integrity in children with hemiplegic cerebral palsy.  Experimental Brain Research, In press.

Brandão MB, Ferre C, Kuo HC, Rameckers EA, Bleyenheuft Y, Hung YC, Friel K, Gordon AM.  (2014)  Comparison of Structured Skill and Unstructured Practice During Intensive Bimanual Training in Children With Unilateral Spastic Cerebral Palsy.  Neurorehab Neural Repair, doi:10.1177/1545968313516871.

Friel KM, Chakrabarty S, Martin JH.  (2013) Pathophysiological mechanisms of impaired limb use and repair strategies for motor systems after unilateral injury of the developing brain.  Dev Med Child Neurol, 55 Suppl 4:27-31.

Friel K.M., Chakrabarty S, Kuo H-C, Martin JM.  (2012) Using motor behavior during an early critical period to restore skilled limb movement after damage to the corticospinal system during development.  Journal of Neuroscience, 32:9265-76.  

Gordon A.M., Hung Y-C, Brandao M., Ferre C.L., Kuo H-C, Friel K.M., Petra E., Chinnan A., Charles J.R. (2011) Bimanual Training and Constraint-Induced Movement Therapy in Children with Hemiplegic Cerebral Palsy: A Randomized Trial. Neurorehabilitation and Neural Repair, 25:692-702.

Martin J.H. Chakrabarty S., Friel K.M.  (2011) Harnessing activity-dependent plasticity to repair the damaged corticospinal tract in an animal model of cerebral palsy.  Dev Med Child Neurol, 53 Suppl 4:9-13.

Gordon, AM, Friel, K.M. (2009) Intensive training of upper extremity function in children with cerebral palsy. In: J. Hermsdoerfer and DA Nowak (Eds) Sensorimotor Control of Grasping: Physiology and Pathophysiology, pp. 438-468.  Cambridge University Press.

Friel K.M., Drew T., Martin J.H.  (2007) Differential activity-dependent development of corticospinal control of movement and final limb position during visually-guided locomotion.  Journal of Neurophysiology, 97:3396-3406.

Friel K.M., Martin J.H.  (2007) Bilateral activity-dependent interactions in the developing corticospinal system.  Journal of Neuroscience, 27:11083-11090.

Friel K.M., Drew T., Martin J.H.  (2007) Differential activity-dependent development of corticospinal control of movement and final limb position during visually-guided locomotion.  Journal of Neurophysiology, 97:3396-3406.

Laboratory

Current Lab Members:

Disha Gupta, Ph.D. —  Instructor
dig2015@med.cornell.edu 

Hsing-Ching (Cherie) Kuo —  Graduate Student
hck3001@med.cornell.edu 

Alexandre Barachant, Ph.D. — Postdoctoral Fellow
alb3001@med.cornell.edu 

Learn more about us and laboratory alumni at The Friel Lab page!


Collaborators:

Yannick Bleyenheuft, Ph.D. — Université Catholique de Louvain

Jason B. Carmel, M.D., Ph.D. — Burke Medical Researh Institute

Dylan J. Edwards, Ph.D. — Burke Medical Research Institute

Andrew M. Gordon, Ph.D. — Teachers College of Columbia University

John H. Martin, Ph.D. — City College of New York

Current Projects

1) Using transcranial magnetic stimulation (TMS) to study motor system plasticity after intensive hand training in children with unilateral cerebral palsy.  We use single-pulse TMS to determine which parts of the brain control hand movement, and how these regions change after an intensive hand training rehabilitation program. 

2) Using magnetic resonance imaging to study brain pathways involved in controlling movement and sensation in children with CP.

3) Examining the safety and efficacy of transcranial direct current stimulation (tDCS) as a therapy for children with CP.

4) Using tDCS and robotic upper limb therapy to improve upper limb function in adults with CP

Funding

National Institute of Child Health and Human Development, National Institutes of Health 
R01 HD 076436
Title
Neural predictors of hand therapy efficacy in children with cerebral palsy   
Dates of project: 
2014-2019

The Thomas and Agnes Carvel Foundation
Title: 
Using tDCS to improve motor function in children with cerebral palsy
Dates of project: 2013-2015

News and Media

October 23, 2014
Dr. Friel has been named one of Westchester County's Top Female Innovators by the Westchester County Association and will be honored at the Women in Tech awards luncheon on November 19. 

August 21, 2014
An article and video in the Westchester Business Journal shows how the Early Brain Recovery Program is helping children with brain injury improve hand strength and coordination.


2013

An article and video in the Journal News highlights how the Early Brain Recovery Program is helping children with brain injury improve hand strength and coordination.

Dr. Friel was a finalist for the 2013 Gayle G. Arnold Award for her research using transcranial magnetic stimulation to study motor cortex plasticity associated with cerebral palsy rehabilitation.


2012

Dr. Friel was awarded the 2012 Gayle G. Arnold Award from the American Academy of Cerebral Palsy and Developmental Medicine.  The Arnold Award is the most prestigious award of the academy, and was given to Dr. Friel to recognize her research in an animal model of cerebral palsy.

Spotlight

Kathleen M. Friel, Ph.D., studies the importance of motor activity in neurorehabilitation.  She joined the Burke faculty in February 2013 and is the Director of the Clinical Laboratory for Early Brain Injury Recovery.  Her laboratory specializes in non-invasive brain stimulation to study and promote recovery of movement in children and adults with cerebral palsy.  She was recently awarded a 5-year grant from the National Institutes of Health to study neural predictors of hand therapy efficacy in children with cerebral palsy.

When did you know you wanted to be a scientist?
In high school.  That’s when I realized that science isn’t just memorizing things, it’s trying to understand things.

How did you get started in the field of motor rehabilitation?
I did my Ph.D. work looking at motor training in stroke in animals.  Later at Columbia, I worked with Dr. Jack Martin on animal research in cats, trying to understand how the brain is wired and how to rewire the brain after injury.  We used a cat model of cerebral palsy and studied motor training to restore brain networks.  The cats wouldn’t get food in their home cage, so they had to reach for pieces of steak outside the cage—they were reaching all day and actually gained weight!

Your current work focuses on improving hand function in children with cerebral palsy.  How does motor training help with that?
Over the last 30 years, people realized that the brain is plastic, even in adults.  Now we know that it changes all the time.  Some injuries are more severe than others—but as long as there are some residual motor connections left, we can try to strengthen them.

What we believe is that neurons fire when they’re active and movement seems to activate the networks that have been injured.  A lot of the basic science shows that through training, the particular brain areas you use get stronger. 

What kind of training does the Early Brain Injury Recovery Program offer?
Together with Dr. Andrew Gordon at Teachers College of Columbia University, we run an intensive hand therapy day camp for three weeks that helps kids with hemiplegia improve hand function through fun games, arts, and crafts.  The key is really trying to use their hands in skillful ways, like holding cards, moving dice, or drawing.  This means challenging them to do things they can’t do very easily, and making it more difficult week by week.

We use single pulse TMS (transcranial magnetic stimulation) essentially for brain mapping.  If you give someone a single pulse TMS over the motor cortex, you’ll see a muscle move.  This allows us to get a map of the whole brain showing which brain areas control movement.  After therapy, we do TMS again and we see that the brain is bigger and they improve on measures of hand function, like how well they use two hands together.

Are these changes in the brain long-lasting?
We follow-up through 6 months and the changes do last.  They have to practice for one hour a day, but hopefully they are using their hands more—like a habit, not homework.  Kids with hemiplegia—one side is more impaired than the other—will do everything with the opposite hand, and a lot of kids think it’s good enough.  But after therapy, they’ll say, “Oh, I never thought I could use both hands.  Now I can.”  Their confidence goes up and they use their hands more.

What is the biggest unanswered question in your area of research?There are so many questions!  In motor rehab, one question is what kinds of therapy are best for which kids?  What are the predictors of efficacy?  Different kinds of therapy might be ideal for different kinds of kids based on their impairments and how their brains are wired.  If we know that, we can tailor therapy to individual kids.

What is the most rewarding part of your job?
Seeing the kids improve and realizing they can do more.  Working with the kids is a lot of fun.  They have their own opinions of what’s going on in their brains, how their brains are organized, and it’s cool to see them get interested in the science.  One kid participated in our therapy camp when she was 14 years old.  Now she is eighteen and is a computer science major at Smith College.  She interned in our lab this past summer.  The children in the camp responded extremely well to her, as she was able to share her personal perspective with them.

November 2014