2022 Summer Edition

Featured Researcher

Dr. Barbuto, MD PhD, is an Assistant Professor in the Physical Medicine and Rehabilitation Department at Columbia University Medical Center. Dr. Barbuto obtained his undergraduate degree from Bowdoin College, MD from Weill Cornell Medical College, and PhD from Rockefeller University. He completed his internship in Medicine at Mount Sinai Beth Israel and his residency at New York Presbyterian Cornell-Columbia. After graduating residency, he completed a one-year fellowship in neurorehabilitation focusing on the treatment of individuals with stroke, movement disorders, cerebral palsy, and multiple sclerosis.

His research focuses on spinocerebellar ataxias and the effects of exercise. His initial studies depicted that rigorous aerobic training was acceptable to individuals with spinocerebellar ataxias; both retention to the exercise program and adherence to training was high. Dr. Barbuto then devised a phase I randomized controlled trial comparing home balance to aerobic training. Individuals in each group were asked to train for 30 minutes per day, 5 times a week for 1-month. Although a small study with 10 individuals randomized to each training group, results demonstrated those in the aerobic group had more improvement in ataxia symptoms than those in the balance group. At the three-month follow-up assessment, results showed that improvements in ataxia symptoms declined back to baseline for individuals who stopped training.

Funded by the National Center for Advancing Translational Sciences through Grant Number KL2TR001873under the mentoring of Dr. Yaakov Stern, Dr. Joel Stein, Dr. Michael O’Dell, and Dr. Sunil Agrawal, Dr. Barbuto moved on to a phase II study comparing home balance to aerobic training. Compared to the initial study, this study had a larger enrollment, 36 subjects, and training time was extended from 1-month to 6-months. Similar to the preliminary work, retention in the study was high (89% for aerobic training, 82% for balance training), and adherence to training protocols for both groups was over 70%. There were no serious adverse events caused by the home training in either group, and training was not interrupted by minor adverse events such as back pain and minor falls. Results indicated that the aerobic training group had a statistically and clinically significant improvement in ataxia symptoms when compared to the balance group.

For his next study, funded by the National Institute of Neurological Disorders and Stroke through grant K23NS121518, Dr. Barbuto will try to determine how the aerobic training improves ataxia symptoms in individuals with spinocerebellar ataxias. Does the training allow for better compensation for deficits, or does the training lead to neuroplastic changes in the brain that slow disease progression? To answer this question, Dr. Barbuto will be using high resolution MRI scans to investigate changes within the brain structure after training. Eventually, Dr. Barbuto hopes to conduct a phase III trial using aerobic training as a treatment for these disabling diseases