MRRI Director Dylan Edwards, PhD, is looking forward to collaborating with colleagues at the Medical University of South Carolina as they establish The National Center of Neuromodulation for Rehabilitation (NC NM4R) with funding recently awarded from the National Institutes of Health. The Medical University of South Carolina is a world-class institution with a history of excellence in education, research, and patient care spanning nearly 200 years. The NC NM4R will serve as a hub for generating and integrating new knowledge in the area of neuromodulation with a focus on how this knowledge can be used to enhance rehabilitation. The NC NM4R is one of six centers in the NIH Medical Rehabilitation Research Resource Network. This Center will provide important support for investigators using neuromodulation methods as research tools or potential treatments in rehabilitation.
Dr. Edwards is a renowned expert in applications of non-invasive brain stimulation in neurorehabilitation across a variety of patient populations, including stroke, cerebral palsy, and spinal cord injury. As a consultant on this NIH award, Dr. Edwards will share his expertise through NC NM4R lectures and workshops. A virtual workshop has been planned in which Dr. Edwards and other leaders in the field will discuss using transcranial magnetic stimulation (TMS) for motor mapping in neurorehabilitation. Motor mapping during rehabilitation can provide valuable insights on the control of movement and allow for more precise targeting of the application of neuromodulation therapies. Currently, there is no consensus within scientific and clinical communities regarding mapping protocols or analysis methods. In this upcoming workshop, Dr. Edwards plans to cover innovations in TMS mapping techniques that may inform how researchers and clinicians use motor mapping in rehabilitation research and practice.
Collaborations such as this provide valuable opportunities for MRRI scientists to share their expertise and connect with researchers at other top tier research institutions to make important contributions to the field of rehabilitation research.
MRRI provides exceptional training opportunities for early-career scientists through a postdoctoral research program funded by a National Institutes of Health T32 training grant in translational neurorehabilitation research. Marja-Liisa Mailend, Ph.D., is one of those scientists who recently completed her postdoctoral fellowship position at MRRI. We chatted with her to discuss her career, research, and experiences during her time at MRRI.
1) Can you tell us more about your current position and where you are now?
I am currently in a transition phase as my husband and I work to synchronize the next steps of our careers. Both of us are pursuing academic careers. It does not mean that I am bored – quite the opposite. I am continuing my research at MRRI on several projects and have started an exciting new collaboration with the Department of Speech and Hearing Sciences at the University of North Carolina.
2) How did you first get interested in rehabilitation research?
My undergraduate and Master’s degrees are in speech-language pathology. My interest in rehabilitation research came directly from realizing, through my studies and clinical placements, that there is a great need for a solid scientific basis for clinical work. I also discovered that I greatly enjoy the process of scientific thinking and conducting research.
3) Can you describe your academic background and the steps that led you to your fellowship at MRRI?
Deciding what to study after high school was hard for me. I knew that I wanted to continue my studies at a university, but considered vastly different fields from chemistry to psychology. Ultimately, I decided to pursue speech-language pathology and special education. The curriculum appealed to me because of its interdisciplinary nature; it covered subjects from philosophy and linguistics to anatomy and physiology. My young self also was hoping to become involved in a career that could make a difference in people’s lives. Speech-language pathology checked all the boxes.
The idea of pursuing research and doctoral studies never crossed my mind until suddenly it seemed like the most logical next step. In Estonia, where I completed my Bachelor’s and Master’s degrees, the final requirement for both of these degrees was a thesis. After completing my Bachelor’s thesis, I realized that working on my thesis had been the most exciting experience in my undergraduate studies. Discussing this with my advisor, he invited me to join a large research project. I was the youngest and the least experienced person on the team and, thus, had the most to learn. I worked on that project in parallel with my Master’s studies. After graduating, it was clear to me that I wanted to pursue a research career and needed to find a Ph.D. program to acquire the necessary knowledge and skills.
It is a complicated story that eventually led me from my little Northern home country of Estonia to the University of Arizona (UofA) located in the sunny and wonderful Sonoran Desert. The story does involve the world-class reputation of the Department of Speech, Language, and Hearing Sciences at UofA, excellent potential mentors, the love of my life for 14 years and counting, and probably a good amount of luck. I had the opportunity to work with and be mentored by some amazing scientists at UofA who effortlessly solidified my career choice and continue to inspire me today.
4) Why did you choose to conduct postdoctoral research at MRRI?
So many reasons drew me here: the outstanding and highly impactful aphasia research developed at MRRI, exceptional mentors, interest in experiencing a different setting apart from a university, integration with a world-class rehabilitation hospital at MossRehab, excellent resources (particularly in terms of participant recruitment, which can be a major obstacle in my line of work), and so much more.
5) What experiences or skills from your fellowship at MRRI do you think will be most important in your career going forward?
This is a difficult question. I have gained a very rich experience for launching the career in rehabilitation research that I want to pursue. I learned a lot, from the nuts and bolts of conducting rehabilitation research to the big picture issues in the field, which—as anyone in MRRI is ready to explain—is interestingly unique and different from its better-known cousin, pharmacological research. I have many more friends and colleagues within my profession compared to three years ago, when I started here, and I have been a part of the everyday life of two successful labs within a successful research institute. All sorts of skills and ideas seep through one’s clothes through active participation in an environment such as this.
6) What did you enjoy most about working at MRRI?
I enjoy the focus and collective enthusiasm for rehabilitation research. MRRI has a very collegial yet stimulating environment for research. The institute is filled with people who can, and happily do, sink their teeth into any rehabilitation research question. This pertains not only to scientists but to other staff members, such as clinicians and research assistants. The competence and enthusiasm of my colleagues make for very lively meetings and talks at MRRI. These experiences prepare you for whatever may come once outside the institute’s walls. At MRRI, many problems are solved informally simply by wandering into the kitchenette and talking to whoever is brewing their coffee or waiting for the microwave to announce lunch-time. In addition to the scientific community, it is the very capable administrative staff who make work at MRRI so enjoyable. The administrative staff typically addresses your problems before those problems even take shape. This supportive yet stimulating environment makes a difference because it is easy to feel lonely and stressed in this demanding line of work.
7) What was one of your most memorable moments at MRRI?
Quite a selection of moments rushes into my mind. One of them is seeing my first participant with aphasia in the first experiment that I set up at MRRI. I work on a phenomenon called speech entrainment, which refers to the act of speaking in synchrony with another person. Typical speakers are extremely good at performing this task. Remarkably, some people with aphasia, whose independent speech is very limited, also can produce much more speech under speech entrainment. It was fascinating to witness that phenomenon for the first time in person.
8) What is something you are working on now that you are really excited about?
Most of my career so far has focused on understanding acquired neurogenic communication disorders such as aphasia and apraxia of speech. The long-term goal is to find better, more effective ways to remediate aphasia and apraxia of speech. At MRRI, I have been able to take the next step towards this goal. My current study explores the possibility of using speech entrainment—the phenomenon previously described —to help people with aphasia and/or apraxia of speech improve their independent speech. We now know that speech entrainment helps many people with aphasia to produce more speech. Now, we want to know if practicing with entrainment will help them speak independently after practice when the entrainment support is removed.
9) Can you share some of the key findings from your research and the impacts your work may have on rehabilitation?
One key finding from my research is with the underlying mechanism of apraxia of speech – a speech disorder that affects the planning of speech movements. Speaking is an incredibly complex skill that involves many levels of processing from forming a thought to precisely-timed muscle contractions in the systems for articulation, phonation, and breath support. My research is focused on the operations that translate a verbal idea in a speaker’s mind into the physical movements that ultimately produce speech. Currently, we assume that this task is achieved via planning chunks called motor programs. Rather than planning each muscle contraction separately, we plan larger units that may correspond, for example, to a syllable in a person’s speech. My research has shown that while motor programs are largely intact in people with apraxia of speech and aphasia, the process of accessing them is impaired. This finding is important clinically because most current treatment approaches explicitly or implicitly assume that the motor programs are not intact in apraxia of speech and must be reestablished in the context of treatment. My research suggests that effective treatments should focus instead or in addition to the process of accessing and selecting the intended motor programs. The next question is how that can be achieved in a treatment context.
10) Can you tell us about some of your interests or hobbies outside of your research? These days I spend quite a bit of time playing in the sandbox, throwing little rocks in the stream, singing made-up songs, and collecting acorns – I am a mother to a two-year-old. I have also collected True American Experiences for quite some time. More recently, I have become a circular economy enthusiast, that is, I am fascinated with the ideas that envision our economy and everyday lives.
October was a busy and productive month for MRRI scientists. In addition to receiving three new grant awards from the Albert Einstein Society, our researchers presented oral and poster presentations at seven different national and international virtual conferences.
MRRI Director Dylan Edwards, PhD, presented a virtual seminar on combinatorial approaches in robotic rehabilitation at the World Congress for NeuroRehabilitation, and also served on a panel on biases in research and research funding at the American Medical Rehabilitation Providers Association Educational Virtual Conference and Expo.
Work on cognitive planning for action imitation from the laboratory of MRRI Associate Director Laurel Buxbaum, PsyD, was presented at the Neuromatch 3.0 online conference. In addition, new findings from Dr. Buxbaum’s group on audiovisual comprehension in people with aphasia was presented at the virtual meeting of the Society for the Neurobiology of Language.
Erica Middleton, PhD, served as an author on a poster presentation at the Society for the Neurobiology of Language that shared their recent data on the neural bases of conceptual combination in people with aphasia after stroke. Dr. Middleton also presented a poster at the virtual meeting of the Academy of Aphasia on how distributed practice and criterion level affect word retrieval in people with aphasia.
John Whyte, MD, PhD, participated in a variety of events at the recent American Congress of Rehabilitation Medicine (ACRM) virtual conference. He co-led a half-day course on the Rehabilitation Treatment Specification System (RTSS) and presented a symposium on how to use the RTSS to improve research design and the clinical implementation of research. Dr. Whyte also spoke about improving access to sleep apnea diagnosis for people with acute traumatic brain injury to maximize the outcomes of neurorehabilitation. In addition, he served as a panelist for the Women in Rehabilitation Science Symposium.
At the ACRM conference, MRRI Institute Scientist Umesh Venkatesan, PhD, presented research from his lab that examined the associations between the duration of post-traumatic amnesia and memory impairment in people with chronic moderate-to-severe traumatic brain injury. We are proud to announce that Dr. Venkatesan’s poster was chosen to receive the Brain Injury Interdisciplinary Special Interest Group Early Career Poster Award.
Amanda Rabinowitz, PhD, also spoke at ACRM as part of a symposium on best practice interventions for managing acutely confused patients during inpatient rehabilitation.
These virtual conferences provided valuable opportunities for MRRI scientists to share their work, hear more about studies conducted by researchers from around the world, generate new ideas, and reconnect with collaborators and colleagues.
A few months ago, we chatted with one of MRRI’s cherished research participants, Tyrone Ogburn. In the ten plus years since having a stroke, Tyrone has participated in several research studies, making him an ideal candidate not only to talk about how stroke affects one’s life but what it’s like to participate in research on the behavioral and neurological effects of stroke.
Almost thirteen years ago in March of 2008, Tyrone was living in Atlanta, Georgia. A few days after visiting his friends and family in Philadelphia for his birthday, he woke up not feeling well. When his mom came to wake him in his room, she could tell from their conversation that something was wrong. Thankfully, she convinced him to call an ambulance. Like many stroke survivors, the rest is hard for Tyrone to remember. At only 45 years old, Tyrone was in good health and working in the medical field as a Certified Nursing Assistant.
Moss Rehabilitation Research Institute Helped with Speech Problems
After his stroke, Tyrone was diagnosed with aphasia, a language disorder that affects a person’s ability to produce and/or understand speech. Tyrone spent months in therapy at MossRehab after his stroke to overcome this speech problems. That’s how he discovered the MossRehab Aphasia Center and Moss Rehabilitation Research Institute (MRRI) – and soon became a research participant in an aphasia study
Naming problems or having difficulty fluently producing words for common objects, familiar people’s names, and known places is almost always present in aphasia. That was the case for Tyrone. A recent language study in which Tyrone participated with MRRI involved practice-targeting his naming problems. The study, conducted by the Language and Learning Lab and directed by MRRI Institute ScientistDr. Erica Middleton, identifies what kinds of naming practice promote the strongest, longest-lasting improvements in naming ability across a large group of people with aphasia. By studying individuals like Tyrone in a large group of people, the study will improve MossRehab’s understanding about which kind of person with aphasia benefits most from which kind of naming treatment.
Research Helps Tyrone Help Other Stroke Victims
When asked why he decided to participate in research after his stroke, Tyrone said, “I want somebody else to know that if I can do it, someone else can too.” Tyrone talks about how much research helped him express his feelings when he was still unable to communicate effectively after his stroke. He further explained how the patience and understanding of everyone in his first study encouraged him to continue volunteering for new research opportunities.
Tyrone said, “I wanted to do it again because it’s a really good purpose for the speech problems”.
While Tyrone’s interests in research are mostly language-related because of his aphasia diagnosis, he has participated in many other MRIII research studies. Last year Tyrone was a participant in an ongoing study in the Neuroplasticity and Motor Behavior Lab directed by MRRI Institute ScientistDr. Shailesh Kantak. This study is examining how stroke can affect upper limb coordination. He also completed a study in the Cognitive Motor Learning Lab directed by MRRI Institute ScientistDr. Aaron Wong thataims to determine how people use visual information versus sensations to guide movements.
Tyrone Encourages Family Members to Participate in Research
Tyrone has valued his research participation so much that when his aunt suffered a stroke last year, he encouraged her enrollment in our Research Registry. When Tyrone isn’t volunteering his time to participate in research, he enjoys a variety of fulfilling activities. He loves taking his dog, Sadie, to nearby parks and walking around their neighborhood in South Philadelphia. In addition, he likes to explore local flea markets and shops as well as having cookouts with his friends and family. Research participants like Tyrone are critical for our mission at MRRI to improve the lives of individuals with neurological disabilities through research. We value the time and commitment of all of the volunteers who contribute to MRRI research and appreciate the opportunities to share our research with these individuals and their families.
