Meet MRRI Postdoctoral Fellow Haley Dresang

Haley standing next to an MRI image of a brain.

Haley Dresang, PhD, joined Moss Rehabilitation Research Institute (MRRI) as a Postdoctoral Fellow in August of 2020. Since then she has been working with MRRI Associate Director Laurel Buxbaum, PsyD, and Roy H. Hamilton, MD, MS, Associate Professor at The University of Pennsylvania on a project investigating the use of gestures and brain stimulation to enhance language in people after stroke. In this interview, she shares more about her career, her research interests, and how she spends her time outside of the lab.

1) Can you tell us more about your academic background and training?

I began in academia studying neurobiology and Spanish as a pre-medical student at the University of Wisconsin-Madison. I volunteered in a cellular neuroscience lab for a year, but I was eager to have more direct work with patients. Then I joined the lab of Lyn Turkstra, PhD, where I had the opportunity to research cognitive and communication impairments in patients living with traumatic brain injury. For me, this was the perfect coalescence of neuroscience, linguistics (I have always loved languages.), and patient care.

I went on to earn my PhD in communication science and disorders at the University of Pittsburgh with a concentration in neuroscience from the Center for the Neural Basis of Cognition at Carnegie Mellon University. During my doctoral studies, my work centered on aphasia, which is a communication disorder following brain damage such as stroke or neurodegenerative disease. My mentor, Mike Dickey, PhD, provided me opportunities to work across multiple institutions and departments, including cognitive psychology (Tessa Warren, PhD), the VA Pittsburgh Medical Center (Will Hula, PhD), and neurosurgery at the University of Pittsburgh Medical Center (UPMC; Frank Yeh, MD, PhD). My research has developed from this multidisciplinary training, with a specific focus on elucidating how undamaged brain systems can be leveraged to improve function following neurological injury.

2) What attracted you to the field of neurorehabilitation?

I have had chronic migraines since age 12, and this condition has involved a long journey of auras, medication resistance, side effects, and neurology visits. Through this experience, I became fascinated by how little is known about the human brain. I also learned about the challenges and stigmas associated with neurological conditions, which are often considered “invisible illnesses.” Working in the field of neurorehabilitation enables me to feed my curiosity about the brain and to help others, while working toward improving disparities in medicine.

3) Why did you decide to work at MRRI?

The NIH-funded T32 postdoctoral fellowship provides a terrific training program, including seminars and workshops specifically designed for early-career researchers in translational neuroscience and neurorehabilitation. The shared environment between the University of Pennsylvania (Penn, where I hold my primary position) and MRRI offers me a unique opportunity where I can work across multiple disciplines with neuroscientists, neurologists, cognitive scientists, speech-language pathologists, and motor scientists. I admire the patient-centered work done at MRRI, and I look forward to joining the impressive group of scholars who have completed this T32 program.

4) What are some of the things you hope to learn or skills you hope to develop as a postdoc?

One of my goals is to work with patients with a variety of neurological disorders that affect cognition and communication. Over the past year, I have had the opportunity to research conditions including post-stroke aphasia, limb apraxia, primary progressive aphasia, Alzheimer’s disease, and Parkinson’s disease. Another goal I have is to develop expertise in neuroplasticity. I am learning different forms of non-invasive brain stimulation (NIBS) and the specific ways in which they can alter brain activity in service of rehabilitation. I have also gained experience in analyzing NIBS data along with neurophysiological and genetic biomarkers of neuroplasticity to improve our understanding of language recovery following strokes. (A preprint of that research is available here.) The goal I am working toward next is writing a grant proposal that will facilitate my transition to becoming an independent investigator.

5) Can you tell us more about a research project you are currently working on?

I am involved in many research projects through Penn, MRRI, and various collaborations. One new project I am leading will integrate multimodal gesture cues with non-invasive brain stimulation to investigate how activating undamaged semantic brain networks can help stroke patients with aphasia find and produce words more effectively. Read more about this project here.

6) What are the potential impacts your work may have in terms of future research and patient care?

My work makes contributions toward understanding how the human brain recovers from injury to support language, memory, and action. This research can inform prognostics for functional recovery and facilitate the development of precision medicine approaches in rehabilitation by improving predictions of which patients will respond best to different types of treatment.

My work also provides evidence for how patients may adapt to rely more heavily on relatively undamaged cognitive systems to improve both language and movement. This can guide development of neurorehabilitation strategies that target ancillary cognitive systems, like semantic memory (one’s general knowledge about the world). Finally, my work also includes development of novel assessment measures, which provide new tools for researchers and clinicians to help detect the presence and impacts of specific impairments across many patient populations.

7) Can you describe some of the challenges you have faced in your research or your career?

I know I’m not alone in saying that COVID-19 presented numerous challenges for me, both personally and professionally. I completed my PhD, moved to a new city, started my postdoc, and became a primary caregiver during the pandemic. Despite these challenges, I received great support from my colleagues, and I managed to make meaningful progress on a number of research projects this past year.

8) What have been some of your most memorable experiences in your first year at MRRI?

I have really grown from meeting new people through MRRI. There is an inspiring community of postdoc fellows, who have helped me navigate the pandemic, provided me with project feedback, and enhanced my professional development. I have also met many scientists and clinicians through virtual meetings and events. It is wonderful to learn different perspectives from such a diverse set of experts. Moving forward, I am particularly excited to work on a new project with an international group of female clinician-scientists led by Drs. Laurel Buxbaum and Gabriella Vigliocco, PhD, who is a Scientist in Residence at MRRI.

9) What are your long-term career goals?

My overarching career goal is to advance scientific understanding of brain-behavior relationships and to translate this information to improve clinical medicine and rehabilitation. To achieve this goal, I aim to be a researcher or professor in an environment with strong connections between medical, academic, and scientific research teams. I believe that multidisciplinary collaborations are essential to advancing translational neuroscience and neurorehabilitation, and I relish opportunities to learn new and diverse perspectives.

10) How do you like to spend your time when you’re not working?

I have been out exploring Philadelphia a lot! I love taking long walks to explore the many parks, markets, museums, coffee shops, and restaurants around the city. I try to do something active and/or creative every day. Some of my hobbies include painting, photography, playing piano, reading, song writing, yoga, and trying new ways to work out – kickbox Tabata, barre, and Latin dancing are some of my current favorites. Finally, I am very excited to start traveling when it is safe again!

MRRI Scientist in Residence Gabriella Vigliocco Featured in a New Podcast Interview

As a Scientist in Residence, Gabriella Vigliocco, PhD, has collaborated with scientists at Moss Rehabilitation Research Institute (MRRI) on a variety of research projects focused on language and cognition. Dr. Vigliocco was recently invited to discuss her research, her career, and her life in an episode of the People Behind the Science podcast.

During the interview Dr. Vigliocco spoke with podcast host Marie McNeely, PhD, about an exciting ongoing study in which she is characterizing language development and language comprehension in face-to-face social interactions. We also learned more about her scientific journey, starting in a small village in rural Italy where she grew up. Dr. Vigliocco also shared her passion for cooking, reading science fiction and fantasy books, and other interests outside of science.

Dr. Vigliocco is currently Professor of Psychology and Language Sciences in the Department of Experimental Psychology at University College London where she directs the Cognition and Language Laboratory.

You can listen to the full interview and learn more about Dr. Vigliocco on the People Behind the Science website.

MRRI Receives NIH Grant to Study Apraxia and Potential Pathways to Target in Rehabilitation

The athletic prowess seen in sporting events like the Olympics and the musical skills demonstrated at concerts highlight the amazing variety and complexity of skillful behaviors that humans are capable of producing. These and many other actions performed throughout daily life rely on at least two critical abilities. The first is the ability to quickly learn new behaviors through imitation. For example, when learning to dance, people often watch an instructor demonstrate a move and then attempt to copy it. Humans have a remarkable ability to imitate others, even without ever having seen a particular movement before. With this ability, people don’t have to spend a long time trying different actions to figure out how to successfully accomplish a task. The second critical ability is the use of tools such as hammers and saws, sporting equipment, musical instruments, and so forth. Tools increase the number of ways that individuals can influence their environments, helping them accomplish a much wider range of things than might otherwise be possible. However, tools are only helpful to people if they have the ability to properly manipulate the tools to achieve their desired effects.

Although on the surface imitation and tool use seem like two very different abilities, they are surprisingly related to each other. Their relationship is highlighted by the observation that losing the ability to imitate and to use tools are the two hallmark impairments of a neurological disorder known as limb apraxia. Limb apraxia can be observed in many common neurological disorders such as Parkinson’s disease, Alzheimer’s disease, and Autism Spectrum Disorder, although it is most commonly studied in individuals who have had a stroke on the left side of their brain. In fact, apraxia can be detected in roughly 50% of people who have a left-hemisphere stroke (about 200,000 people each year in the United States). Apraxia is unusual because although it affects the ability to move, it cannot be explained by the typical underlying movement problems, like muscle weakness or paralysis, that are commonly observed after a stroke – particularly as apraxic impairments can be detected on the less affected side of the body. Despite that, the presence of apraxia is one of the best indicators of poor recovery and caregiver reliance after experiencing a stroke. Unfortunately, understanding exactly what the problem is, and why imitation and tool use are the two abilities specifically affected, remains a puzzle despite over 100 years of investigation into this disorder.

Eight years ago, Dr. Aaron Wong, Dr. Laurel Buxbaum, and Dr. John Krakauer realized that a new approach would greatly benefit our understanding of apraxia. Although apraxia is a disorder that resides somewhere along the spectrum between high-level cognition and low-level control of movement, it had until that point rarely been studied by neuroscientists with a primary background in investigating the control of movement. This unfortunately had resulted in theories about apraxia that were somewhat disconnected from current views about the way in which the brain actually plans and controls movements. By combining the expertise of individuals who study apraxia with those who study the neuroscience of movement, it would be possible to develop a more comprehensive and contemporary understanding of apraxia.

This approach has culminated in the recent receipt of a five year, $2.2 million grant from the National Institutes of Health (NIH) to conduct a series of studies testing a novel theory about what might have gone awry in individuals with apraxia. This grant is being led by Dr. Wong, Director of the Cognitive-Motor Learning Laboratory at Moss Rehabilitation Research Institute (MRRI). MRRI Associate Director Dr. Buxbaum, and long-time collaborators Dr. Krakauer at Johns Hopkins University and Dr. Branch Coslett at the University of Pennsylvania, will contribute to the project as co-investigators. The novel theory proposed by these investigators posits that part of the difficulty in nailing down the specific problem caused by this disorder is because individuals may actually plan imitation and tool-use movements in two distinct ways. First, people can specify how to move various parts of their body relative to each other. For example, tennis coaches sometimes tell their players to focus on where their elbow is positioned relative to their hand during a tennis serve. Alternatively, people can plan the desired motion of their hand as it moves through space, without also worrying about the motion of the rest of the arm. For example, a tennis player might instead focus on producing a smooth arcing motion of the racket as it moves to hit the ball. Dr. Wong’s recent work has not only shown that people are able to use these two distinct strategies when preparing a movement, but also that impairments when imitating bodies or motion paths are associated with strokes to different parts of the brain.

Dr. Wong’s team will test their new theory using a variety of tools including carefully measuring the behavior of individuals with left-hemisphere strokes, as well as examining the specific locations in the brain that may be responsible for these impairments using state-of-the-art lesion-symptom mapping techniques as well as transcranial magnetic stimulation. Experiments to test this theory for imitation are currently underway, and Dr. Wong is looking forward to expanding this work to study tool-use abilities in early 2022. If borne out, this research will lay the groundwork for developing new rehabilitation approaches that could train people to leverage the movement strategy that is less affected by the stroke (that is, by focusing on whole-arm positions versus hand paths) in order to overcome imitation and tool-use impairments. This NIH-funded study illustrates MRRI scientists’ expertise in developing innovative theory-driven research projects with the long-term goal of improving clinical treatments in neurorehabilitation.

MossRehab Aphasia Center Featured in WHYY in Segment on Language

Recently, public radio station WHYY broadcast a segment taking a deep look at different aspects of language. They interviewed experts to shed light on the process of language learning and what happens when a person’s ability to communicate is disrupted.

Aphasia is an acquired language impairment that commonly affects people after stroke. People with aphasia may have challenges in remembering and expressing words. More than two million Americans are affected by aphasia, and the MossRehab Aphasia Center is a world class center dedicated to meeting the long-term communication and psychosocial needs of people with aphasia.

In this radio segment, expert clinicians and scientists including MossRehab’s Karen R. Cohen, MSPA, CCC-SLP, and Sharon Antonucci, PhD, CCC-SLP, share their expertise.

You can listen to the full story on WHYY’s website.

A History of Pioneering Research and Clinical Care for People with Aphasia

Since opening its doors in 1996 as the third aphasia center in North America, MossRehab Aphasia Center has been a leader in aphasia rehabilitation. In recognition of National Aphasia Awareness Month, we are pleased to highlight the exceptional contributions of the Center.

The MossRehab Aphasia Center has been a pioneer in developing and implementing programs to address the long term communication and psychosocial needs of those living with aphasia (Fink & Schwarz, 2000). An early adopter of the Life Participation Approach to Aphasia (Chapey et al., 2001), the work of the Center has always been guided by several foundational principles:

  • Recovery from aphasia involves a life-long process of re-education, adaptation, and support.
  • Under the right conditions, people with aphasia can continue to recover even years after the onset of aphasia.
  • Participating in social, recreational, and educational activities reduces isolation and helps people with aphasia and their families make psychosocial adjustments.
  • Individuals with aphasia and their families can play an important role in increasing public awareness of aphasia.

Through the collaboration of founding directors, Myrna Schwartz, PhD (research director), and Ruth Fink, MA, CCC-SLP (clinical director), the Center has always been a place in which the convergence of scholarly and clinical innovation is the norm, a trajectory that continues today.

Through the integration of the Aphasia Activities Center, the Advanced Clinical Therapy Program, and ongoing aphasia rehabilitation research, the Center supports the continuum of communication needs of people with aphasia and their families. Access to cutting edge treatment has been brought into the homes and communities of those with aphasia, through early adoption of technology and through ‘outside the box’ approaches to targeting the psychosocial consequences of aphasia.  

Aphasia Activities Center

Social interaction facilitates rehabilitation. The Activities Center provides a variety of opportunities for engagement and conversation, activities that are therapeutic and life-enhancing. Group activities including Constance Sheerr-Kittner Conversation Cafés, Talking Book Club, and Reta’s Games Groups provide not only for practicing communication, but perhaps even more critically, for building friendships. Computer lab, technology workshops, and online resources such as the Aphasia Center Blog and library of video resources expand the reach of the Center beyond the space and provide additional ways for members to reach out into their communities.

The Advanced Clinical Therapy (ACT) Program

ACT is a specialized outpatient program bringing up-to-the-minute aphasia rehabilitation research into a clinical setting. Clinicians use this cutting edge research and computer technology to design a program for each individual that emphasizes effective home practice routines using computers whenever possible.

Aphasia Rehabilitation Research: Innovative Treatments

Scientific and clinical collaborations at the MossRehab Aphasia Center have facilitated the development of novel treatments, informed by cognitive neuropsychology and psycholinguistics, as well as by a person-centered approach to rehabilitation.

  • MossTalk Words 2® is an evidence-based computer-assisted treatment program developed to strengthen understanding and production of single words for individuals with aphasia.
  • Mapping Therapy (Schwartz et al., 1994) is a treatment for agrammatism that targets the ability to link grammatical constituents (subject, object) with thematic roles (agent, theme) to facilitate  comprehension and production of language at the sentence level.
  • The Persons with Aphasia Training Dogs (PATD) Program is a treatment designed to target the psychosocial consequences of aphasia by training participants in positive reinforcement dog training techniques that harness new skill learning and the advantages of human-animal interactions.

The Center has always maintained a commitment not only to developing the highest quality programs, but also to providing community leadership.

  • Aphasia rehabilitation research evidence has been disseminated to scientific and consumer communities through more than 40 peer-reviewed publications and presentations based on work at the Center.
  • As a founding member center of Aphasia Access and a member of the Aphasia Resource Collaboration Hub, the Center participates in local, national, and international education and advocacy efforts with healthcare professionals and community advocates around the world.

The clinicians, scientists, community advocates, donors, and most importantly, the members of the MossRehab Aphasia Center have contributed substantially for 25 years to research and rehabilitation.  We look forward to continuing this innovation and person-centered service with the goal of supporting individuals and families in living well with aphasia.

Interview with MRRI Postdoctoral Fellow Abhijeet Patra

Abhijeet Patra, PhD, joined Moss Rehabilitation Research Institute (MRRI) as a postdoctoral fellow at the end of 2018. During his time at MRRI, he has conducted exceptional research in the Language and Learning Laboratory. As Dr. Patra prepares to wrap up his postdoctoral training and begin his new position at Manchester Metropolitan University, we were pleased to have an opportunity to speak with him about his career and his experiences at MRRI.

1. How did you first get interested in science and rehabilitation research?

I remember that when I was in high school, I went to visit a relative who was undergoing treatment in a rehabilitation hospital. After completing high school, I explored different career options, but I was not really sure which direction to go. However, I think my experience that day in the hospital made me lean more towards a career in rehabilitation. Especially, after seeing the dedication of the clinicians working in that rehabilitation hospital, I wanted to have a career where I could help people after injury and improve their quality of life. After completing a clinical undergraduate degree in speech-language therapy and audiology, I decided to pursue a master’s degree in cognitive science. During my master’s degree, I gained further knowledge about the relationship between brain and behavior and how brain injury or stroke can impact that relationship. Once I completed my master’s degree, I decided to pursue a PhD to further continue my research in the rehabilitation field. I received my PhD from the University of Reading, UK in 2018, and I am glad that my PhD research work involved patients from the same region (Kolkata, India) where I started my career as a clinician.      

2. Why did you choose to come to MRRI for a postdoctoral fellowship?

Throughout my academic career, I have read multiple impactful research articles written by MRRI scientists and that’s why MRRI was always on the top of my list. After completing my PhD, I was looking for research opportunities which would be more translational, and I came across the work of Erica Middleton, PhD (my current postdoctoral mentor). I started reading her papers and was fascinated by her simple yet powerful approach to rehabilitation. One day, I decided to write an email to Dr. Middleton. I discussed my research interests and my background with her, and that’s how it all started.

3. What has it been like working at MRRI?

I believe that my decision to come to MRRI has been one of the best decisions in my life. From day one, I have continued learning new and valuable things. All the scientists, research assistants, and staff at MRRI are wonderful, and they are always there to help. There is a very supportive and vibrant work culture at MRRI, and I feel that my postdoctoral mentors, lab members, and all the MRRI people are like my family.

4. What are some of the key questions you are focusing on in your research?

My postdoctoral work has focused mainly on three key areas: 1) how to improve naming impairments in people with aphasia using psychological learning principles, 2) understanding the changes in brain waves when an individual with aphasia produces common naming errors (e.g., saying cat instead of dog) and how that understanding may lead to better understanding of such impairment, and 3) understanding the relationship between sentence comprehension and cognitive control (e.g., inhibiting prepotent responses, working memory) in healthy adults and people with aphasia.

5. What have been some of the findings of your work?

In one of our studies, we found that people with aphasia make more naming errors when we asked them to name common everyday objects which belong to the same semantic category (e.g., dog, cat, elephant) versus objects from multiple semantic categories (e.g., dog, table, orange). However, one day later, that performance was reversed such that greater effort during training provided greater learning opportunities and led to better performance in future. During COVID-19 last year, we ran a web-based study on healthy young adults where participants read sentences word-by-word and also performed various cognitive control tasks. Our results provide evidence to support that cognitive control modulates sentence processing in healthy adults. We are currently writing the report to submit to a journal, and we also have plans to replicate these findings. These are only a few of the findings from my work, and I am looking forward to analyzing the results of a variety of other studies in the pipeline.

6. In terms of your research, what is the next step or something new you are excited to begin working on?

I am currently in the process of designing two electroencephalogram (EEG) experiments that I wanted to start last year but could not do due to COVID-19. I am looking forward to finally being able to get these studies going. In one of the experiments, I will look at the changes in brain activity during word production in people with aphasia. In the second, I will be examining the changes in brain activity during sentence processing in people with aphasia.

7. Thinking about the big picture, can you describe some of the impacts or potential impacts of your research?

During my PhD, I examined the characteristics of language breakdown in Bengali-English bilinguals with aphasia. Despite Bengali being the sixth most spoken language in the world, there were very few studies in the aphasia literature at that time when I started my PhD. I feel that through my PhD work I was able to contribute to broadening the sparse literature in this area. I have done some exciting research as a postdoc at MRRI, and I am still working on several projects. I think the output of my postdoctoral research will help the rehabilitation community better understand the relationship between cognitive control and language processing in aphasia and how to improve language impairments in those population.   

8. What experiences or skills from your fellowship at MRRI do you think will be most important as you transition into your first faculty position?

I have learned many skills during my fellowship at MRRI that I feel will be important in my future job position. However, I would say following are the top four in my list: 1) experience in writing grant proposals, 2) communicating research ideas and results to people outside my field, 3) how to manage a lab, and 4) how to successfully manage my time and work on multiple projects at the same time.

9. Can you share one of your favorite memories from your time at MRRI?

I think it will be my first lab/postdoctoral get together at my mentor Dr. Middleton’s place. I had a really good time with everyone there, but I would like to mention one particular experience from that day. For most of my life, I was afraid of dogs and would avoid them if I could. However, I was surprised to discover that I really liked Dr. Middleton’s dog when I had a chance to spend time with the dog at her house. After this enjoyable encounter, I have decided to get a dog for myself someday.

10. Outside of research, what are some of your favorite pastimes or interests?

I am a fan of cricket, a very popular sport in India that is not as well-known in the U.S. I enjoy watching cricket games as well as playing tournaments. I also love cooking and experimenting with different cuisines.

Dr. Sharon Antonucci Discusses Her Life and Research in a New Podcast Interview

MossRehab Aphasia Center Director Sharon M. Antonucci, PhD, CCC-SLP, was recently featured as a guest on an episode of the People Behind the Science podcast. During her interview, Dr. Antonucci had an opportunity to discuss an exciting new research project at the Aphasia Center that has been funded by the National Institutes of Health (NIH). The Persons with Aphasia Training Dogs (PATD) Program combines Dr. Antonucci’s research interests in finding innovative ways to improve rehabilitation for people with aphasia with her lifelong love of dogs. In her interview, Dr. Antonucci described how the program was developed and the unforgettable moment when she received the news that their NIH grant application was successful.

Dr. Antonucci also spoke with podcast host Marie McNeely, PhD, about her career path, the influential mentors who had a big impact on her, some of her favorite authors, memorable travel experiences in Italy, and more.

You can listen to the full audio interview on the People Behind the Science website.

MRRI Scientists to Present in Workshop on TMS Motor Mapping in Neurorehabilitation

Mapping the locations in the motor cortex that are involved in the performance of different movements has been an important tool in both rehabilitation research and clinical practice. Motor mapping using transcranial magnetic stimulation (TMS) can provide insights on how movements are controlled in individuals with and without neurological disease or damage. It can also play an important role in targeting neuromodulation during rehabilitation. Despite the utility and benefits of TMS motor mapping, researchers and clinicians have not reached consensus on the protocol that should be used, optimal methods for data analysis, and the interpretation of results.

Moss Rehabilitation Research Institute (MRRI) Director Dylan Edwards, PhD, is chair of an upcoming virtual workshop that will address these topics. The event will be hosted by the National Center of Neuromodulation for Rehabilitation (NCNM4R), an NIH Medical Rehabilitation Research Resource Network center at the Medical University of South Carolina.

In addition to Dr. Edwards, MRRI Institute Scientist Shailesh Kantak, PT, PhD, and MossRehab Physician Nathaniel Mayer, MD, will join leading international experts to present and discuss content on motor mapping. Presentations will cover the full spectrum from preclinical research in animal models to clinical applications in humans.

The Contemporary TMS Motor Mapping in Neurorehabilitation Workshop will be held on Friday, June 25th, 2021 from 10:00 am – 3:00 pm EDT. It will include a combination of pre-recorded presentations and live Q&A sessions held virtually via Zoom. For more information and to register to participate in the workshop, please visit the NCNM4R website.

MRRI scientists look forward to participating and sharing their expertise in this engaging international event.

Improving Neurorehabilitation by Incorporating Gaming Theory and Technologies

Moss Rehabilitation Research Institute (MRRI) scientists are at the forefront of research applying new technologies to developing therapeutic games for neurorehabilitation. MossRehab’s Accepting the Challenge blog recently published a three-part series on how research at MRRI and clinical care at MossRehab are leveraging therapeutic gaming to increase engagement and enhance rehabilitation. 

Part 1 of the series provides an overview of how theories from neural and behavioral science are being applied game design for optimizing rehabilitation outcomes. Part 2 translates these principles from the lab to the clinic and describes how therapeutic games are currently being used in clinical care at MossRehab. Read more in Part 3 about the ongoing research projects that MRRI Scientists are involved in to develop the therapeutic games of the future.

The third article features a number of current projects spanning several MRRI research laboratories. One of these is a collaborative effort involving Dylan Edwards, PhD, Laurel Buxbaum, PsyD, Aaron Wong, PhD, Shailesh Kantak, PT, PhD, and collaborators from other leading research institutions. They are developing a new therapeutic gaming system for motor recovery after stroke, called Mindpod Dolphin. Dr. Buxbaum also describes two projects that use virtual reality games for assessment and treatment. Dr. Edwards discusses his work on NeuroMotion, a portable gaming console from TRCare, Inc. This console is designed for patients who experienced a stroke to assist them in recovering upper extremity functions in their own homes. Dr. Rabinowitz describes how her work on mobile technology in brain injury rehabilitation is enhancing our ability to promote adherence to home therapy and goal attainment.  

These research projects demonstrate how MRRI scientists are using theory-driven research to develop novel rehabilitation approaches to help improve the lives of individuals with neurological disabilities.

Check out the whole series on MossRehab’s Accepting the Challenge blog.

Using Gestures and Brain Stimulation to Enhance Language in People with Stroke

What’s the word? Those tip-of-the-tongue moments, when a word is seemingly right there but just out of reach, can temporarily hinder our ability to communicate effectively. Everyone experiences word-finding challenges (called anomia) from time to time. However, for people who have aphasia, an acquired language disorder following stroke or brain injury, these word-finding challenges can be very frequent and disruptive, causing problems for everyday communication needs. Verbs present a particular challenge for the majority of people with aphasia. Verbs are vital because we need them to communicate about actions and events, and they are central to sentence structure and conveying relationships between subjects and objects. Without using verbs, language can sound telegraphic or robotic, and it becomes very hard to get a point across.

Gestures can help people retrieve words when they get stuck. Using a gesture to pantomime an action can convey a speaker’s intended message to others, and it can furthermore help the person produce the verb they want to say. Unfortunately, producing gestures can also be impaired following stroke, and many patients who have aphasia also have limb apraxia, a disorder that impairs skilled action and gesture production.

However, it is possible that simply watching someone else produce a gesture may help adults living with stroke to get those words off the tip of their tongues. This is possible when an observed gesture and intended verb share meaning, or semantics. Semantic knowledge consists of everything we know about the world, and it is stored in long-term memory. Semantics are distributed in a network of regions across the brain and can therefore be resilient to damage. Neurorehabilitation treatments that enhance semantic activation may therefore benefit many patients with different patterns of brain damage. Moss Rehabilitation Research Institute (MRRI) and University of Pennsylvania researchers Haley Dresang, PhD, Laurel Buxbaum, PsyD, and Roy Hamilton, MD, MS, are combining gesture observation with non-invasive brain stimulation to investigate whether enhanced activation of action knowledge (semantics) can facilitate verb production in patients with aphasia. This is the first study to implement a specific type of excitatory stimulation – intermittent theta-burst stimulation – on verb-production impairments, and also the first to combine brain stimulation with gesture-observation cues in aphasia. First, this research examines whether passive observation of gestures can help patients produce verbs. Second, this research compares the benefit of gestures on verb production in patients who have had a stroke that damaged the left anterior versus the left posterior parts of the brain. Third, Dr. Dresang and colleagues are also investigating whether applying non-invasive brain stimulation to increase activation in intact nodes of the semantic neural network will enhance the benefits that observing gestures may have on verb production. The researchers will apply a magnetic current that amplifies the activity of neurons in brain regions important for semantic processing, and they will assess whether patients are able to successfully name more verbs based on observed gestures while receiving this brain stimulation. This study will begin recruiting participants later this summer. This research advances scientific understanding of how the brain functions following injury. Furthermore, this work seeks to create a novel neurorehabilitation approach that will improve treatment success for a variety of stroke patients with language and/or motor impairments.