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Collaborating for Rigorous Rehabilitation Research
By: MossRehab Admin
Dec 20 2016

MossRehab and Moss Rehabilitation Research Institute (MRRI) scientists and clinicians have long sought collaborations with top international researchers doing work that aligns with their projects or interests. 

It’s helpful to understand variations in research and treatment approaches around the world,” says John Whyte, MD, PhD, director of MRRI. “We grow as scientists when we’re stimulated by the work of other scientists, wherever they come from.”

Dr. Whyte’s most extensive collaborations have been with colleagues at Glostrup Hospital in Denmark. There, patients are allowed to stay in the hospital much longer after a neurological event than patients in the U.S.

“They have a very different healthcare system, which allows us to study how differences in healthcare delivery might affect outcomes after traumatic brain injury (TBI),” he explains. “In the U.S., our payment model limits variations in healthcare, so going to another country allows us to observe situations that don’t exist within our own and compare results.”

The MRRI and Denmark teams are also developing a patient pain measurement tool together, combining prior work and expertise of researchers from both countries.

Tessa Hart, PhD, institute scientist at MRRI, served as a co-principal investigator on the Denmark study.

“It was a great learning experience,” she says. “We found interesting and unexpected differences between our cultures that affected the work. For example, when we were translating test instruments to measure patient and caregiver outcomes, we learned that the Danes don’t have a word for ‘privacy’ in the sense of having space and time to oneself. This was something we had to work around to assess the impact of caregiving on the caregiver.”

Also, Dr. Hart says, the concept of returning to work after a TBI or other neurological event means very different things in the U.S. than it does in Denmark.

“In America, you can get some vocational assistance, but you’re expected to continue – or find – a competitive job,” she explains. “In Denmark, everyone is supported in some way. Someone recovering from an injury can take a lesser job and still receive a full wage. There’s not the same financial pressure. These are the cultural differences you get to explore in international research.”

Sharing Expertise and Experience

Researchers at MRRI are internationally recognized for the quality, impact and number of their scientific papers in highly ranked international journals and for their presentations at international conferences. 

“Frequently performing leading-edge research requires collaboration with similarly advanced teams of researchers from all over the world who possess complementary expertise,” says Laurel Buxbaum, PsyD, associate director of MRRI.

“For example, MRRI is proud to be the site of one of the world’s largest registries of individuals who have sustained a stroke or traumatic brain injury, have participated in research- quality brain scanning and have agreed to be contacted for research,” she explains. “This invaluable resource enables MRRI scientists and their collaborators to answer questions that require access to large numbers of patients.”

On the clinical side, international collaborations allow scientists to share insights about rehabilitation innovations and apply these insights to better-informed treatment research. 

“An international researcher might study how the healthy brain learns a new motor skill, and MRRI researchers might translate that knowledge to clinically useful research and ultimately, to treatment,” she explains.

A paper Dr. Buxbaum published with an international collaborator, Solene Kalenine, PhD, from the University of Lille, detailed a first-of-its-kind study with stroke survivors to show the connection of how human’s knowledge of how objects co-occur is strongly informed by how they use those objects. Further investigation, which included a close collaborator at the University of Bologna, Anna Borghi, PhD, showed that the brain processes objects differently when they occur in various everyday situations.

Following on from this highly productive line of research, Dr. Buxbaum recently received a new $2.9 million grant from NIH to study the diffculties faced by stroke patients in choosing the correct action at the correct time in a task sequence.

Understanding the nature of neurologic impairments in patients with brain damage helps Dr. Buxbaum and her collaborators understand how to design treatment studies.

In a similar vein, Dr. Buxbaum is conducting research with Ricarda Schubotz, PhD, from the University of Muenster on patients who have sustained stroke or traumatic brain injury and have difficulty with everyday tasks because they lose track of where they are in the task sequence.

“Dr. Schubotz has shown the healthy brain keeps track of the probability that one action event will follow another,” says Dr. Buxbaum. “I shared the hypothesis that some neurologically impaired patients may lose this ‘predictability’ signal. Our research together explores that hypothesis with patients at MRRI. A graduate student from her lab recently spent several months here testing patient participants. Understanding this signal loss may be the first step in designing therapies to augment it.”

Establishing Foundations for Future Study

Dr. Buxbaum says both national and international research collaborations give scientists the chance to see tentative ideas and thoughts take shape through extensive back-and-forth discussion. And these partnerships are ever-growing.

Beginning with 2016 and every summer going forward, Gabriella Vigliocco, PhD, co-director of the Deafness, Cognition and Language Research Centre and director of the Language and Cognition Laboratory at University College London will serve as a Scientist in Residence at MRRI.

“I am very much looking forward to interacting with the many bright researchers, postdocs and students at the Institute,” says Dr. Vigliocco. “I plan to have many discussions with colleagues to bring myself up to date with the work on aphasia and apraxia that is being carried out here and to supervise my student who is currently collecting data on the shared project with Dr. Buxbaum.”

Dr. Vigliocco says she believes international collaboration is at the heart of success in academia.

“Ideas do not have boundaries, and it is by establishing collaborations on topics of mutual interest that we can really make breakthroughs.”

Drs. Vigliocco and Buxbaum will develop grant applications together based on the data they collect.

“She is experienced in studying language disorders, and I am best known for studying perceptual-motor disorders of action and object use,” explains Dr. Buxbaum. “Because of the way the brain is organized, those disorders occur together in many patients. The question is why. And might these two functions be able to augment each other in patients who have de cits in one or the other? Dr. Vigliocco and I are embarking on what we hope will be a long line of research into these questions, and we expect our ongoing collaboration to positively impact research both at MRRI and at UCL.”

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