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Since founded in 1992, Moss Rehabilitation Research Institute has maintained a leading role in the study of Traumatic Brain Injury (TBI). In honor of Brain Injury Awareness month, we are highlighting some new and ongoing projects to advance the understanding and treatment of TBI. To kick off the month, let’s first look at some of the key contributions to brain injury rehabilitation research throughout the institute’s history.

The TBI Model System

Since 1997, MossRehab has retained its status as a TBI Model System. The National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) provides funding for institutions recognized as national leaders in clinical research and patient care through its TBI Model Systems grant program. A Model System is a center of excellence that performs at the highest level in research and treatment of a particular condition.

• MossRehab has received funding as a TBI Model System Center since 1997. Over more than 20 years, MRRI Scientists and MossRehab clinicians have led and contributed to state-of-the-art research studies, shared their findings with the public, and provided comprehensive clinical care to help guide patients from traumatic brain injuries through re-entry into community living.
• The Moss Traumatic Brain Injury Model System led by MRRI Institute Scientists Amanda Rabinowitz, PhD, and John Whyte, MD, PhD, is one of only 16 TBI Model Systems in the United States and the only Model System in Pennsylvania. MRRI scientists collaborate with clinicians at the Drucker Brain Injury Center at MossRehab Elkins Park to conduct cutting-edge research on brain injury while  providing world-class patient care for those  with brain injury.

John Whyte’s Pioneering Work on the Rehabilitation of Patients with Disorders of Consciousness

• Dr. Whyte’s research has focused on assessment and treatment of patients with traumatic brain injury, including those with disorders of consciousness. Throughout his career, he has participated in the key research, policy, and ethical developments addressing this patient population.
• Dr. Whyte received the American Congress of Rehabilitation Medicine’s Lifetime Achievement Golden Key Award in recognition of his work. Read more about his research, including his work on disorders of consciousness.
• Dr. Whyte’s work over the years has been integral in the recent development of new evidence-based guidelines about the care of people with disorders of consciousness. You can read more about these recommendations here: https://mrri.org/criteria-to-care-for-patients-with-disorders-of-consciousness/

Tessa Hart’s Distinguished Work on Cognition and Emotional Functioning after TBI

• Tessa Hart, PhD, is a scientist emerita at MRRI, with a program of TBI research spanning more than 20 years. A major focus of her research is creating and testing interventions to improve executive function and emotional status using theoretically-based, self-regulation models.
• Dr. Hart received The Robert L. Moody Prize for Distinguished Initiatives in Brain Injury Research and Rehabilitation in 2019 in recognition of her work:
• Recently, Dr. Hart led a study to evaluate the impact of a new protocol for caring for patients with severe memory deficits (called post-traumatic amnesia) due to acute TBI. Learn more about the post-traumatic amnesia (PTA) protocol developed by Moss scientists and clinicians.  

The Development of Novel measures to Assess Brain Injury Outcomes

MRRI scientists have led the development of tools for assessing individuals with traumatic brain injury.

• The Moss Attention Rating Scale (MARS) was designed as an observational rating scale to provide a reliable, quantitative and ecologically valid measure of attention-related behavior after TBI. Learn more information about the MARS tool.
• The Brain Injury Functional Outcome Scale (BI-FOM) provides a measure of global functioning after moderate-severe TBI.  It was designed to capture variations in function among individuals at both high and low levels of impairment. Read about BI-FOM.
• The Brain Injury Nociception Assessment Measure (BINAM) is a measure of nociception designed to assess pain, independent of the level of consciousness. . Assessing painful conditions in Individuals with impaired consciousness after severe brain injury previously was a challenge. Read about BINAM.

The Development of Novel Treatments

MRRI Scientists are at the forefront of developing and testing pharmacologic and behavioral interventions for individuals with TBI.

• Dr. Whyte co-led (with Joseph Giacino of Spaulding Rehabilitation Hospital) a randomized placebo-controlled trial of amantadine, which demonstrated, for the first time, that a treatment could accelerate the pace of recovery of consciousness. The amantadine trial was published in the New England Journal of Medicine (2012) and led to large scale adoption of this treatment. Read about the successful trial of amantadine for accelerating the recovery of consciousness after very severe brain injury.  
• In 2011, Dr. Hart, colleagues from MRRI and Craig Hospital in Englewood, Colorado launched the first multicenter, randomized-controlled trial of a psycho-educational treatment for anger following TBI. The anger self-management training was effective and showed durable benefits for reducing some aspects of problematic anger.  Results in the Journal of Head Trauma Rehabilitation (2017).  Read about  Regulating Emotion After Traumatic Brain Injury.
• In 2019, Dr. Hart published the results of a randomized-controlled trial evaluating a treatment for depression and/or anxiety in individuals with moderate to severe TBI. The treatment in this study is based on Behavioral Activation (BA)—an intervention that focuses on increasing involvement in rewarding and pleasurable activities. Those in the BA condition reported more exposure to environmental reward and greater productivity. Read about Promoting Health After TBI.

TBI Scientists join the MRRI team

In recent years, the TBI research program at MRRI has added two new laboratories.

• In 2015, Dr. Rabinowitz, came to MRRI to direct the Brain Injury Neuropsychology Laboratory. With research focused on cognitive and emotional sequelae TBI, she brings expertise in mild TBI and sports-related concussion to the TBI research team.
• In 2019, Umesh Venkatesan, PhD, joined the TBI research team, bringing his expertise in neuroimaging and assessment of memory and social cognition in the context of TBI. He established the Brain Trauma and Behavior Laboratory (BraTBehavior), which studies aging with TBI and proposed links between chronic TBI and neurodegeneration.

MRRI scientists have contributed substantially over the years to advancing our understanding of traumatic brain injury and developing novel assessment and treatment methods. We look forward to conducting more innovative research in this area with the goal of improving the lives of individuals with neurological disabilities through research.