by Kelsey Herbers
In support of her research to understand and improve long-term outcomes of individuals with traumatic brain injury, Melissa Duff, PhD, associate professor of Hearing and Speech Sciences, was recently named a 2018 Distinguished Switzer Research Fellow by the National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR).
This annual recognition, which is only awarded to a handful of researchers nationwide, provides Duff with a one-year, $80,000 grant to fund a new patient study focused on characterizing memory and learning profiles in individuals with traumatic brain injury.
According to Duff, there are different types of biological memory systems, but not all of them are studied equally, leaving mysteries surrounding which systems are more vulnerable to traumatic brain injury effects. However, most patients receive the same intervention even though their deficit profiles and outcomes are often wildly different.
“It’s like giving the same treatment to a group of patients who all have trouble moving their arms, but some have broken bones and some have a neurological disorder. If the treatment is a cast, it is only going to work for a subgroup of the patients,” said Duff. “The challenge of studying and treating people with traumatic brain injury is there’s tremendous variability. While they share this diagnostic label of traumatic brain injury, they often don’t have a lot in common in terms of deficits and outcomes, and our current treatments don’t account for this variability.”
Duff’s study aims to phenotype individuals with traumatic brain injury based on their memory profile to see if reliable subgroups can be formed, providing insight into which patients will be best suited for certain types of therapy. Patients within the 100-person sample size of individuals with moderate to severe traumatic brain injuries will be placed through a battery of memory and learning tasks before being grouped into subcategories.
If reliable subgroups can be formed and are proven to be stable over time, the information can be used to predict a patient’s success as a function of his or her phenotype.
“We believe one’s ability to be successful in the world and to take full advantage of rehabilitation depends on the capacity for memory and learning. Rehabilitation is learning. Getting better after your brain injury is learning,” said Duff. “We’re trying to put this big puzzle together, and we’re confident that there are relationships here that we can use to change the trajectory of a patient’s outcome. We’re just trying to systematically put the pieces together to get there.”
“Dr. Duff is forging a new path for understanding the memory deficits of those with traumatic brain injury,” said Anne Marie Tharpe, PhD, chair of the Department of Hearing and Speech Sciences and associate director of the Vanderbilt Bill Wilkerson Center. “This work has the potential to impact positively on the treatment provided to these patients who are seen every day in our clinics across VUMC.”
For Duff, recognition from the NIDILRR provides verification that her work is headed in the right direction.
“It’s a strong vote of confidence for the path that we’re on. We’re making several decisions in the design of this study that haven’t been done before and that go against the grain of some of the assumptions that are in the literature, so it’s validating to receive the money to be able to do this.”