PhD studies relevant to cognitive rehabilitation at the Cognition and Brain Sciences Unit.

We welcome applications from, and prior discussions with, potential PhD students interested in work which is relevant to neuropsychological rehabilitation. This is a broad definition that can encompass various methods and approaches including cognitive neuropsychology studies, functional imaging work and theoretical development through to work with the healthy population as well as more direct rehabilitation studies. Typically students will use a variety of methods, which is both good for the convergent validity of the work and for career development. Although animal studies may have relevance to human neurological conditions and rehabilitation, we do not have facilities or experience in this area. The range of projects undertaken is probably best illustrated by considering the work of current and recently completed PhD students summarised below. Details about the CBU’s PhD programme and application procedures can be found here

Karolina Moutsopoulou, currently in her final year and jointly supervised by Rhodri Cusack, is interested in the mirror neuron system and the possibility that this system could be used more strategically in rehabilitation of motor and other functions. Mirror neurons are cells which have been observed to respond both when we observe another person making an action and when we make that action ourselves. Her work is an interesting example of where an initially clinical question informs a series of studies with the healthy population in order to answer basic, prerequisite questions. In particular she is interested in the degree to which mirror neuron and related brain regions are modulated by attention (i.e. whether they respond automatically to human movements anywhere in the visual field or only if attention is paid to them). To this end she has undertaken three functional imaging studies with groups of healthy volunteers and developed a behavioural paradigm looking at the effects of observed movements on participants’ own actions. These studies have allowed her to refine her ideas before addressing patient studies in her final year.

Jessica Fish’s PhD was on the topic of prospective memory, or remembering to do something in the future. This is one of the most common complaints of patients following brain injuries of all sorts and yet our capacity to reliably assess it is surprisingly poor. Jessica’s work looked at both assessment and rehabilitation. For example, she examined the predictive validity of desktop prospective memory (PM) measures and conventional executive and memory measures for performance assessed over a period of a week in everyday life. In this respect she refined a technique in which patients were asked to make phone-calls to a voice mail system at particular times of each day as a dependent variable. Her work examined potential modulators of PM performance such as whether the act of making notes changed the probability of subsequent PM success (even when the notes were not subsequently available) and the effect of reward on PM and other executive measures. She also looked at one of the major interventions for PM problems – the Neuropage System – examining factors that were associated with the maintenance of gains even when the paging system was withdrawn. In a single case study, Jessica examined the effectiveness of reintroducing a Neuropage intervention with a patient who had previously shown benefits (with a new emphasis of cueing ‘executive reviews’ (see below) in addition to specific tasks such as ‘take your medication’). Using the phone-call task as a dependent variable, Jessica examined the long-terms effectiveness of ‘content free cueing’. Here, a brief version of Goal Management Training was associated with a cue phrase (STOP!), designed to help patients briefly step aside from their current activities to think about their overall plans (an ‘executive review’). The results showed considerable gains in the PM task which persisted over the 2 week trial.

Christopher Dodds‘ PhD was on the interaction between levels of alertness and spatial bias. It consisted of group and single case studies with patients with spatial neglect, a functional imaging study, a study examining the effects of psychostimulants and purely behavioural studies with healthy volunteers. The patient studies demonstrated that the severity of spatial neglect shown by a patient varies considerably from one moment to the next and that their levels of alertness – their ‘readiness to respond’ – predicts a good deal of the variability. In a single case study, these effects were mirrored in changes in EEG during performance of a spatial task. Chris’ work provided a further demonstration that a consistent alertness-bias relationship can be seen in the healthy population (for example, responses consistent with a reduced leftward/increased rightward bias increasing with time-on-task). In a double-blind pharmacological study (with Ulrich Muller), he found that the stimulant modafinil ameliorated these effects. Chris also completed an MRI study which, among other things, set out to examine the neural correlates of sustained attention.

Veronica Dobler’s PhD concerned spatial function in children. Following on from the observation that, in adult patients with left spatial neglect, the severity of that neglect appeared to be modulated by changes in alertness she set out to examine this effect in children. Initially looking at children with a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) and poor sustained attention she completed a comprehensive case study with a boy (JK) who showed marked levels of spatial bias despite no obvious neurological abnormality. She was able to demonstrate that the bias was present in a purely visual task (i.e. one which did not require a motor response) and, crucially, that this bias could be ameliorated using external alerting. In a larger group clinical study she found consistent (although less marked) associations between poor sustained attention and rightward bias and that sustained attention function (rather than diagnostic category) was the best predictor. Her work also demonstrated that, in the non-clinical child population, children with relatively poor sustained attention showed a relative rightward bias and that the bias of all children showed a rightward shift with declining alertness during a repetitive task. Veronica’s work found that another effect noted in adult neglect patients – specifically modulation of spatial bias with left hand use – was present in children.