.jpg)
Researcher/Professor
University of Colorado School of Medicine
BIOGRAPHICAL SKETCH
NAME: Andrew C. Smith, PT, DPT, PhD
eRA COMMONS USER NAME (credential, e.g., agency login): ANDREWSM8
POSITION TITLE: Primary Mentor; Co-investigator
EDUCATION/TRAINING:
University of Washington, Seattle, WA USA B.A. 06/2005 Psychology
University of Washington, Seattle, WA USA D.P.T 06/2008 Physical Therapy
Northwestern University, Chicago, IL USA Ph.D. 09/2016 Neuroscience
A. Personal Statement
My background as both a clinical physical therapist working with people who have sustained spinal cord injury (SCI), as well as a researcher investigating SCI for the past 12 years, makes me particularly well-suited to serve as Dr. Thornton’s primary mentor for this proposed research. I am the director of the Spinal Cord Injury Research Laboratory at the University of Colorado Anschutz Medical Campus. I utilize magnetic resonance imaging (MRI) techniques to investigate the extent of SCI and its impact on motor and sensory function. Our laboratory’s recent findings demonstrate strong potential for MRI biomarkers to be used to predict a return of function, as well as identify responders to particular recovery interventions. The ultimate goal of this research proposal is to improve the clinical management of individuals with SCI. I am excited to work with Dr. Thornton in this endeavor to find answers that have the potential to optimize the recovery of this patient population.
A relevant, recently completed project that I would like to highlight is:
R03 HD094577 Smith (PI) 02/2019-01/2021
MRI and Machine Learning to Improve Early Prognosis and Clinical Management After Spinal Cord Injury.
This study proposes to explore the use of advanced spinal cord magnetic resonance imaging techniques and machine learning to predict specific sensory-motor function following spinal cord injury.
Role: Principal Investigator
Relevant Publications related to the research project (selected out of 40):
1. Tefertiller C, Rozwod M, VandeGriend E, Bartelt P, Sevigny M, Smith AC. Transcutaneous electrical spinal cord stimulation to promote upper and lower extremity recovery in chronic spinal cord injury. Frontiers in Rehabilitation Sciences. 2022. doi: 10.3389/fresc.2021.740307.
2. Smith AC, Angeli CA, Ugiliweneza B, Weber KA, Negahdar M, Mesbah S, Boakye M, Harkema SJ, Rejc E. Spinal cord imaging markers and recovery of standing with epidural stimulation in individuals with clinically motor complete spinal cord injury. Experimental Brain Research. 2022;240(1):279-288.
3. Rejc E, Smith AC, Weber KA, Ugiliweneza B, Bert RJ, Negahdar M, Boakye M, Harkema SJ, Angeli CA. Spinal cord imaging markers and recovery of volitional leg movement with spinal cord epidural stimulation in individuals with clinically motor complete spinal cord injury. Frontiers in Systems Neuroscience. 2020; 14:559313. PMCID: PMC7654217.
B. Positions, Scientific Appointments, and Honors
Positions and Employment
2008-2009 Physical Therapist, Infinity Rehab, Spokane and Seattle, WA, USA
2009-2010 Physical Therapist, Harborview Medical Center, Seattle, WA, USA
2010-2012 Research Physical Therapist, Rehabilitation Institute of Chicago, IL, USA
2012-2014 Graduate Student, Northwestern University Interdepartmental Neuroscience Program, Chicago,
IL, USA
2013-2016 Instructor/Lecturer, Northwestern University Department of Physical Therapy and Human
Movement Sciences, Chicago, IL, USA.
2014-2016 PhD Candidate, Northwestern University Interdepartmental Neuroscience Program, Chicago,
IL, USA
2016-2020 Assistant Professor, Regis University School of Physical Therapy, Denver, CO, USA
2020- Assistant Professor, University of Colorado School of Medicine Department of Physical
Medicine and Rehabilitation, Denver, CO, USA
Other Experience and Professional Memberships
2005- American Physical Therapy Association (APTA) Member
2005-2008 University of Washington Doctor of Physical Therapy Class President
2014-2015 Northwestern University Searle Teaching Certificate Program
2016- APTA Orthopaedic Section Imaging Special Interest Group Member
2016- Licensed Physical Therapist, State of Colorado, DORA, Division of Professions and
Occupations, PTL.0014215
2018- APTA Academy of Neurologic Physical Therapy Spinal Cord Injury Special Interest Group
2018- Colorado RSVP Clinic (Craig Hospital) Pro Bono Physical Therapist and Research Board
2021- Colorado RSVP Clinic Executive Board
Honors
2004-2005 Psy Chi International Honor Society in Psychology Member
2004-2005. University of Washington Mortar Board Scholar
2008 American Physical Therapy Association Minority Award for Excellence Recipient ($6000, 1 year
award)
2009 Infinity Rehab Shining Star Award Recipient
2012 Foundation for Physical Therapy Florence Kendall Doctoral Scholarship Recipient ($5000, 1
year award)
2014 Foundation for Physical Therapy Promotion of Doctoral Studies I Recipient ($7500, 1 year
award)
2015 Invited Speaker. Northwestern University Department of Physical Therapy and Human
Movement Sciences Grand Rounds seminar. Chicago, IL USA
2015-2016 Foundation for Physical Therapy Promotion of Doctoral Studies II Recipient ($15000, 1 year
award)
2015-2016 Foundation for Physical Therapy Mary Lou Barnes Award
2016 Invited Speaker. American Physical Therapy Association Combined Sections Meeting. Anaheim, CA USA
2016 Invited Speaker. Rehabilitation Institute of Chicago’s Spinal Cord Injury Symposium. Chicago, IL USA.
2017 Invited Speaker. American Physical Therapy Association Combined Sections Meeting. San Antonio, TX USA 2017
2017 Invited Speaker. APTA Colorado 2017 Rocky Mountain Fall Symposium. Keystone, CO USA 2017
2018 Invited Speaker. American Physical Therapy Association Combined Sections Meeting. New Orleans, LA USA 2018
2019 Invited Speaker, Shirley Ryan Ability Lab Spinal Cord Injury Symposium. Chicago, IL USA 2019
2019 Invited Speaker, American Physical Therapy Association Colorado Fall Conference. Denver,
CO USA 2019
2020 Invited Speaker, Academy of Spinal Cord Injury Professionals Annual Conference. Virtual, USA
2021 Invited Speaker, University of Colorado School of Medicine Department of Physical Medicine
and Rehabilitation Grand Rounds. Aurora, CO USA 2021
2021 2021 APTA Academy of Neurologic Physical Therapy Spinal Cord Injury SIG Research Award
2022 Invited Speaker, Shirley Ryan Ability Lab 45th Interdisciplinary Spinal Cord Injury/Disease Course
2022 American Spinal Injury Association Translational Research or Human Neuroscience Studies in Spinal Cord Injury (TRoHNS) Award
2021-2022 Comprehensive Opportunities in Rehabilitation Research Training (CORRT) Scholar
2022 Jayanthi Lectureship Recipient, Academy of Spinal Cord Injury Professionals
2022-2025 Boettcher Foundation Webb-Waring Biomedical Research Award
C. Contributions to Science
1. My R03-funded research uses advanced spinal cord magnetic resonance imaging techniques to characterize spinal cord damage to predict long-term functional outcomes. This research project aims to improve the prognosis and early hospital management of individuals who have incurred a spinal cord injury. The objective, early, and accurate prediction of functional recovery will maximize future rehabilitative efforts. My team has published five manuscripts from this work.
a. Smith AC, Albin SR, O’Dell DR, Berliner JC, Dungan D, Sevigny M, Draganich C, Elliott JM, Weber KA. Axial MRI biomarkers of spinal cord damage to predict future walking and motor function: A retrospective study. Spinal Cord. 2020. doi:10.1038/s41393-020-00561-w.
b. Smith AC, O’Dell DR, Albin SR, Berliner JC, Dungan D, Robinson E, Elliott JM, Carballido-Gamio J, Stevens-Lapsley J, Weber KA. Lateral corticospinal tract and dorsal column damage: predictive relationships with motor and sensory scores at discharge from acute rehabilitation after spinal cord injury. Archives of Physical Medicine and Rehabilitation. 2021;S0003-9993(21)01345-9. doi: 10.1016/j.apmr.2021.07.792. Online ahead of print.
c. Berliner JC, O’Dell DR, Albin SR, Dungan D, Sevigny M, Elliott JM, Weber KA, Abdie DR, Anderson JS, Rich AA, Seib CA, Sagan HGS, Smith AC. The influence of conventional T2 MRI indices in predicting who will walk outside one year after spinal cord injury. Journal of Spinal Cord Medicine. 2021. doi: 10.1080/10790268.2021.1907676.
d. O’Dell DR, Weber KA, Berliner JC, Connor JR, Cummins DP, Heller KA, Hubert JS, Kates MJ, Mendoza KR, Elliott JM, Smith AC. Midsagittal tissue bridges are associated with walking ability in incomplete spinal cord injury: a magnetic resonance imaging case series. Journal of Spinal Cord Medicine. 2020;43(2):268-271. PMCID: PMC7054908.
2. My work with the R01 project, Neuromuscular Mechanisms Underlying Poor Recovery from Whiplash, involved manual segmentation of deep extensor musculature of the cervical spine, as well as lower extremity musculature, in patients status post whiplash injury using Dixon fat/water MRI. Our team then used these measures to develop a convolutional neural network to automatically segment the muscles of interest and quantify their volumes and magnitude of muscle fat infiltration. We found that both the human and artificial intelligence measures were related to clinical outcomes in these patients.
a. Weber KA, Smith AC, Wasielewski M, Eghtesad K, Upadhyayula PA, Wintermark M, Hastie TJ, Parrish TB, Mackey S, Elliott JM. Deep learning convolutional neural networks for the automatic quantification of muscle fat infiltration following whiplash injury. Nature Scientific Reports. 2019;9(1):7973. PMCID: PMC6538618
b. Smith AC, Albin SR, Abbott R, Crawford RJ, Hoggarth MA, Wasielewski M, Elliott JM. Confirming the geography of fatty infiltration in the deep cervical extensor muscles in whiplash recovery. Nature Scientific Reports. 2020;10,11471. https://doi.org/10.1038/s41598-020-68452-x. PMCID: PMC7351986
c. Weber KA, Abbott R, Bojilov V, Smith AC, Wasielewski M, Hastie TJ, Parrish TB, Mackey S, Elliott JM. Multi-muscle deep learning segmentation to automate the quantification of muscle fat infiltration in cervical spine conditions. Nature Scientific Reports. 2021;11,16567. https://doi.org/10.1038/s41598-021-95972-x.
3. My PhD thesis’ final aim involved the utilization of magnetic resonance imaging to examine the relationships between spinal cord damage and motor output in individuals with motor incomplete spinal cord injury (iSCI). The purpose of our study was to establish the correlational value of axial spinal cord edema using T2-weighted MRI. We hypothesized a direct relationship between the size of damage on axial MRI and walking ability, motor function and distal muscle changes seen in iSCI. We found that spinal cord damage was negatively correlated with walking ability, average daily strides and motor output, and that specific descending motor regional damage was associated with reduced function in an ipsilesional manner. Our findings motivated this current research project to apply these imaging techniques to a larger patient population, using a retrospective design, with the overall goal of improving the prognosis and clinical management of patients with spinal cord injury.
a. Smith AC, Weber KA, Parrish TB, Hornby TG, Tysseling VM, McPherson JG, Wasielewski M, Elliott JM. Ambulatory function in motor incomplete spinal cord injury: A magnetic resonance imaging study of spinal cord edema and lower extremity muscle morphometry. Spinal Cord. 2017;55:672-678. PMCID: PMC5501756
b. Smith AC, Weber KA, O’Dell DR, Parrish TB, Wasielewski M, Elliott JM. Lateral corticospinal tract damage correlates with motor output in incomplete spinal cord injury. Archives of Physical Medicine and Rehabilitation. October 2017. doi:10.1016/j.apmr.2017.10.002. PMCID: PMC5871547
c. Smith AC, Knikou M, Yelick KL, Alexander AR, Murnane MM, Kritselis AA, Houmpavlis PJ, McPherson JG, Wasielewski M, Hoggarth MA, Elliott JM. MRI measures of fat infiltration in the lower extremities following motor incomplete spinal cord injury: reliability and potential implications for muscle activation. Conf Proc IEEE Eng Med Biol Soc. 2016: 5451-5456.
4. This project was the initial study of my PhD thesis. It was necessary to establish the level of reliability of muscle-fat magnetic resonance imaging (MRI) across different scanner strengths, as well as to establish validity of this imaging technique by comparing to the gold standard, muscle biopsy. Two different samples or skeletal muscle tissue (porcine and leporine species) were utilized. Specifically, this project presented the preliminary work underpinning the development of the MRI measures for quantifying muscular fat in the neck and lower extremity muscles of human participants. Our results suggested that a 2-point Dixon fat/water separation MRI technique may provide reliable quantification of muscle fat infiltration at varying field strengths across different animal species, and consistency was established with biopsy. The results set a foundation for larger scale investigation of quantifying muscle-fat in neuromuscular disorders.
a. Smith AC, Parrish TB, Abbott R, Hoggarth MA, Mendoza K, Chen YF, Elliott JM. Muscle-fat magnetic resonance imaging: 1.5 Tesla and 3.0 Tesla versus histology. Muscle and Nerve, 2014;50:170-176. PMCID: PMC6778690
5. The purpose of this project was to establish the mechanisms and the changes of specific spinal neuronal pathways underlying recovery of walking and sensorimotor function following intensive treadmill training in people with a spinal cord injury. I served as the lead research physical therapist at this laboratory and was responsible evaluating and training participants with spinal cord injury in step training using a robotic exoskeleton device. Additional responsibilities included EMG data reduction, electrophysiology and spinal reflex tests, data analysis, scientific writing, and research presentation.
a. Smith AC, Knikou M. A review on locomotor training after spinal cord injury: reorganization of spinal neuronal circuits and recovery of motor function. Neural Plasticity, 2016:1216258. PMCID: PMC4879237
b. Smith AC, Rymer WZ, Knikou M. Locomotor training modifies soleus monosynaptic motoneuron responses in human spinal cord injury. Experimental Brain Research, 2015; 233:89-103. PMCID: PMC4441795
c. Smith AC, Mummidisetty CK, Rymer WZ, Knikou M. Locomotor training alters the behavior of flexor reflexes during walking in human spinal cord injury. Journal of Neurophysiology, 2014;112:2164-2175.
d. Smith AC, Mummidisetty CK, Rymer WZ, Knikou M. Effects of mechanical vibration of the foot sole and ankle tendons on cutaneomuscular responses in man. Neuroscience Letters, 2013: 545:123-126.
Complete List of Published Work in MyBibliography: https://www.ncbi.nlm.nih.gov/myncbi/1l581LQVlowkn/bibliography/public/