Dr. John Whyte Featured in the Latest Episode of RehabCast

Dr. John Whyte

The Archives of Physical Medicine and Rehabilitation produces the RehabCast podcast to share high-impact research published in the journal and important news for rehabilitation professionals. In the latest RehabCast episode, John Whyte, MD, PhD, speaks with host Dr. Ford Vox about the development of the Brain Injury Functional Outcome Measure (BI-FOM). He describes how this new measurement tool may help clinicians and researchers better track recovery from brain injury and patients’ responses to interventions. Dr. Whyte is the founding director of the Moss Rehabilitation Research Institute and director of MRRI’s TBI Rehabilitation Research Laboratory.

You can listen to the full episode now.

MRRI Participant Spotlight: Jim Rigney

On October 5th, 2017, Jim Rigney’s life changed dramatically. He woke up to get ready for work early in the morning, and his arm was completely numb. When he tried to get out of bed, his leg collapsed under him. It, too, was numb, but he hadn’t realized it yet. Hearing the commotion that ensued, Jim’s daughter rushed into the room. As an x-ray technician, she had a clinical background and was able to identify the signs of a stroke. Jim was rushed to the hospital, and he soon began his long journey of recovery.

The stroke occurred on the right side of Jim’s brain, and it primarily affected his left arm and left leg. ”Actually, it was pretty scary,” Jim noted. “I had never been in the hospital before. I said the only time before that I was in the hospital was when I was born.” At the time of the stroke, Jim was 61 years old, relatively healthy, and working 60 hours a week as a quality assurance manager for a pharmaceutical company. For him, there were no red flags or warning signs.

Much of Jim’s rehabilitation at MossRehab focused on learning how to walk again as well as regaining use of his left arm. While at MossRehab, Jim learned about some of the research opportunities available. He got involved right away in a clinical research study for robot-assisted therapy at MossRehab. In this study, Jim spent a few hours each week playing different video games while his left arm was attached to a robotic system designed to help aid his recovery. Jim felt more optimistic after participating in this study because he noticed that he had more control of his arm than he had realized.

Since this first study, Jim has participated in multiple research projects at MRRI, spanning the Cognition and Action Lab directed by Laurel Buxbaum, PsyD, the Cognitive Motor Learning Lab directed by Aaron Wong, PhD, and the Neuroplasticity and Motor Behavior Lab directed by Shailesh Kantak, PhD. Recently, he participated in a study investigating spatial navigation problems in people with stroke. This study involved navigating (both by walking and being pushed in a wheelchair) through real-world environments. The study is being conducted by Drs. Erica Barhorst-Cates, Buxbaum, and Wong to better understand the scope of navigation deficits after stroke and the characteristics of individuals who may experience impaired spatial navigation.

For Jim, participation in research is rewarding and educational. He conducted research after college, so it has been intriguing to see the research process from the other side as a participant. Jim noted that participating in different studies that tested his navigation, movement, memory, and perception has given him insight into his condition and where he may have weaknesses. ”I feel like I’m giving back a little bit,” Jim commented. “These people helped me rebuild my life. […] If I can show them some of the things that I’m going through, and it helps them understand how to treat the next patient coming through [..] why shouldn’t I do that?”

He has also enjoyed the opportunity to meet interesting people, and he has appreciated the time they spent answering his questions and telling him more about the research studies. “They really were very supportive. They wanted me to get a good experience out of it,” he noted.

Jim has had a positive experience participating in research at MRRI, and he has encouraged others to get involved as well. ”The more the researchers know about it and the medical practitioners know about it, the better they can treat us and take care of us, so it’s worth the effort,” Jim said.

Though Jim had to retire from his job in the pharmaceutical industry, he has been making steady progress in his recovery and has been able to return to some of his favorite activities, including hiking and camping with friends. We appreciate the dedication and important contributions of research participants like Jim, and we are grateful to have the opportunity to share his story.

To learn more about opportunities to participate in research at MRRI, you can visit our MRRI Research Registry website.

Dr. Abhijeet Patra to Join the Faculty of Manchester Metropolitan University

We are pleased to announce that Moss Rehabilitation Research Institute (MRRI) Postdoctoral Fellow Abhijeet Patra, PhD, recently accepted a permanent senior lecturer position in speech-language therapy at Manchester Metropolitan University, UK. Dr. Patra came to MRRI in Dec 2018 to continue his research training working in the Language and Learning Laboratory with his mentor Erica Middleton, PhD. Prior to his time at MRRI, Abhijeet was awarded his PhD in clinical language sciences from the University of Reading, UK in 2018 where he examined the relationship between word production and cognitive control in healthy bilinguals as well as in bilinguals with aphasia. The pursuit of a research career in communication disorder stems from the theoretical experience Dr. Patra obtained during his master’s degree in cognitive science in consort with the clinical exposure attained during the four-years of his undergraduate degree in speech-language pathology and audiology in India.  

Dr. Patra’s research interests are in improving the understanding of the interplay between cognitive and linguistic processes required for successful communication in healthy and neurologically impaired speakers (such as aphasia). In his new position at Manchester Metropolitan University, Abhijeet will continue pursuing his current research interests as well as develop, deliver, and help to lead undergraduate and postgraduate programs in speech-language therapy. He will begin his work there in early August 2021. We look forward to continuing to keep in touch with Dr. Patra as he embarks on this next stage of his scientific career.

Interview with MRRI Scientist in Residence Dr. Lyn Turkstra

MRRI developed its Scientist in Residence program to continue to foster collaborations with exceptional researchers at world-class institutions around the world. Dr. Lyn Turkstra has been a Scientist in Resident at MRRI since July 2019, and she has contributed to a variety of collaborative projects in the areas of cognition and communication after a brain injury. In this interview, Dr. Turkstra shares more about her research and her experiences working with scientists at MRRI.

1) What are some of the main questions you are focusing on in your research?

My research focuses on one big question: how can we best support adolescents and adults with traumatic brain injury (TBI) to be successful in everyday life? My work has two main themes: developing effective assessment and intervention methods for social communication problems; and developing state-of-the-art rehabilitation methods for individuals with TBI-related cognitive impairments.

2) What have been some of the key findings and impacts from your research thus far?

A key finding early on in my research was that many people with TBI have challenges ‘reading’ social cues in the environment. Until that time, most therapy for people with TBI-related social problems focused on modifying behavior (e.g., improving ‘turn-taking skills’). Our findings showed that some behavior problems came about because the person didn’t pick up on verbal and nonverbal cues. For example, a person with TBI might monopolize a conversation because they miss cues that their partner wants a chance to talk.

3) How did you get connected and begin collaborating with scientists at MRRI?

For the past 10 years or so, I’ve been working on the Rehabilitation Treatment Specification System (RTSS) project with Dr. John Whyte, Dr. Tessa Hart, Mary Ferraro, and Andy Packel at MossRehab. The Moss group, along with Dr. Marcel Dijkers, had been working on this project for a few years at that time, and they realized that their multi-disciplinary team was missing a speech-language pathologist. Working with this group of great minds has been an incredible opportunity. Our work has completely changed my thinking about clinical practice and introduced me to a global community of clinical researchers who are moving the field forward. It also introduced me to the amazing clinicians at MossRehab, who are on the leading edge of clinical practice.

4) Can you tell us more about one of the recent projects you have worked on with MRRI scientists?

The Moss project that I’m most proud of so far is the Post-Traumatic Amnesia (PTA) Protocol, developed with the leadership of Mary Ferraro. In this project, Mary and her multidisciplinary team trained staff members to modify their communication when they interact with patients in PTA. The modifications include asking only questions about the here and now, and avoiding questions about recent past events (patients in PTA cannot remember new facts and events). The group also transformed a common therapy tool – the patient’s “Memory Book” – into a resource for staff and families. These sound like simple changes but they took a lot of thought, collaboration, and practice. I’m excited about the potential of the Moss PTA Protocol to enhance the patient’s experience, improve care, and minimize the patient’s learning of error responses during this critical time.

5) Why do you think collaborative science is beneficial, and what do you think are the most important factors to look for or keep in mind to ensure a successful research collaboration?

Collaboration is the cornerstone of rehabilitation – our patients have complex and dynamic needs, and it takes a team to develop and implement treatments that will improve everyday life. It makes sense that rehabilitation research also must be collaborative. We each have a piece of the puzzle, and we need to put those different pieces together to understand the effects of neurological damage.

A few years ago, I was involved in a study to identify factors supporting successful collaboration between SLPs and Neuropsychologists in rehabilitation (Wertheimer et al., 2008). I believe the important factors we identified in that study apply to collaborative research as well: 1) institutional support for collaboration, including a culture of collaborative clinical research; 2) time and space to collaborate, which these days might include literal and figurative bandwidth; 3) respect for the contribution of each person on the team and an understanding of each other’s perspectives and theoretical frameworks; and 4) collegiality and open communication. Moss has all of these!

By bringing together the expertise and experience of different scientists, both within and outside of MRRI, we have been able to address important questions in the fields of neuroscience and neurorehabilitation. MRRI is dedicated to working together with experts from diverse backgrounds to improve the lives of individuals with neurological disabilities through research.

Dr. Amanda Therrien Featured on the People Behind the Science Podcast

Amanda Therrien, PhD, is featured in the latest episode of the People Behind the Science Podcast published this week. Dr. Therrien is an Institute Scientist and Director of the Sensorimotor Learning Laboratory at MRRI.

In her interview, Dr. Therrien talks about some of her favorite pastimes, including running, knitting, gardening, and cooking. She walks listeners through her career path and shares what it has been like launching her new research laboratory over the past year.

The interview also covers some of Amanda’s new and ongoing research projects. In one of her research lines, Dr. Therrien is working to optimize therapeutic interventions for ataxia, a disorder caused by damage to the cerebellum that results in impaired movement coordination. The goal of these interventions is to teach people with ataxia how to achieve movement outcomes (e.g. reaching to a target in a coordinated way) by leveraging a training mechanism that is less dependent on the cerebellum. Dr. Therrien also describes a new collaborative research study that will elucidate the sensorimotor processing involved in dynamic proprioception. Dynamic proprioception refers to our sense of where our limbs are in space while they are moving, and it is important for motor learning.

Listen to the full interview on peoplebehindthescience.com.

WHYY Features Dr. Amanda Rabinowitz and Her Recent Research on Chatbot Technology for TBI Rehabilitation

In America alone, nearly 125,000 people experience a traumatic brain injury (TBI) each year. Beyond the need for rehabilitation to address impairments in function, there is a critical need to help patients combat the depression and loss of motivation which commonly occur after injury. In fact, people with traumatic brain injury are eight times more likely to be diagnosed with depression compared to those without brain injury. Amanda Rabinowitz, PhD, is director of the Brain Injury Neuropsychology Lab at MRRI, and she has been working with colleagues to develop a chatbot to help people with TBI continue to stay focused and connected between clinical care visits.

Philadelphia Public station WHYY recently featured Dr. Rabinowitz and the RehaBot chatbot she has been studying.

“It extends the reach of the therapy by providing an always-available companion that can help somebody between sessions be more successful in fulfilling their goals and doing more of the activities that we know lead to a sense of accomplishment and pleasure that can lift somebody out of a depression,” Dr. Rabinowitz explained in the interview.

This chatbot operates via text message, and it uses elements specifically targeted to engage users and facilitate behavior change.

At MRRI, researchers are dedicated to conducting theory-driven research to improve the lives of people with neurological disabilities. RehaBot is currently being evaluated in focus groups, and it may ultimately become an important resource for people with traumatic brain injury.

Listen for the full story on whyy’s website.

MRRI Virtually Hosts Three Visiting Scholars in Recent Language Mini-Series

Areas of interest within the Cognitive Neuroscience and Cognitive Rehabilitation focus area at Moss Rehabilitation Research Institute (MRRI) include investigating the neural underpinnings of language processing and expression, as well as understanding how language can be impacted by brain injury or disease. MRRI is dedicated to engaging with other leaders in the field to exchange ideas and continue important discussions in these research areas. Over the past three months, MRRI hosted a series of virtual presentations from leading experts in our Visiting Scholars Language Mini-Series. Each presentation is available on our YouTube channel for anyone interested in learning more.

Dr. Brenda Rapp

Professor in the Departments of Cognitive Science and Neuroscience at Johns Hopkins University

View Dr. Rapp’s presentation titled “From voxels to hemispheres: Understanding language recovery at multiple network scales” recorded on January 27, 2021.

Network science provides a promising approach to understanding post-stroke recovery in aphasia. One challenge, however, is the fact that brain networks occur at multiple scales, from micro to macro. In terms of the functional networks that can be evaluated with fMRI, these may range from networks of clustered voxels, functional connectivity within processing components, connectivity between components as well as inter-hemispheric connectivity. We don’t yet know if any or if all of these levels will be relevant for understanding the brain changes that support recovery of function in post-stroke language disorders. In this talk, Dr. Rapp discusses data analyses and findings that identify changes that occur at these multiple levels and which are linked with behavioral changes resulting from language treatment. She proposes that these findings provide a basis for beginning to understand and ask motivated questions about the complex, multi-level network processes involved in recovery of function in the damaged brain.  

Dr. Peter Turkeltaub

Associate Professor of Neurology and Rehabilitation Medicine at Georgetown University Medical Center

View Dr. Turkeltaub’s presentation titled “Inner Speech in Aphasia” recorded on February 24, 2021.

Many people with aphasia report that they can say words in their heads that they can’t say aloud. Understanding more about these subjective reports could have implications for our understanding of the nature of inner speech and self-awareness and could have clinical implications for how we diagnose and treat anomia. Dr. Turkeltaub discusses a series of studies assessing how these subjective reports relate to objective measures of word retrieval and production. He also shares recent related work on overall awareness of anomia and error awareness in aphasia.

Dr. Kara Federmeier

Professor in the Department of Psychology, Department of Kinesiology, Program in Neuroscience, and the Beckman Institute for Advanced Science and Technology at the University of Illinois.

View Dr. Federmeier’s presentation titled “Finding meaning in time:  What electrophysiology reveals about how the brain makes sense of the world” recorded on March 24, 2021.

A lynchpin of human cognition is the ability to rapidly and effectively link incoming sensory information to knowledge stored in long-term memory. Work in Dr. Federmeier’s laboratory, focusing on the cognitive and neural mechanisms that make this possible, has revealed the critical import of time and context for meaning processing. Comprehension is sub served by a set of core mechanisms that use time to create links between sensory stimuli and stored semantic knowledge, affording the continuous infusion of meaning into human perception. In addition, compelling evidence shows that language processing can be facilitated by active, context-based expectations for semantic, lexical, and sensory features of likely upcoming words. In this presentation, Dr. Federmeier reviews the neural and cognitive bases for expectation-based processing. She describes emerging evidence showing that multiple language comprehension mechanisms are implemented in parallel and that the brain dynamically adapts its use of these mechanisms, both over the long-term in response to changing neural and cognitive abilities with age, and over the short-term in response to situational and task demands. Collectively, these findings reveal the complex relations among sensory processing, attention, memory, and control systems that allow people to rapidly and fluidly understand one another across the lifespan.

Laurel Buxbaum Named to Board Of Directors of American Society Of Neurorehabilitation

Laurel Buxbaum

Laurel Buxbaum, PsyD, associate director of MRRI, director of the MRRI Cognition and Action Lab, and research professor of Rehabilitation Medicine at Jefferson University has been appointed to the Board of Directors of the American Society of Neurorehabilitation (ASNR).

Dr. Buxbaum will share with ASNR her expertise in the interface between cognition and motor control, patient-based cognitive neuroscience, and neurorehabilitation assessment and treatment. Her research has been funded by the National Institutes of Health, the James S. McDonnell Foundation, and the National Institute for Disability and Rehabilitation Research.

ASNR was founded in 1990 to advance clinical care as well as basic and clinical research of patients with chronic neurological disabilities. “I’m looking forward to supporting the outstanding mission of ASNR,” Buxbaum said. “ASNR’s meetings, mentorship, and high-quality scientific journal (Neurorehabilitation and Neural Repair) all facilitate rigorous basic and clinical research, so the values of the organization align very closely with the mission of MRRI and MossRehab.”

Dr. Buxbaum’s three-year term begins immediately.

Learn more about Dr. Buxbaum and her work in neurorehabilitation.

Dr. Marja-Liisa Mailend Joins Our Team of Institute Scientists

We are pleased to announce that Marja-Liisa Mailend, PhD, has recently joined our team of Institute Scientists at MRRI. Dr. Mailend’s academic training began with a clinical focus at the University of Tartu in Estonia where she received her master’s degree in speech-language pathology. During her early scientific training, she realized the critical need for further development of a solid evidence base for clinical care. This, combined with her passion for research and scientific thinking, drove her to pursue a doctoral degree. Dr. Mailend was awarded her Ph.D. in Speech, Language, and Hearing Sciences from the University of Arizona where she had an opportunity to work with several exceptional researchers. In 2017, Dr. Mailend came to MRRI where she trained as a postdoctoral fellow under the mentorship of Erica Middleton, PhD, and Laurel Buxbaum, PsyD.

Research in Dr. Mailend’s new laboratory focuses on improving our understanding of impairments of phonological encoding and motor planning for speech. She applies theoretical models of typical speech production to elucidate the underlying impairments in apraxia of speech (a motor speech disorder that makes it difficult to speak) and aphasia (an acquired language impairment that impairs one’s ability to express and understand language). The ultimate goal of Dr. Mailend’s research program is to develop theory-driven assessments and treatments to help people with speech and language impairments lead independent and fulfilling lives.

Dr. Mailend’s work complements ongoing research at the Institute in the area of cognitive neuroscience and cognitive rehabilitation, and she looks forward to continuing to build collaborations with other world-class researchers both within and outside of MRRI.

Radio Spotlight on Chatbot Technology for People With Traumatic Brain Injury

MRRI Institute Scientist Amanda Rabinowitz, PhD, was recently featured on KYW Newsradio. During her interview, Dr. Rabinowitz discussed her recent work developing a chatbot to help people with traumatic brain injury. After a brain injury, many people experience depression and loss of motivation. This can have a tremendous impact on their quality of life as well as the course of their rehabilitation. In developing the chatbot, Dr. Rabinowitz and her colleagues incorporated evidence-based principles that promote engagement and behavior change. The chatbot (called RehaBot) operates via text message and could be a key resource for patients between their therapy sessions.

“We think that this is going to be a really effective way to keep people focused on maintaining their progress and give them that sense of joy and accomplishment and pull them out of the depression,” Dr. Rabinowitz noted.

This study is one of many innovative research projects at MRRI that are incorporating rigorous, theory-driven approaches to contribute to the development of novel clinical treatments in neurorehabilitation.

Listen to the full story on KYW Newsradio’s website.