Featured Projects and Publications

Previous literature has linked traumatic brain injury (TBI) to a multitude of behavioral health problems, including depression, anxiety, and substance abuse. These studies, however, have been focused on prevalence rates within a population of individuals with a history of TBI. This study led by Dr. Jennifer Bogner expands upon previous literature by looking at prevalence rates within a general population, using a random sample of 6996 Ohioans. The results revealed that those with a history of TBI, and especially those who have experienced loss of consciousness, severe TBI, or multiple injuries, are at an increased risk for behavioral health problems. Compared to demographics and history of TBI from other states, Ohioans with a history of TBI had a higher risk of alcohol abuse and were more likely to smoke. The findings help support the need for access to behavioral healthcare for persons with TBI.

Although follow-up is key for outcomes in children with traumatic brain injury (TBI), families often have to overcome barriers to access necessary healthcare services. A study of 368 pediatric TBI patients examined family socioeconomic status (SES) and driving time to the hospital in relation to the patient’s return for their first follow-up appointment. Return for follow-up was less likely for families living a shorter drive from the hospital (within 15 minutes) but was even more strongly related to lower SES. The research team calls for futher research into the relationship of SES to service utilization in pediatric TBI patients.

Formal tests to assess deficits resulting from traumatic brain injury (TBI) may not capture the nuanced consequences for discourse processing and the effects of these deficits in preventing students from getting the assistance they need in the school setting. This study focused on expository language with an interest in fluency and microstructural variables, including productivity, lexical diversity, and syntactic complexity. Five children with TBI and five typically developing (TD) control children watched three short lectures (a narrative, a compare-contrast expository, and a cause-effect expository) and were asked to summarize them. In both the compare-contrast and cause-effect conditions, those with TBI produced fewer utterances and a shorter mean length of C-unit (independent and corresponding dependent clauses) than their TD counterparts. Children with TBI also had more pauses in producing the compare-contrast cause-effect summaries. Targeting deficits in discourse processing in evaluating the effects of TBI in youth may be help in accessing school programs that lead to better outcomes.

The proposed study is a Phase III trial powered to determine efficacy of two different doses of I-ACQUIRE for children 8 to 36 months old with PAS and hemiparesis. The design is a prospective Randomized Controlled Trial (RCT) in which 240 children will be randomly assigned to one of 3 treatment groups (N=80 per group): 1) Moderate Dose I-ACQUIRE (3 hrs/day, 5 day/wk X 4 wks), 2) High Dose I-ACQUIRE (6hrs/day, 5 days/wk X 4 wks), or 3) Usual and Customary Treatment (U&CT). I-ACQUIRE will be delivered by protocol-trained therapists and monitored weekly for dosage and treatment fidelity; U&CT will be provided by community therapists with dosage and approaches documented weekly. All primary and secondary efficacy outcomes rely on blinded assessments at baseline, end of treatment, and 6 mos post-treatment. Exploratory outcomes and supplemental clinical measures may provide valuable additional data about development and health in this sample of children with PAS.

For more information about the I-ACQUIRE trial for infants with hemiplegic cerebral palsy due to perinatal arterial ischemic stroke visit NIH Stroke Net or ClinicalTrials.gov.

Click here to visit the I-ACQUIRE trial national center.

Though it is likely that speech-language pathologists (SLPs) will be involved in the assessment and rehabilitation of children with mild traumatic brain injury (mTBI), research has provided little information to help guide approaches to intervention. Recently the Center for Disease Control and Prevention (CDC) released guidelines to assist in the treatment of this population. This article reviews the guidelines and how they can be applied by SLPs in clinical and school settings in designing methods for acute symptom monitoring and assessment and in setting long-term treatment goals. The article also underscores the importance of including SLPs in assessment and interventions for children with mTBI and their unique contributions to a child’s interdisciplinary care team.

Deficits in the ability to appreciate others’ perspectives, referred to as “theory of mind (ToM),”  is a major challenge faced by many children and adolescents with traumatic brain injury (TBI). Damage to brain regions in the Mentalizing Network (MN) resulting from TBI may help to explain these difficulties. This study compared 82 children with TBI to 61 control children with orthopedic injury (OI) on measures of brain volume, executive function, ToM, and social functioning. Children with severe TBI performed more poorly than the OI group on ToM tasks. Although there was no significant difference between the groups in social adjustment, findings indicated associations of poorer social functioning with decreased volume in the MN and impaired ToM. These findings highlight the importance of further research on mechanisms underlying the social disabilities in children with TBI and support the need to consider social-cognitive functioning in programs to improve long-term outcomes.

The threat of neurocognitive and behavioral decline secondary to sub-concussive impacts in youth tackle football is a growing concern. A study of 166 youth football players, including 70 primary school players (ages 9-12) and 96 high school players (ages 15-18), had helmet-based sensors to record the magnitude of head impacts during practices and games conducted across two seasons. The participants were assessed on a battery of tests to determine cognitive and behavioral outcomes during both preseason and postseason periods. The study, led by Sean Rose, MD, co-director of the Complex Concussion Clinic and a member of NRAG at Nationwide Children’s, found minimal associations between behavioral, cognitive and neurologic outcomes over the course of the two seasons and number or intensity of impacts. The team hopes to follow the same cohort through future seasons to collect more extended follow-up data.

Little is known about the short-term neurocognitive outcomes of repetitive head impacts (RHI) while playing youth contact sports. Moreover, it is critical to understand the relationship between age of first exposure to contact sports and neurocognitive function. A research team led by Dr. Jaclyn Caccese wanted to uncover this relationship by examining Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) scores from the Concussion Assessment, Research and Education (CARE) Consortium to approximate neurocognitive functioning in collegiate student athletes and examine the relationship by group. Groups were organized by collegiate athletes in contact sports (e.g., football, ice hockey, lacrosse, wrestling, and soccer) vs. non-contact sports (e.g., baseball, golf, track, rowing/crew, swimming, or tennis) and by athletes that were first exposed to the sport before age 12 vs. after age 12. No association was found between the neurocognitive measures and age of exposure to contact sports in three separate studies examining effects of age of exposure in: 1) NCAA football players, 2) all other contact sports (men and women), 3) male student athletes participating in contact sports while in a U.S. Service Academy.

H. Gerry Taylor, PhD, a principal investigator in the Center for Biobehavioral Health, is a co-principal investigator on a project entitled “PediaTrac™: Web-based Measure to Screen and Track Early Developmental Trajectories.” The project is a multi-million dollar, 5-year, multi-site grant from the National Institute of Child Health and Human Development (NICHD). The research team is headed by Dr. Renee Lajiness-O’Neill, at Eastern Michigan University, and includes investigators at the University of Michigan and Case Western Reserve University. 

The aim of this research is to develop and validate PediaTracTM, a novel web-based assessment tool. This low-cost, comprehensive tool is designed to engage parents/caregivers in the gathering of longitudinal, real-time, multi-domain data on infant/toddler development beginning at birth. The measure allows caregivers to enter developmental data at home and well-child or other clinical visits. Core domains of early development include feeding/eating, sleep, sensorimotor, social-communication/cognition and attachment. Administered longitudinally, the tool has the potential to serve as a primary method for early detection of developmental deviations in infants and young children so that interventions can be individualized and may begin as early as possible. The trajectory data from PediaTrac could also easily be linked with data on changes in brain structure and function, allowing a more sophisticated understanding of brain-behavior relationships. 

Monitoring complex movements such as joint flexion (i.e. bending) and rotation in a person’s natural environment is an important step toward more robust real-world monitoring of motion. Many of the existing technologies in joint motion monitoring such as motion capture labs (MoCaps), inertial measurement units (IMUs), or bending sensors have been unable to elicit a reliable, safe, unrestricted and seamless motion response outside of the laboratory setting. Technology developed in the ElectroScience Laboratory by Vigyanshu Mishra and Dr. Asimina Kiourti at the Ohio State University can overcome shortcomings of the state-of-the-art. In contrast to their previous design that had poor resolution at smaller angles and zero rotation monitoring, the group used Electrically Small Loop Antennas (ESLAs) across the joint to monitor both flexion and rotation with improved resolution. An example of the new design allows 10o of flexion/rotation angular resolution with a 2 ESLA system, while a 3 ESLA system allows up to 2o of angular resolution. This technology provides a smart garment-based solution, wherein sensors made using e-threads can be integrated on garments inconspicuously. This allows seamless motion monitoring in free living conditions using a comfortable and wearable smart garment-based solution leading to transformative benefits. The team anticipates the new technology could be used outside of a lab setting to monitor several motor disabling conditions caused due to Traumatic Brain Injury and Parkinson’s, among many others.

A Brain-Computer Interface (BCI) allows for a direct interface between a computer and an individual’s brain activity. Interest in medical applications of BCIs stems from the potential of these systems to assist in monitoring neural signals of persons with brain-based disorders such as epilepsy and Alzheimer’s disease. In an effort to mimic an in vivo clinical environment, Katrina Guido and Asimina Kiourti applied a new method developed in the ElectroScience Laboratory at the Ohio State University to connect a BCI using saline to mimic human body fluid. The research team believes this new BCI validation design, which reduced BCI sensitivity errors, will decrease chances of wasted in vivo trials in the future.

The Duchenne Muscular Dystrophy Carrier Study is being conducted to determine the neuromuscular, cardiovascular, and psychosocial impact of being a carrier of the Duchenne or Becker muscular dystrophy gene. Seventy-five mothers of children with either Duchenne or Becker muscular dystrophy and 26 control women participated in the study. Preliminary results indicate that women who have a mutation on the DMD gene have more cardiac scarring and elevated creatine kinase levels as compared to those who do not. Mothers report poorer health-related quality of life than controls and high levels of anxiety. They also shared their experiences and the challenges that they face in caring for a chronically ill child. These preliminary findings provide impetus for further research on associations of caregiver stress and biomarkers of stress with cardiac scarring and CK isoenzymes.

Extremely preterm children have higher rates of impairment in cognitive abilities and more learning and behavior issues than children born at term. However, many of these children develop normally despite their early birth. A study of 146 extremely preterm/extremely low birth weight and 111 normal birth weight children attending kindergarten were assessed on achievement tests and parent ratings of child behavior problems. The research team identified a substantial subset of preterm/extremely low birth weight children (45%) without problems in achievement or behavior. The “resilient” preterm children were from more advantaged home environments than the subset of children with problems, suggesting that the home environment helps to protect preterm children from the negative effects of preterm birth.

Survivors of congenital heart disease (CHD) often face emotional challenges as they enter adulthood and can lead to internalizing disorders such as anxiety and depression. A multitude of factors are associated with the severity of these challenges, including the functional impairments associated with CHD. Deficits in executive functioning, for example, can lead to maladaptive coping mechanisms and impede more positive adaptations such as acceptance, positive thinking, and cognitive reappraisal. This study examined the relationship between executive functioning, coping, and emotional distress in adolescent and young adult CHD survivors. Participants completed measures of executive functioning (Behavior Rating Inventory of Executive Function), coping (Responses to Stress Questionnaire), and internalizing symptoms (Youth or Adult Self Report or Adult Self Report. Findings revealed that more maladaptive coping in young adults was associated with both functional impairment and increased internalizing symptoms, suggesting that positive coping may play an important role in enhancing long-term outcomes of CHD.

Although survivors of pediatric brain tumors are at risk for neurocognitive impairments, the brain abnormalities underlying these deficits are not well understood. To explore associations between white matter integrity and neurocognitive outcomes, 11 brain tumor survivors (ages 8-16, >2 years post-treatment) were compared to 14 matched healthy controls using diffusion tensor imaging (DTI) and neuropsychological assessments. Survivors performed worse on measures of overall IQ, working memory, processing speed, divided attention and memory, but not long-delay memory.  White matter density for survivors was lower in the inferior fronto-occipital fasciculus, uncinate fasciculus, and genu of the corpus callosum. Despite evidence for a relationship between neurocognitive outcomes and white matter, there was little evidence for associations of specific cognitive functions to circumscribed brain regions. Further research is suggested to elucidate the brain systems underlying neurocognitive disorders in this population.

Internalizing disorders such as depression and anxiety are often associated with epilepsy and seizures. A study assessed 45 children (ages 6-18) with intractable epilepsy for internalizing symptoms and conducted MR and PET scans to examine possible structural and functional differences in the brain. Findings indicated that over 40% of the youth had clinically significant internalizing symptoms. Among the youth with these symptoms, the MR and PET scans revealed reductions in cortical volume, cortical thickness and functional activation in key brain regions such as the left temporal regions, bilateral occipital/parietal lobe and left inferior frontal cortex. The results suggest that youth with intractable epilepsy should be evaluated for depression and anxiety during clinic visits for more comprehensive care.

Adolescence, or the period between puberty and full maturity, is a time when many developmental changes take place in the brain. Some of these changes are thought to be initiated or moderated by the direct effects of puberty hormones on the brain. Puberty suppression is a common treatment for transgender adolescents or those with gender dysphoria. This paper is a statement from leaders in the neuroscience and adolescent development fields on the need to study the effects of puberty suppression and offers a consensus statement of areas in which this research should focus and methods which should be used.

Social learning is an important part of peer interactions during adolescence, when expectations and predictable social rules are acquired.  Variation in predictability and valence of social interactions are particularly difficult for teens with social anxiety.  This study used functional MRI to assess brain response to predictable and unpredictable positive and negative social interactions in 112 youth aged 8-18 (57 with anxiety).  Results indicate that age, predictability and outcome impact brain response in anxious adolescents.  In youth with anxiety, being disliked by a peer generated enhanced brain response in social brain regions, but only in younger youth.  These results may offer insight into how anxiety can shape social expectations and mold brain responses across adolescence

Little is known about the development of emotion recognition (ER) through tone of voice, and even less is known about the development of the associated neural networks. Forty-one adolescents were recruited to examine the connections between vocal ER and these networks during development. Participants underwent functional magnetic resonance imaging (fMRI) while listening to different sentences being spoken in tones of voice conveying happiness, fear, anger, sadness, and neutral. Participants had a 5-second window after each stimulus to select the intended emotion. Older participants did better overall on emotion recognition tasks and their performance was accompanied by greater increased activation in frontal regions of the brain. Researchers also found connections between the frontal regions of the brain, the insula, and the temporal-parietal region, suggesting that these areas may be involved in the development of vocal emotion recognition.