Advancing Research and Advocacy for People with Brain Injury

Brain injury is a chronic condition. However, many people think about a brain injury as a single, isolated event from which a person fully recovers. This incorrect perception is something that Monica Vaccaro, M.S., is determined to change. Ms. Vaccaro is a Research Associate at MRRI as well as the Director of Programs at the Brain Injury Association of Pennsylvania, a non-profit organization dedicated to preventing brain injuries and fostering an inclusive community of education, advocacy, support, and research to maximize quality of life for people with brain injuries and their families.

At MRRI, Ms. Vaccaro works in the Brain Injury Neuropsychology Laboratory directed by Amanda Rabinowitz, PhD. In this role, Ms. Vaccaro assists with clinical trials of potential treatments for brain injury rehabilitation, co-chairs the Advisory Council, represents the Moss TBI Model System on the Pennsylvania Department of Health Brain Injury Advisory Board, helps with planning an annual consumer conference, and coordinates focus groups with individuals with brain injury and their caregivers.

“The persons with lived experience with brain injury (the survivors and their family members), their stories, their experiences — that’s what drives me. Because in my role, I get to directly interact with people with lived experience all the time, and they really inspire me. It’s a group of people who are brave, navigating a difficult world, and doing so many wonderful things,” Ms. Vaccaro explained.

Ms. Vaccaro’s Path To a Career in Brain Injury

Her career began in education, and Ms. Vaccaro spent about ten years as a teacher for children in preschool through fifth grade with significant learning disabilities. During her time as a teacher, Ms. Vaccaro became fascinated by the kinds of errors she saw her students making, and she wanted to learn more about the brain and how disabilities could impact learning. She decided to go back to school to study the brain and neuropsychology.

As a student, Ms. Vaccaro had an opportunity to work at Einstein Healthcare Network and Moss in the early 1990s through a pre-doctoral clerkship program. This experience allowed her to conduct inpatient neuropsychological evaluations, and it was a major turning point in her career. Working with patients was powerful and eye-opening. After her internship, Ms. Vaccaro accepted a position in the inpatient unit of the hospital, and she worked there for years before transitioning to directing an outpatient program, and then moving into research at MRRI.

After more than three decades of working with people with brain injuries, Ms. Vaccaro has important insights into the needs of the brain injury community that remain unaddressed. These include greater awareness of brain injury as a chronic condition, funding for brain injury research and resources,

Raising Awareness About Brain Injury

While Ms. Vaccaro and many others are committed to increasing awareness of brain injury year-round, brain injury awareness and advocacy efforts are particularly concentrated during the month of March as The Brain Injury Association of America leads nationwide efforts in observing Brain Injury Awareness Month. A key goal of these efforts is to change the public perception of brain injury from thinking about it as one transient event to understanding that it is a chronic condition. After experiencing a brain injury, individuals can show substantial improvements in the acute phase, but many may take longer to recover or may have life-long impairments.

It is critical for the public, as well as legislators and other policymakers to realize that many people with brain injury require ongoing treatment and services for a long time. Currently, traumatic brain injury is not recognized as a chronic condition by either the Centers for Disease Control (CDC) or Centers for Medicare & Medicaid Services (CMS), and this has a detrimental impact on the availability and affordability of long-term care for people with brain injury, as well as funding to support brain injury research and resources.

Advocating for More Funding for Brain Injury Research, Resources, and Clinical Care

Recently, Ms. Vaccaro joined others from the Brain Injury Association of America and the brain injury community in participating in a rally on Capitol Hill for Brain Injury Awareness day on March 5, 2024. One of their goals was to encourage legislators to reauthorize the Traumatic Brain Injury (TBI) Act which was signed into law in 1996. The most recent TBI Program Reauthorization Act in 2018 ensures funding of the Program through 2024. Brain injury advocates are hoping to include language in a new reauthorization act that would add brain injury to the CDC and CMS’s list of chronic conditions.

The TBI Act also provides funding to states to support brain injury resources and initiatives. In Pennsylvania, the Department of Health has received funding to develop infrastructure that is crucial for serving the needs of people with brain injuries and their families. For example, the Pennsylvania Department of Health has contracted with the Brain Injury Association of Pennsylvania to provide education and training about brain injury to professionals in the community who will come into contact with individuals with brain injury in their everyday work, including counselors, nurses, general practitioners, first responders, law enforcement, and others. The Brain Injury Association of Pennsylvania also operates the Brain Injury Resource Line, which is a venue for people from the community to call in with questions and learn about resources. Another key program in Pennsylvania supported by funding from the TBI Act is the NeuroResource Facilitation Program for Brain Injury Services which helps people with brain injury and their families identify and navigate brain injury resources, services, and supports.

In addition, during her visit to Capitol Hill, Ms. Vaccaro shared important work being done by the TBI Model Systems nationwide, including at the Moss TBI Model System, and requested additional funding to support these critical efforts to advance brain injury research and clinical care. Further research, including research being done at MRRI, is critical for understanding which interventions are effective and ensuring that people with brain injury can access effective interventions that are developed.

Thinking about other areas of need, Ms. Vaccaro highlighted the importance of providing services to marginalized populations, including individuals with brain injury in the justice system, those with mental health conditions, and people who are homeless or have housing insecurity. She would also like to see funds budgeted at the state level for services such as conferences, information lines, support groups, or other necessary resources.

Ms. Vaccaro is part of a coalition of stakeholders working with policymakers in Pennsylvania to try to get funding to support clinical care beyond acute inpatient rehabilitation. Currently, there is limited funding to support outpatient rehabilitation and post-acute care, so many individuals with brain injury are not getting the care they need. To address this care gap, the coalition has proposed a plan for commercial insurance providers to pay for post-acute rehabilitation services for brain injury. “This, again, emphasizes that brain injury is a chronic condition. It isn’t over after a person leaves the acute care setting,” Ms. Vaccaro stated.

As part of The Brain Injury Association of America’s Brain Injury Awareness Month Campaign, they are asking people with brain injury to share their story to help reinforce the chronic nature of brain injury. “Brain injury is a lifelong journey for many people,” Ms. Vaccaro reflected. Visit The Brain Injury Association of America’s website to learn more about the Brain Injury Awareness Month Campaign and read some of these stories.

MRRI Welcomes Speech Language Pathologist Kelly Horel

MRRI is pleased to announce that Kelly Horel, M.S., SLP, has recently accepted a position at MRRI. Ms. Horel graduated from Rutgers University with a B.A. in Linguistics and minors in Psychology and Cognitive Science. While at Rutgers, she worked as a Research Assistant in a Phonetics Laboratory. After graduation, she began working at MRRI under Erica Middleton, PhD, and Myrna Schwartz, PhD, in the Language and Aphasia Lab. Ms. Horel worked as a Research Assistant at MRRI from 2011-2013.

She was inspired to go to graduate school to become a Speech Language Pathologist (SLP) after working with Adelyn Brecher, SLP, and with the people with aphasia who would come in to participate in research studies. Ms. Horel graduated from Boston University in 2015 with an M.S. in Speech-Language Pathology. From there, she worked clinically in a variety of settings including sub-acute rehabilitation, home health, and in local schools. After taking some time off for the births of her children, Ms. Horel began working part-time at the Adler Aphasia Center (Maywood, NJ) as an aphasia group facilitator. This position renewed her passion for working with people with aphasia. Remembering her experiences at MRRI, Ms. Horel explained, “When I saw that MRRI was looking for a research SLP, I knew I had to reach out!”

She is excited to be starting her position as a Research Associate – Speech Language Pathologist in the Language and Learning Laboratory under Dr. Middleton and the Speech and Language Recovery Laboratory under Marja-Liisa Mailend, PhD. In this role, she will be administering language and cognition tests and transcribing and coding data, among other tasks. In thinking about her new role, she noted “I am eager to contribute to research that will support clinicians in helping people with aphasia in their recovery process.”

Meet MRRI Scientific Advisory Board Member Dr. Monique R. Pappadis

In celebration of Black History Month, MRRI is excited to be highlighting the careers of Black scientists in neuroscience and neurorehabilitation and their important contributions to the field. One such scientist who has been a valued colleague and collaborator in the area of traumatic brain injury research is Monique R. Pappadis, MEd, PhD, PhD. Dr. Pappadis is a tenured Associate Professor and Vice Chair in the Department of Population Health and Health Disparities at the University of Texas Medical Branch (UTMB) at Galveston. In addition, Dr. Pappadis is an Investigator and the Director of Dissemination and Cultural Humility at TIRR Memorial Hermann’s Brain Injury Research Center in Houston, Texas. Learn more about Dr. Pappadis, her career, and her research in our interview below.

1) How did you get interested in rehabilitation research?

 I became interested in rehabilitation when I got my first research job after finishing my postbaccalaureate degree in psychology. I worked as a Research Associate at the Brain Injury Research Center at TIRR Memorial Hermann under the supervision and mentorship of Angelle Sander, PhD, and Margaret Struchen, PhD. I worked in this capacity for 11 years before becoming a faculty member at the University of Texas Medical Branch at Galveston. Thankfully, I am still able to hold an appointment with TIRR Memorial Hermann Hospital and collaborate with their researchers.

2) Can you tell us more about your research and/or a contribution to the field of neurorehabilitation research that you are most proud of?

 Broadly speaking, my research addresses disparities in care and outcomes after traumatic brain injury and stroke and coming up with solutions to address the needs of underserved populations with disabilities. I am also exploring ways to better support and protect older adults with cognitive impairments from experiencing harm, neglect, or exploitation.

3) Can you tell us more about your interactions with MRRI and MRRI scientists?

My interactions with MRRI and MRRI scientists started very early in my career due to being a data collector for the Traumatic Brain Injury Model System National Database study. It also helped that my research supervisors are friends with some of the greats of MRRI — John Whyte, MD, PhD, and Tessa Hart, PhD. I am thankful that I have co-authored manuscripts and/or served on national stakeholder meetings with Drs. Whyte and Hart. I have also developed a great professional relationship with Amanda Rabinowitz, PhD, and Umesh “Umi” Venkatesan, PhD, where we are collaborating on TBI Model Systems-related projects. Most recently, I was invited as a Visiting Scholar and had the opportunity to share my research with the MRRI research and clinical teams.

4) What have you enjoyed most about working with the team at MRRI?

 I have enjoyed working with so many professionals who are creative thinkers and have a passion for improving the lives of individuals with disabilities.

5) As an expert in the field, what do you think are the biggest challenges or opportunities right now in rehabilitation and rehabilitation research?

One of the biggest challenges is related to funding. We need more funding to support rehabilitation research and funding to support treatment and services during acute and post-acute care, as well as within the community. We need to be able to still support individuals who are aging with disability who will have varying needs with time.

Thank you to Brandon Knight for inspiring the Black History Month blog series.

MRRI Presenting New Research on Apraxia of Speech at the 2024 Motor Speech Conference

Apraxia of speech is a disorder that affects a person’s ability to guide the movements of their articulators to produce speech. It can occur in children or adults, and individuals with the disorder are commonly classified into three categories: those with childhood apraxia of speech, stroke or trauma-induced apraxia of speech, or progressive apraxia of speech due to neurodegeneration. The condition is difficult to diagnose, and current diagnostic efforts are limited by the absence of a gold standard diagnostic test or clear diagnostic procedures. These diagnostic limitations impact both research being conducted on the disorder and the ability of clinicians to optimally treat individuals with apraxia of speech.

In the Speech and Language Recovery Laboratory at MRRI, Marja-Liisa Mailend, PhD, is investigating the cognitive mechanism of apraxia of speech to improve assessment and differential diagnosis of the disorder. She is an author on two posters that will be presented at the upcoming 2024 Motor Speech Conference in San Diego, CA, February 21-24. Research for both posters was done in collaboration with Katarina Haley, PhD, CCC-SLP, and Adam Jacks, PhD, CCC-SLP, from the University of North Carolina at Chapel Hill.

In their first poster, Drs. Mailend, Haley, and Jacks completed an important early step in addressing issues surrounding the diagnosis of apraxia of speech without a gold standard test for the disorder. This project involved a literature review of recent research on apraxia of speech in the past five years. Their findings indicated that the differential diagnosis in most of these studies was based on clinical judgments that were not standardized and could be susceptible to bias. They suggest that future research in this area should acknowledge the limitations of diagnosing apraxia of speech in the absence of a gold standard, and aim to reduce bias in the diagnostic procedures by way of converging evidence.

In their second poster, Drs. Mailend, Haley, and Jacks further examined the Apraxia of Speech Rating Scale, an instrument that was developed to standardize how researchers and clinicians diagnose apraxia of speech. The validity of this rating scale has not yet been firmly established for diagnosing apraxia of speech in individuals who do not have a neurodegenerative disease, and more work is necessary to confirm its reliability. Drs. Mailend, Haley, and Jacks were interested in further clarifying the Apraxia of Speech Rating Scale so that it can serve as a valid and reliable scale for diagnosing apraxia of speech in people after stroke. Based on their findings in independently applying the scale to sample videos and audio clips, they proposed refined operational definitions and updated procedures to augment the published guidelines for the scale. These refined definitions and procedures can now be used to formally test the reliability of the Apraxia of Speech Rating Scale in a stroke population.

“I’m really looking forward to sharing our recent work at the Motor Speech Conference this year. One thing that makes this conference unique in the field is that it brings together motor speech researchers whose work focuses on adults with motor speech conditions, as well as scientists who study motor speech in children,” explained Dr. Mailend. “My work bridges these two populations, and there are many benefits to thinking about the bigger picture — how our findings and the methods we develop in childhood apraxia of speech may be relevant for apraxia speech in adults and vice versa,” Dr. Mailend continued.

Dr. Mailend’s presentations at the Motor Speech Conference will provide an excellent opportunity to highlight her expertise as an early-career independent investigator, connect with current and prospective collaborators, and get feedback from other experts in the field.

Meet MRRI Scientific Advisory Board Member Dr. Lewis Wheaton

Meet MRRI Scientific Advisory Board Member Dr. Lewis Wheaton

In honor of Black History Month, MRRI is pleased to be sharing the perspectives and important contributions to science by Black researchers in the fields of neuroscience and neurorehabilitation. One inspirational scientist that MRRI is honored to have as a member of the Institute’s Scientific Advisory Board is Lewis Wheaton, PhD. Dr. Wheaton is a Professor in the School of Biological Sciences at Georgia Institute of Technology (Georgia Tech). Learn more about Dr. Wheaton, his career, and his role on our Scientific Advisory Board in our interview below.

1) How did you get interested in rehabilitation research?

While it may sound cliché, it is being able to help people directly. It is similar to why I got into research in humans. While I appreciate the science that uses cellular, theoretical, and animal models, there was always something special about being able to work with people. While I was a fellow at the NIH, one of the first persons with a neurological disorder that I enrolled in one of my first clinical studies told me something that I will never forget. She enrolled in the study not to help herself (she knew she was not going to live much longer), but so that she might help someone who would have to bear the burden of the disorder in the future. That selfless mindset is still inspiring to me and compels me to think about what part I might be able to play in improving lives.

2) Can you tell us more about your research and/or a contribution to the field of neurorehabilitation research that you are most proud of?

My research focuses on how the brain is changing following neural injury and how to leverage those changes to promote neurorehabilitation. In my Cognitive Motor Control Lab at Georgia Tech, we have a particular focus on upper limb amputation and stroke. In amputation, we want to understand how to use neural adaptations following traumatic limb loss to promote prosthesis adoption. I am very proud of one area we are continuing to develop in utilizing action observation in persons with amputation, harnessing the visual system adaptations as a way to promote functional gains in prosthesis use. I am very excited as it might open a door to a validated rehabilitation approach based on nervous system changes. We are pursuing a similar line of thought in action observation work in stroke.

3) Can you tell us more about your interactions with MRRI and MRRI scientists?

MRRI has several outstanding scientists, some of whom I have known well for years. Laurel Buxbaum, PsyD, and I share a strong enthusiasm for understanding apraxia, which drew us together almost 20 years ago, and we have remained connected ever since. As well, through the American Society of Neurorehabilitation, I have come to know the outstanding work of people like Dylan Edwards, PhD. John Whyte, MD, PhD, is someone I have known for years through many shared interests.

4) What have you enjoyed most about working with the team at MRRI?

Working with MRRI has first off led me to get to know better some of the great scientists at MRRI. During a recent meeting, I was very excited to see the growth of the Institute and the breadth of scientific research that is taking place. I look forward to playing whatever small part I can play in helping to support the mission of the Institute!

5) As an expert in the field, what do you think are the biggest challenges or opportunities right now in rehabilitation and rehabilitation research?

 I think our biggest opportunity in neurorehabilitation research is inclusion. Our field is growing fast which is necessary to support the lives of people that need many forms of rehabilitation. However, we have to be sure that we develop thoughtful ways to support the lives of ALL people who need help in the way they want it. There are a variety of emerging statistical and quantitative tools that might start to get at this, but we should strive to go further. At the end of the day, we have to be sure we are reaching more people of different backgrounds and cultures and seeing what is effective in whom, why it is perhaps not effective in some other group, and ensure our theories and approaches aren’t inadvertently leaving people behind.

Thank you to Brandon Knight for inspiring the Black History Month blog series.

Recognizing the Important Contributions of Women at MRRI

Each year on February 11th, The International Day of Women and Girls in Science is celebrated around the world. This day provides an opportunity to honor the achievements of women and girls in science, technology, engineering and mathematics (STEM) fields and to continue important advocacy efforts to advance gender equality and representation in STEM fields. The International Day of Women and Girls in Science was established by a resolution passed by the United Nations General Assembly in 2015. An Assembly is held annually, and a different theme is chosen every year to raise awareness of a particular element of gender equality in science.

For 2024, the main theme is “Women and Girls in Science and Leadership, A New Era for Sustainability”. At Moss Rehabilitation Research Institute (MRRI), we acknowledge and value the significant contributions of women at MRRI and beyond. Within MRRI, women have been instrumental in conducting pioneering research at our Institute and excelling in leadership roles. Women have served and continue to serve in important leadership positions, and women at MRRI have been pivotal in shaping the Institute, its science, and its culture.

Women not only make up the majority of MRRI’s staff, they comprise more than half of the Institute’s scientists, research assistants, post-doctoral trainees, and administrative support staff. At MRRI, women hold prominent roles in senior leadership positions, including the Associate Director (current and past) and Director of the Aphasia Center. This notable representation is rooted in the Institute’s 30-plus year history, with the pioneering presence of MRRI co-founder Myrna Schwartz, who served as the institute’s first Associate Director.

The inclusion of women in science is also evident in our international collaborations, and our current Scientists in Residence are women hailing from University College London and McMaster University in Toronto. Additionally, a Fulbright Fellow from the French National Center for Scientific Research is visiting MRRI currently, further deepening our connections to the international community of women in science.

MRRI would not be the vibrant research institute it is today without the effort, talent, and dedication of each of the remarkable women who have been part of the institute, and we look forward to continuing to help train and support the next generation of female leaders in neuroscience and neurorehabilitation. “The women of MRRI continue to blaze a trail in the United States and abroad. The breadth and influence of their work can be seen through their engagement onsite at the Institute as well as at scientific conferences, within professional societies, and in the scientific literature. Thank you to all of the women of MRRI for your remarkable and ongoing contributions, no doubt you are an inspiration for girls considering a future in science,” remarked MRRI Director, Dylan Edwards, PhD.

Dr. Carl V. Granger: A Pioneer in Physical Medicine and Rehabilitation

As MRRI celebrates Black History Month, the Institute recognizes and honors the extraordinary contributions of individuals who have left an indelible mark on their fields. One such luminary figure is Carl V. Granger, MD, a third-generation African American physician whose groundbreaking work has significantly shaped the landscape of Physical Medicine and Rehabilitation (PM&R).

Dr. Granger’s legacy is perhaps most prominently defined by his visionary role in developing the Functional Independence Measure (FIM) instrument. This instrument, for many years, served as the gold standard for measuring the functioning and functional independence of patients in rehabilitation. Today, it remains a cornerstone in rehabilitation research, a testament to the enduring impact of Dr. Granger’s innovative contributions.

In 1987, Dr. Granger, in collaboration with the State University of New York (SUNY) Buffalo, founded the Uniform Data System for Medical Rehabilitation (UDSMR). This groundbreaking initiative marked a pivotal moment in the history of PM&R, as it introduced a standardized data set for medical rehabilitation. Dr. Granger’s foresight and dedication paved the way for a systematic and uniform approach to measuring rehabilitation outcomes, significantly advancing our understanding of treatment effectiveness.

Beyond his instrumental role in data standardization, his impact on the profession is evident through his presidency of the American Association of Electromyography and Electrodiagnosis in 1968-69, the American Academy of Physical Medicine and Rehabilitation (AAPM&R) from 1975-76, and the International Federation of PM&R from 1978-1980. As President of these esteemed organizations, Dr. Granger played a crucial role in shaping the direction and standards of the field. He was the author or co-author of over 275 scientific articles. In 2010, a comprehensive review of 45,700 articles within rehabilitation journals identified Dr. Granger as a co-author of 10 among the top 100 cited articles, with him serving as the first author in five instances—more than double the count of any other author.

The impact of Dr. Granger’s work extends to his establishment of the world’s largest and most sophisticated rehabilitation outcomes database. This monumental effort, containing over 13 million patient assessments, positioned PM&R at the forefront of tracking outcomes in medicine. Dr. Granger laid the foundation for “evidence-based” care in the field of rehabilitation, a paradigm shift that has shaped contemporary healthcare practices.

On December 29, 2019, in Buffalo, New York, Dr. Carl V. Granger passed away at the age of 91. Born into a family of African American physicians in Brooklyn, he carried on the family legacy with distinction. As we reflect on Dr. Carl V. Granger’s legacy during Black History Month, we celebrate his vital contributions to physiatry and rehabilitation research.

Thank you to Brandon Knight for inspiring the Black History Month blog series.

Moss Rehabilitation Research Institute Celebrates Black History Month: A Reflection on Diversity in Research and Healthcare

As we begin this Black History Month at Moss Rehabilitation Research Institute (MRRI), our leadership and staff acknowledge the importance of recognizing the contributions of Black Americans to the work that we do. Here at MRRI, we are dedicated to improving the lives of individuals with neurological disabilities through research. This work cannot be meaningfully conducted without attention to the racial healthcare disparities and history of injustice that impact the experience of the populations we study.

Beyond this month and throughout the year, it is crucial to respect and understand the historical context of this country’s relationship with the Black community. At MRRI, we find ourselves at a unique intersection of research and healthcare, shaped by the historical context of events such as the Tuskegee Syphilis Study and other historical injustices. Many of our research participants come from the same racially and economically diverse communities that have been exploited by medical research in the past. Rebuilding trust, promoting transparency, and prioritizing ethical conduct to address the historical injustices that have contributed to healthcare disparities is critical to the work we do at MRRI.

In reflecting on the composition of research and healthcare professions, it is evident that Black Americans are often underrepresented, and when present, they may occupy fewer positions of influence or comparable roles. The statistics from the Society for Neuroscience’s 2017 report shed light on the stark disparities in the field, revealing that Black PhD recipients constituted only 4% of those awarded a PhD in the 2015-2016 academic year, while White/Caucasian recipients accounted for a significant 72% of the total population. The underrepresentation extends to postdoctoral trainees and faculty, with Black individuals comprising 3% and 1%, respectively (Society for Neuroscience, 2017). Although efforts are being made to increase diversity in these fields, the numbers underscore the need for continued awareness and action.

While acknowledging the atrocities of the past, it is equally vital to recognize the significant contributions Black Americans continue to make in advancing research and healthcare. Actively recognizing our history and the achievements of the Black community, this month and throughout the year, is crucial in dismantling systemic racism and fostering a truly inclusive environment. The advancement of knowledge depends on diversity, and by embracing different perspectives, we strengthen our collective pursuit of scientific and medical breakthroughs.

As MRRI celebrates Black History Month, we honor the past and commit to creating a future where diversity thrives, acknowledging the invaluable contributions of Black individuals in shaping the landscape of research and healthcare.

Thank you to Brandon Knight for contributing to the ideas and data included in this post and inspiring the Black History Month blog series.


Society for Neuroscience. (2017). Diversity in Neuroscience.

Collaborative Research Explores Emotional Dysfunction After Traumatic Brain Injury

To female researchers reviewing data on a computer monitor.

After traumatic brain injury (TBI), it is common for individuals to experience difficulties regulating their emotions and behaviors, leading to anger and aggression that may negatively impact their relationships and societal participation. Currently, evidence-based treatments addressing these emotional challenges are lacking. A collaborative study funded by The National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) is exploring this topic to better understand why events in everyday life result in feelings of anger and aggression in people with chronic TBI. Led by Flora Hammond, MD, and Dawn Neumann, PhD, at Indiana University, the Reactions Events Appraisals and Context in TBI (REACT) Study spans five Traumatic Brain Injury Model Systems Sites (Indiana University School of Medicine, Moss Rehabilitation Research Institute (MRRI), TIRR Memorial, Spaulding Rehabilitation, and Craig Hospital).

At MRRI, Amanda Rabinowitz, PhD, serves as the site principal investigator for the REACT Study. Dr. Rabinowitz brings to this project extensive experience using mobile technology for assessment and treatment of people with TBI, as well as expertise in ecological momentary assessment (EMA). EMA involves real-time data collection which can be more accurate than relying on recall of past events. Dr. Rabinowitz has completed various studies using EMA and is currently working on a separate ongoing project characterizing the temporal dynamics of chronic post-concussion symptoms.1-4

In the REACT Study, researchers will sample the thoughts, feelings, and experiences of people with TBI during their daily lives using an accessible mobile application. Participants will report on their experiences of frustrating events, and their emotional and behavioral responses over a two-week period. The study will also examine potential connections between these emotional reactions and factors including the circumstances, patient characteristics, how they assess real-life situations, and their methods of emotional management.

Gaining insight into why people with TBI experience anger and aggression will help scientists and clinicians improve care in a number of ways — by developing better educational approaches for patients and their families, refining screening methods to identify patients at risk, and informing targeted treatments to improve outcomes. “By leveraging valuable collaborations through the TBI Model Systems, this project will bring us closer to developing effective evidence-based interventions to help people with TBI better manage their emotions in real-world situations,” Dr. Rabinowitz remarked.


1) Rabinowitz, A. R., & Fisher, A. J. (2020). Person-specific methods for characterizing the course and temporal dynamics of concussion symptomatology: a pilot study. Scientific reports, 10(1), 1-9.

MRRI’s 2023 Annual Report is Now Available

MRRI Annual Report 2023


MRRI is pleased to release its Annual Report for fiscal year 2023. This report includes updates from Institute leadership, details about our facilities and collaborative team, and information on MRRI’s activities in the past year. We share details about our scientists’ recent publications, presentations, research funding, and summaries of the research conducted within our Laboratories and Programs.

Read the 2023 Annual Report