Research
Whether recovering from injury or disease, the brain's potential to change for the better or the worse – its “plasticity” – creates opportunities to improve neurological outcomes. In our research, we show that rehabilitation, movement re-learning, and noninvasive brain stimulation are simple tools that investigators and clinicians can use to harness the brain's potential for positive change.
Biography
Education & Professional Highlights
Research
Our laboratory’s research interests include brain stimulation, motor control, neuroimaging, clinical neuroscience and rehabilitation. We utilize functional neuroimaging to discern substrates of movement control and movement relearning-related plasticity in the healthy vs. post-stroke brain to draw upon their significance for rehabilitation.
In addition, using noninvasive brain stimulation, including transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), we have explored ways to harness plasticity within implicated substrates to promote recovery in stroke.
Our current research portfolio includes:
- Understanding of normal aging- and disease-related neurodegenerative markers, particularly those affecting motor networks of the brain associated with movement dysfunction, using TMS.
- Modifying activity of motor networks to “stall” or alleviate neurodegenerative effects, in turn improving movement control with rehabilitation and training
- Investigating whether neural substrates associated with training and rehabilitation can be modified adaptively using neuromodulation to supplement therapeutic benefit.
Studies in our laboratory include: 1) investigating neural substrates of neuromodulatory rehabilitation in motor recovery and sensory re-education after stroke; 2) neuromodulation to re-establish memory in paralyzed muscles in spinal cord injury; 3) aging- and training-related neural markers of strength in the elderly, and; 4) neurodegenerative markers of chemotherapy-induced fatigue in cancer.
Our Team
Selected Publications
View publications for Ela Plow, PhD
(Disclaimer: This search is powered by PubMed, a service of the U.S. National Library of Medicine. PubMed is a third-party website with no affiliation with Cleveland Clinic.)
Bhatt [Plow] E, Nagpal A, Greer KH, Grunewald T, Steele JL, Wiemiller JW, Lewis SM, Carey JR. Effect of Finger Tracking Combined with Electrical Stimulation on Brain Reorganization and Hand Function in Subjects with Stroke. Experimental Brain Research 2007;82(4):435-447.
Plow EB, Carey JR, Nudo RN, Pascual-Leone A. Invasive Cortical Stimulation to Promote Recovery of Function After Stroke: A Critical Appraisal. Stroke 2009;40(5):1926-1931.
Plow EB, Arora P, Pline MA, Binenstock MT, Carey JR. Within-limb Somatotopy in Primary Motor Cortex-revealed using fMRI. Cortex 2010;46(3):310-321.
Plow EB, Obretenova SN, Fregni F, Pascual-Leone A, Merabet LB. Comparison of visual field training for hemianopia with active versus sham transcranial direct cortical stimulation. Neurorehabilitation and Neural Repair 2012;26(6):616-626.
Plow EB, Carey JR. Pilot fMRI investigation of representational plasticity associated with motor skill learning and its functional consequences. Brain Imaging Behav. 2012 Sep;6(3):437-53. doi: 10.1007/s11682-012-9158-3. PMID: 22454141 Free PMC article.
Plow EB, Pascual-Leone A, Machado A. Brain stimulation in the treatment of chronic neuropathic and non-cancerous pain. J Pain. 2012 May;13(5):411-24. doi: 10.1016/j.jpain.2012.02.001. Epub 2012 Apr 7. PMID: 22484179 Free PMC article. Review.
Plow EB, Malone DA Jr, Machado A. Deep brain stimulation of the ventral striatum/anterior limb of the internal capsule in thalamic pain syndrome: study protocol for a pilot randomized controlled trial. Trials. 2013 Jul 31;14:241. doi: 10.1186/1745-6215-14-241. PMID: 23902631 Free PMC article.
Cunningham DA, Machado A, Yue GH, Carey JR, Plow EB. Functional somatotopy revealed across multiple cortical regions using a model of complex motor task. Brain Res. 2013 Sep 19;1531:25-36. doi: 10.1016/j.brainres.2013.07.050. Epub 2013 Aug 3. PMID: 23920009 Free PMC article.
Plow EB, Cunningham DA, Bonnett C, Gohar D, Bayram M, Wyant A, Varnerin N, Mamone B, Siemionow V, Hou J, Machado A, Yue GH. Neurophysiological correlates of aging-related muscle weakness. J Neurophysiol. 2013 Dec;110(11):2563-73. doi: 10.1152/jn.00205.2013. Epub 2013 Sep 11. PMID: 24027104 Free PMC article.
Plow EB, Cunningham DA, Beall E, Jones S, Wyant A, Bonnett C, Yue GH, Lowe M, Wang XF, Sakaie K, Machado A. Effectiveness and neural mechanisms associated with tDCS delivered to premotor cortex in stroke rehabilitation: study protocol for a randomized controlled trial. Trials. 2013 Oct 12;14:331. doi: 10.1186/1745-6215-14-331.PMID: 24119615 Free PMC article.
Plow EB, Fehlings MG. Hypoxic locomotor rehabilitation for incomplete spinal cord injury: not an oxymoron. Neurology. 2014 Jan 14;82(2):98-9. doi: 10.1212/01.WNL.0000437415.33516.6e. Epub 2013 Nov 27. PMID: 24285614 No abstract available.
Plow EB, Machado A. Invasive neurostimulation in stroke rehabilitation. Neurotherapeutics. 2014 Jul;11(3):572-82. doi: 10.1007/s13311-013-0245-y. PMID: 24353109 Free PMC article. Review.
Plow EB, Varnerin N, Cunningham DA, Janini D, Bonnett C, Wyant A, Hou J, Siemionow V, Wang XF, Machado AG, Yue GH. Age-related weakness of proximal muscle studied with motor cortical mapping: a TMS study. PLoS One. 2014 Feb 21;9(2):e89371. doi: 10.1371/journal.pone.0089371. eCollection 2014. PMID: 24586726 Free PMC article.
Machado AG, Gopalakrishnan R, Plow EB, Burgess RC, Mosher JC. A magnetoencephalography study of visual processing of pain anticipation. J Neurophysiol. 2014 Jul 15;112(2):276-86. doi: 10.1152/jn.00193.2014. Epub 2014 Apr 30. PMID: 24790165 Free PMC article.
Plow EB, Cattaneo Z, Carlson TA, Alvarez GA, Pascual-Leone A, Battelli L. The compensatory dynamic of inter-hemispheric interactions in visuospatial attention revealed using rTMS and fMRI. Front Hum Neurosci. 2014 Apr 17;8:226. doi: 10.3389/fnhum.2014.00226. eCollection 2014. PMID: 24860462 Free PMC article.
Plow EB, Cunningham DA, Varnerin N, Machado A. Rethinking stimulation of the brain in stroke rehabilitation: why higher motor areas might be better alternatives for patients with greater impairments. Neuroscientist. 2015 Jun;21(3):225-40. doi: 10.1177/1073858414537381. Epub 2014 Jun 20. PMID: 24951091 Free PMC article.
Cooperrider J, Furmaga H, Plow E, Park HJ, Chen Z, Kidd G, Baker KB, Gale JT, Machado AG. Chronic deep cerebellar stimulation promotes long-term potentiation, microstructural plasticity, and reorganization of perilesional cortical representation in a rodent model. J Neurosci. 2014 Jul 2;34(27):9040-50. doi: 10.1523/JNEUROSCI.0953-14.2014.PMID: 24990924 Free PMC article.
Cunningham DA, Machado A, Janini D, Varnerin N, Bonnett C, Yue G, Jones S, Lowe M, Beall E, Sakaie K, Plow EB. Assessment of inter-hemispheric imbalance using imaging and noninvasive brain stimulation in patients with chronic stroke. Arch Phys Med Rehabil. 2015 Apr;96(4 Suppl):S94-103. doi: 10.1016/j.apmr.2014.07.419. Epub 2014 Sep 3. PMID: 25194451 Free PMC article.
Page SJ, Cunningham DA, Plow E, Blazak B. It takes two: noninvasive brain stimulation combined with neurorehabilitation. Arch Phys Med Rehabil. 2015 Apr;96(4 Suppl):S89-93. doi: 10.1016/j.apmr.2014.09.019. PMID: 25813373 Free PMC article.
Sankarasubramanian V, Roelle SM, Bonnett CE, Janini D, Varnerin NM, Cunningham DA, Sharma JS, Potter-Baker KA, Wang X, Yue GH, Plow EB. Reproducibility of transcranial magnetic stimulation metrics in the study of proximal upper limb muscles. J Electromyogr Kinesiol. 2015 Oct;25(5):754-64. doi: 10.1016/j.jelekin.2015.05.006. Epub 2015 Jun 14.PMID: 26111434 Free PMC article.
Potter-Baker KA, Bonnett CE, Chabra P, Roelle S, Varnerin N, Cunningham DA, Sankarasubramanian V, Pundik S, Conforto AB, Machado A, Plow EB. A game of hide and seek: Is it possible to recruit more patients for NIBS studies in stroke? J Neurol Sci. 2015 Nov 15;358(1-2):472-4. doi: 10.1016/j.jns.2015.08.030. Epub 2015 Aug 21.PMID: 26320611 Free PMC article. No abstract available.
Cunningham DA, Varnerin N, Machado A, Bonnett C, Janini D, Roelle S, Potter-Baker K, Sankarasubramanian V, Wang X, Yue G, Plow EB. Stimulation targeting higher motor areas in stroke rehabilitation: A proof-of-concept, randomized, double-blinded placebo-controlled study of effectiveness and underlying mechanisms. Restor Neurol Neurosci. 2015;33(6):911-26. doi: 10.3233/RNN-150574. PMID: 26484700 Free PMC article.
Cunningham DA, Potter-Baker KA, Knutson JS, Sankarasubramanian V, Machado AG, Plow EB. Tailoring Brain Stimulation to the Nature of Rehabilitative Therapies in Stroke: A Conceptual Framework Based on their Unique Mechanisms of Recovery. Phys Med Rehabil Clin N Am. 2015 Nov;26(4):759-74. doi: 10.1016/j.pmr.2015.07.001. Epub 2015 Sep 9.PMID: 26522911 Free PMC article.
Gopalakrishnan R, Burgess RC, Plow EB, Floden DP, Machado AG.Early event related fields during visually evoked pain anticipation. Clin Neurophysiol. 2016 Mar;127(3):1855-63. doi: 10.1016/j.clinph.2015.11.019. Epub 2015 Dec 5. PMID: 26733321 Free PMC article.
Potter-Baker KA, Bonnett CE, Chabra P, Roelle S, Varnerin N, Cunningham DA, Sankarasubramanian V, Pundik S, Conforto AB, Machado AG, Plow EB. Challenges in Recruitment for the Study of Noninvasive Brain Stimulation in Stroke: Lessons from Deep Brain Stimulation. J Stroke Cerebrovasc Dis. 2016 Apr;25(4):927-37. doi: 10.1016/j.jstrokecerebrovasdis.2015.12.044. Epub 2016 Feb 2. PMID: 26851211 Free PMC article.
Potter-Baker KA, Varnerin NM, Cunningham DA, Roelle SM, Sankarasubramanian V, Bonnett CE, Machado AG, Conforto AB, Sakaie K, Plow EB. Influence of Corticospinal Tracts from Higher Order Motor Cortices on Recruitment Curve Properties in Stroke. Front Neurosci. 2016 Mar 8;10:79. doi: 10.3389/fnins.2016.00079. eCollection 2016 PMID: 27013942 Free PMC article.
Roelle S, Wang X, Siemionow V, Yue GH, Plow EB. Post-exercise depression following submaximal and maximal isometric voluntary contraction. Cunningham DA, Janini D, Wyant A, Bonnett C, Varnerin N, Sankarasubramanian V, Potter-Baker KA, Neuroscience. 2016 Jun 21;326:95-104. doi: 10.1016/j.neuroscience.2016.03.060. Epub 2016 Apr 4 PMID: 27058145 Free PMC article.
Battelli L, Grossman ED, Plow EB. Local Immediate versus Long-Range Delayed Changes in Functional Connectivity Following rTMS on the Visual Attention Network. Brain Stimul. 2017 Mar-Apr;10(2):263-269. doi: 10.1016/j.brs.2016.10.009. Epub 2016 Oct 19. PMID: 27838275 Free PMC article.
Machado AG, Plow EB.The effect of motor overflow on bimanual asymmetric force coordination. Cunningham DA, Roelle SM, Allexandre D, Potter-Baker KA, Sankarasubramanian V, Knutson JS, Yue GH, Exp Brain Res. 2017 Apr;235(4):1097-1105. doi: 10.1007/s00221-016-4867-2. Epub 2017 Jan 16. PMID: 28091708 Free PMC article.
Varnerin N, Mirando D, Potter-Baker KA, Cardenas J, Cunningham DA, Sankarasubramanian V, Beall E, Plow EB. Assessment of Vascular Stent Heating with Repetitive Transcranial Magnetic Stimulation. J Stroke Cerebrovasc Dis. 2017 May;26(5):1121-1127. doi: 10.1016/j.jstrokecerebrovasdis.2016.12.030. Epub 2017 Jan 20. PMID: 28117211
Sankarasubramanian V, Cunningham DA, Potter-Baker KA, Beall EB, Roelle SM, Varnerin NM, Machado AG, Jones SE, Lowe MJ, Plow EB. Transcranial Direct Current Stimulation Targeting Primary Motor Versus Dorsolateral Prefrontal Cortices: Proof-of-Concept Study Investigating Functional Connectivity of Thalamocortical Networks Specific to Sensory-Affective Information Processing. Brain Connect. 2017 Apr;7(3):182-196. doi: 10.1089/brain.2016.0440. PMID: 28142257 Free PMC article.
Lempka SF, Malone DA Jr, Hu B, Baker KB, Wyant A, Ozinga JG 4th, Plow EB, Pandya M, Kubu CS, Ford PJ, Machado AG. Randomized clinical trial of deep brain stimulation for poststroke pain. Ann Neurol. 2017 May;81(5):653-663. doi: 10.1002/ana.24927. PMID: 28380672
Sankarasubramanian V, Machado AG, Conforto AB, Potter-Baker KA, Cunningham DA, Varnerin NM, Wang X, Sakaie K, Plow EB. Inhibition versus facilitation of contralesional motor cortices in stroke: Deriving a model to tailor brain stimulation. Clin Neurophysiol. 2017 Jun;128(6):892-902. doi: 10.1016/j.clinph.2017.03.030. Epub 2017 Mar 21. PMID: 28402865 Free PMC article.
Potter-Baker KA, Janini DP, Lin YL, Sankarasubramanian V, Cunningham DA, Varnerin NM, Chabra P, Kilgore KL, Richmond MA, Frost FS, Plow EB. Transcranial direct current stimulation (tDCS) paired with massed practice training to promote adaptive plasticity and motor recovery in chronic incomplete tetraplegia: A pilot study. J Spinal Cord Med. 2018 Sep;41(5):503-517. doi: 10.1080/10790268.2017.1361562. Epub 2017 Aug 7. PMID: 28784042 Free PMC article.
Potter-Baker KA, Lin YL, Machado AG, Conforto AB, Cunningham DA, Sankarasubramanian V, Sakaie K, Plow EB. Variability of motor evoked potentials in stroke explained by corticospinal pathway integrity. Brain Stimul. 2018 Jul-Aug;11(4):929-931. doi: 10.1016/j.brs.2018.03.004. Epub 2018 Mar 9. PMID: 29563050 No abstract available.
de Araújo AVL, Ribeiro FPG, Massetti T, Potter-Baker KA, Cortes M, Plow EB, da Silva TD, Tonks J, Anghinah R, Magalhães FH, Fregni F, de Mello Monteiro CB. Effectiveness of anodal transcranial direct current stimulation to improve muscle strength and motor functionality after incomplete spinal cord injury: a systematic review and meta-analysis. Spinal Cord. 2020 Jun;58(6):635-646. doi: 10.1038/s41393-020-0438-2. Epub 2020 Feb 17. PMID: 32066873
Lin YL, Potter-Baker KA, Cunningham DA, Li M, Sankarasubramanian V, Lee J, Jones S, Sakaie K, Wang X, Machado AG, Plow EB. Stratifying chronic stroke patients based on the influence of contralesional motor cortices: An inter-hemispheric inhibition study. Clin Neurophysiol. 2020 Oct;131(10):2516-2525. doi: 10.1016/j.clinph.2020.06.016. Epub 2020 Jul 3. PMID: 32712080
Ferrari C, Fiori F, Suchan B, Plow EB, Cattaneo Z. TMS over the posterior cerebellum modulates motor cortical excitability in response to facial emotional expressions. Eur J Neurosci. 2021 Feb;53(4):1029-1039. doi: 10.1111/ejn.14953. Epub 2020 Sep 14. PMID: 32860302
Garcia JO, Battelli L, Plow E, Cattaneo Z, Vettel J, Grossman ED. Understanding diaschisis models of attention dysfunction with rTMS. Sci Rep. 2020 Sep 10;10(1):14890. doi: 10.1038/s41598-020-71692-6. PMID: 32913263 Free PMC article.
Fiori F, Plow E, Rusconi ML, Cattaneo Z. Modulation of corticospinal excitability during paintings viewing: A TMS study. Neuropsychologia. 2020 Dec;149:107664. doi: 10.1016/j.neuropsychologia.2020.107664. Epub 2020 Oct 29.PMID: 33130160
Ferrari F, Shell CE, Thumser ZC, Clemente F, Plow EB, Cipriani C, Marasco PD. Proprioceptive Augmentation With Illusory Kinaesthetic Sensation in Stroke Patients Improves Movement Quality in an Active Upper Limb Reach-and-Point Task. Front Neurorobot. 2021 Mar 1;15:610673. doi: 10.3389/fnbot.2021.610673. eCollection 2021. PMID: 33732129 Free PMC article.
Arora T, Potter-Baker K, O'Laughlin K, Li M, Wang X, Cunningham D, Bethoux F, Frost F, Plow EB. Measurement error and reliability of TMS metrics collected from biceps and triceps in individuals with chronic incomplete tetraplegia. Exp Brain Res. 2021 Aug 10. doi: 10.1007/s00221-021-06160-2. Epub ahead of print. PMID: 34374814.
Careers
Research News
The event celebrated early successes of a research joint venture between Cleveland Clinic and Cleveland Clinic Rehabilitation Hospitals, in partnership with Select Medical Network.
The novel therapy combination targets the uninjured hemisphere
