Overarching Objective: To conduct research that capitalizes on assets of innovative technologies to address the needs of individuals with neurological compromise and aid in their return to functional everyday activities.
Project Title: “Defining virtual reality driving in TBI”
NIH R01: Institute Child Human Development (NICHD)
Research Team:Maria Schultheis, Ph.D., Dario Salvucci, Ph.D., Jocelyn Ang, BA, Kevin Manning, MS, collaborators from the University of Iowa (Linda Boyle, Ph.D. Dan McGehee, Ph.D., Dave Nygens), NJIT (Lisa Simone, Ph.D.), Digital Mediaworks (Dean Klimchuk, Roman Mitura).
Description:A recently emerging methodology that may offer numerous benefits for both assessment and rehabilitation for persons with Traumatic Brain Injury (TBI) is virtual reality (VR). One area within rehabilitation in which VR can offer solutions, and which has tremendous impact on daily functioning and independent living status of persons with disability, is the assessment of driving ability following TBI. The overaching goal of this study is to use a multidisciplinary approach to combine findings from the fields of Neuropsychology and Transportation to develop a VR driving simulator that generates measures that are both clinically relevant and empirically based. To achieve these objectives 35 individuals with traumatic brain injury (TBI) and 35 matched controls will be given a driving task in both a virtual reality driving simulator and an on-road driving evaluation (using an instrumented vehicle). In addition, cognitive measures will be administered to examine the influence of cognition on driving performance in both of these conditions.
Project Title: “ The use of VR for driving assessment after TBI”
National Institute on Disability & Rehabilitation Research
: Maria Schultheis, Ph.D., Emily Roseman,MS collaborators from Northeastern University (Ronald Morant, Ph.D.), Kessler Institute for Rehabilitation (Richard Nead).
Description:This line of research aims to examine the efficacy of a virtual reality driving system (VRDS) for the assessment of driving ability in persons with aquired brain injury (ABI) from injury and stroke. The primary objectives are 1) to evaluate the concurrent validity of a VR driving protocol, by comparing it to a traditional rehabilitation hospital based driving evaluation, 2) to examine the effects of the addition of complex and challenging driving factors (i.e. nighttime and traffic congestion), to driving performance within a VR environment, and 3) to elucidate the effects of demographic and medical factors, which may impede or facilitate driving performance within a VR environment. To achieve these objectives, 38 participants with ABI will be administered both the traditional hospital-based driving evaluation and the VRDS. An additional 21 age and education matched healthy control subjects will be administered the VRDS, to address the second objective and allow interpretation of VRDS performance.
"Examing the Demands of Driving after MS"
Funding Agency:National Multiple Sclerosis Society
Research Team:Maria Schultheis, Ph.D., Emily Roseman, MS, collaborators from Northeastern University (Ronald Morant, Ph.D.), Kessler Institute for Rehabilitation (Richard Nead).
Description:The current study, is examining how cognitive and physical impairments secondary to multiple sclerosis (MS) can affects driving skills. The study seeks to understand the specific cognitive factors that impact driving and is evaluating any potential combined impact on driving when physical and cognitive impairments are present. The study has enrolled a total of 66 individuals with MS and 30 matched Healthy controls and individuals measure of cognitive performance, physical performance (including visual) and driving (behind the wheel evaluation).
Project Title: “Executive Dysfunction and Everyday Functioning Deficits in Parkinson's Disease."
Funding Agency: N/A
Research Team:Maria Schultheis, Ph.D., Laura Brennan B.A., Allison Blasco, B.S., Jocelyn Ang, B.A.
Description:Using a retrospective database, the aim of the current study is to elucidate the impact of differential cognitive domains on everyday functioning in Parkinson's Disease. The researchers hypothesize that executive functioning deficits will better predict functional deficits than other cognitive domains and global cognition. Also that an executive test requiring set-shifting and task monitoring skills will demonstrate the strongest relationship with functional deficits compared tests of other executive skills such as planning or initiation and perseveration.
I. Virtual Reality
Project Title:"Examining learning and memory in Virtual Office"
Research Team:Maria Schultheis, Ph.D., collaborators from (Robert Matheis, Ph.D.), University of Southern California (Albert Rizzo, Ph.D.).
Description:It has been suggested that virtual reality may provide a medium for producing neuropsychological measures with greater ecological validity. The present study examined the usefulness of virtual reality (VR) to assess learning and memory in individuals with traumatic brain injury (TBI). Twenty TBI participants were compared with 20 healthy controls on their ability to learn and recall 16 target items presented within a VR-based generic office environment. The results indicated that VR memory testing accurately distinguished the TBI group from controls. Additionally, non-memory impaired TBI participants acquired targets at the same rate as HC participants. Finally, there was a significant relationship between the VR Office and a standard neuropsychological measure of memory, suggesting the construct validity of the task. These findings suggest that the VR Office provides a viable medium for measuring learning and memory. The present results provide preliminary support for the ecological validity of the VR Office, which ultimately can improve assessment of real-world functioning following TBI.
Project Title:"Development of a virtual reality driving simulator "
Research Team:Maria Schultheis, Ph.D., collaborators from Digital Mediaworks (Dean Klimchuk, Roman Mitura).
Description:The current research focuses on integrating findings from the various studies to develop a virtual reality (VR) based driving simulator that can be used to evaluate and retraining driving ability following neurological compromise. Specifically, the VAR driving simulator is designed to target the cognitive demands of driving and is consistent with our long term goal of developing a simulator available to clinicians which requires a system that is 1) low-end technology (preferably run on commercially available platforms), 2) does not require extensive space and 3) does not require specialized personnel. The goal is a VRdriving simulator that is more informative (than traditional measures) but not as complex as high end simulators (e.g. full vehicles).
Project Title:"Simulated Driving Performances Across all Ages "
Research Team: Maria Schultheis, Ph.D., Dario Salvucci, Ph.D., Kevin Manning, MS, Allison Blasco, BS, Laura Brennan, BS, Kelly Pillard, BS, Jason Clarke
Descriptions: This study will examine performance on a virtual reality driving simulator among healthy individuals of varying ages. The data collected will serve to establish a normative database about driving with a simulator. Participants will also be asked to complete real world challenges such as text messaging. This information can then be useful in identifying individuals who are not performing within the normal range and help in the development of virtual reality driving simulator as a potential tool for evaluating driving ability.
Project Title:"Neurocognitive and Cognitive Assessment after Traumatic Brain Injury"
Research Team:Maria Schultheis, Ph.D., Anna Merzegora, Valerie Weisser, collaborators from Bancroft Neuro Rehab in NJ (Trish Shewokis).
Description:Functional near infrared spectroscopy (fNIRS) is a light-based technology that offers functional brain imaging capacity, in a system that is portable, low-cost and non-invasive. Because fNIRS does not have the restrictions (large scanners, artificial conditions) imposed by traditional brain imaging technologies (eg. fMRI, CT Scans), it offers unique opportunities for recording brain activities during everyday activities, such as reading or completing a task. The current line of research is examining the application of this portable brain imaging methodology to neurorehabilitation. Specifically, studies will begin o examine the concurrent and discriminant validity of this tool in evaluating cognitive functioning in individuals with and without brain injury. Other applications in rehabilitation, that can benefit from repeatable and portable brain imaging are also being explored.
Project Title:"Characteristics of Diurnal Cerebral Blood Flow; an fNIRS Study"
Funding Agency: N/A
Research Team: Maria Schultheis, Ph.D., Douglas Chute, PhD., Jennifer Gallo, PhD., Leela Ehrhart, John Medaglia, BS., Anna Merzegora, MS., and Valerie Weisser
Description:The objective of this research study is to use functional near-infrared spectroscopy (fNIRS), a neuroimaging technology, to identify the characteristics of diurnal cerebral blood flow during naturalistic behaviors throughout the course of an average day.
Project Title: Episodic Memory after TBI: fNIRS and fMRI
Funding Agency: National Institutes of Health
Research Team: Joseph Ricker, PhD (PI) University of Pittsburgh, Kathryn C. Russell, M.S., Joelle M. Scanlon, Ph.D., Patricia M. Arenth, Ph.D., Ross D.Zafonte, D.O., Drexel Psychology (Maria T. Schultheis, Ph.D.), Drexel Biomedical Engineering (Kurtulus Izzetogglu)
Description:This study being conducted by the University of Pittsburgh is comparing performance on tasks of episodic memory among adults with traumatic brain injury while using two neuroimaging techniques: fMRI andfNIRS. The study will be the first to compare these two paradigms in adults with TBI.
Interface of Cognition, Technology, and Function.
Project Title: "Examining the relationship of self-awareness and functional performance in mild Alzheimer's"
Research Team: Maria T. Schultheis, Ph.D., Emily Roseman, Kevin Manning, and Allison Blasco
Description:Alzheimer’s dementia (AD) is characterized by a progressive decline in memory in addition to decline in at least one other cognitive domain. Integral to the diagnosis is a simultaneous decline in functional abilities. Additionally, individuals with AD may not be aware of their functional decline and therefore continue to put themselves and those around them in compromising situations. Unawareness of one’s deficit, or anosognosia, is a common and debilitating symptom common in AD. Individuals who are unaware of deficits are often unable to accept the help that they need in completing functional tasks. Cognitive status explains some, but not all, of the variability in functional abilities. Little is known about the exact relationship between unawareness and specific functional tasks. This study aims to examine the relationship between cognition, unawareness, and functional ability. This study will specifically examine driving ability, as measured by a driving simulator. Additionally, reliable informants will be asked to report the participant’s level of functioning on a variety of functional domains in their daily lives. In this way, the researchers seek to understand the role that unawareness plays in different functional abilities.
Project Title: "Simulation sickness and VR exposure in clinical populations"
Research Team:Maria T. Schultheis, PhD., Anna Merzegorra, collaborators from Northeastern University (Ronald Mourant, PhD).
Description:This research is examining issues of usability related to the application of virtual reality technology for clinical populations. The current study is examining the incidence and possible contributors to the onset of simulation sickness during VR exposure. By definition simulation sickness (SS) can include symptoms similar to those seen in motion sickness, including nausea, sweating, disorientation, eyestrain, salivation, headache and dizziness. Given that little is known about the overall risks for simulation sickness for neurologically compromised individuals using HMD-virtual reality, the current study sought to investigate several aspects of simulation sickness among three groups, adults with traumatic brain injury, stroke and healthy controls. First, an overall incidence rate was calculated based on subjective reports of SS symptom onset. Second a objective comparison was made using a standardized Simulation Sickness Questionnaire (SSQ) that has been well-documented and applied in other VR research. It was hypothesized that individuals with neurological compromise (TBI and stroke) would show a higher incidence of SS qualitatively and quantitatively. Finally, in order to examine the potential concomitant effects of SS with pre-existing symptoms related to TBI or stroke, a modified version of the SSQ was derived to allow comparison of Pre-VR exposure symptoms ratings and post-VR exposure symptom ratings. It was hypothesized that individuals with neurological compromise would
demonstrate significantly higher symptom ratings Pre-VR exposure, and this would result in higher ratings post-VR exposure.