New paper on link between language impairment and alexithymia in stroke

In this new paper, led by Hannah Hobson, we found that self-reported communication difficulties associated with higher scores of alexithymia.

Lay summary:

Some people report that they struggle to identify and communicate their emotions after experiencing a stroke. Problems recognising your own feelings – sometimes called “alexithymia” – has been found to be a predictor of mental health difficulties in people who have not had a stroke, so understanding what causes this problem could be useful to supporting the mental health of stroke patients.

One idea is that disrupted language abilities might contribute to emotional problems: we might use language to help us make sense of, label, and communicate how we are feeling. If our language abilities are disrupted, our emotional abilities might suffer as a result.

This project examined the links between alexithymia and language problems in stroke survivors. Interestingly, while behavioural language abilities (those measured with a task, such as being able to give the right word for a picture) did not predict alexithymia. However, when patients were asked about how they felt their communication abilities had changed, these self-reported measures of language were associated with alexithymia.

These findings partly replicate previous results from studies with Traumatic Brain Injury patients. One reason that we see differences between the task-based and self-reported measures could be that the task-based measures only reflect quite severe language impairments, while asking patients might reflect more subtle impairments.

 

The full text (accepted author-version of the paper) can be accessed here.

COVID-19: Suspension of patient recruitment on studies

Following the Corona-virus outbreak, we have suspended recruitment for all ongoing datacollection. This includes OCS-Recovery which was recruiting in the John Radcliffe acute stroke unit and Oxfordshire Stroke Rehabilitation Unit in Abingdon;  COMPASS feasibility and validation on the acute general medicine wards and homevisits from outpatient memory clinics as well as OX-Chronic long-term stroke survivors from our screening cohorts.

The latter in particular has been a very difficult decision, with many of our regular stroke survivor research volunteers some of whom we have been working over the last 6 years now isolated in their homes.  We are going to keep in contact over the phone, just to check in and help keep everyone safe, but not forgotten.

 

Our lab has also moved into remote working set-ups with everyone working from home. Videocalls and virtual coffee breaks are keeping us working closely together.

 

New labmember: Dr Owen Williams

Welcome to Owen Williams, who is joining us as the lead postdoctoral researcher on the Stroke Association Priority Programme Award project OX-CHRONIC. Owen joins us from his previous postdoctoral research post at the NIH on the Baltimore Longitudinal Study of Aging project.

UK Stroke Forum 2019

In December 2019, the Translational Neuropsychology Group travelled to Telford for the 14th annual UK Stroke Forum, hosted at the Telford International Centre. The UK Stroke Forum is a multidisciplinary conference for any stroke care professional. There was a mix of practicing clinicians, occupational therapists, physiotherapists, doctors, researchers, and also stroke survivors and their families. This unique mixture of those involved in stroke care enabled us to focus our efforts on disseminating information related to our new and improved cognitive screening tools. Thanks to the efforts of our Research Coordinator Romina Basting we were able to coordinate the group’s efforts through three intense days of talks, training workshops, demonstrations, and networking.

Talks and Demonstrations

On the first day, Prof. Nele Demeyere & Dr Kathleen Vancleef ran two back to back interactive workshops for over 200 attendees as part of the clinical training stream hosted by Dr Charlie Chung (Stroke Specialist Occupational Therapist), to explain the how, what and why of the Oxford Cognitive Screen (OCS) for screening post-stroke cognitive impairment.

 

Another talk by Prof. Nele Demeyere was our most anticipated, where we launched the OCS-Plus. The OCS-Plus is a stand-alone computer-tablet based extension of the OCS which screens for milder cognitive impairments, teasing out subtle impairments which are missed by gross level cognitive screens. As expected, this talk garnered much interest from the attendees and our stall was flooded with interested clinicians. Sam Webb was kept busy for the bulk of the Stroke Forum, where he demonstrated the OCS-Plus in action to many interested groups. Through sign-up sheets we were able to see just how many clinicians and clinical groups are interested in running the OCS-Plus in their own settings. We are currently only able to set up research collaborations, but will be keeping everyone posted on when the tests will be available clinically.

Posters

Both of our DPhil Students, Elise Milosevich and Margaret Moore presented on their latest projects, as well our Postdoctoral research fellow Dr Kathleen Vancleef and our Research Assistant Sam Webb. During 3 minute-slot poster tours our group were able to test our quick dissemination skills by running groups through our projects from start to finish. It was an excellent opportunity to show stroke care professionals what our research group does and how our individual projects are merging to improve current clinical practice regarding screening for impairments.

 

 

 

 

 

 

 

Sam Webb presented our ongoing norming and validation study of the COMPASS tool, his poster is uploaded here. Prof. Nele Demeyere presented the poster for our newly launched OCS-Plus app, including healthy normative data and validation information, the poster is accessible here. All other posters were logged in the UK Stroke Forum 2019 app and journal indexed.

Prof Demeyere & Richard Raynor talk at IF festival

On Sunday 20th October, Nele and Richard teamed up to talk to members of the general audience as part of the public engagement IF festival (Oxford Science and Ideas Festival).

Richard Raynor described how his world was turned upside down at the age of 31, when a severe stroke led to a loss of language. In this vibrant, colourful and coming-to-terms talk, Richard described the day of his stroke, his recovery, intensive rehabilitation, and his involvement in our neuropsychology research. Associate Professor of Psychology, Nele Demeyere, explained how cognitive neuropsychology studies of these often hidden consequences of brain injuries have provided essential windows into understanding how our brains work.

 

Richard’s positive outlook and message on living life is awe-inspiring, and led him to be awarded as Stroke Association Life after Stroke Award

 

Oxford Open Doors

Last weekend (14th and 15th September 2019) the Department of Experimental Psychology hosted an Open Doors events. The Open Doors event is “is an annual celebration of Oxford across all walks of life, its places and its people” and you can find more information on Oxford Open Doors. Having the department open for the public meant that over 450 people attended over the weekend and we received quite a large proportion of people who wanted to sign up as volunteers to take part in research. Sam Webb, Grace Chiu, and Michael Colwell were able to entertain 207 people on the first day by showcasing the OCS-plus, COMPASS, and other neuropsychological tests used in the lab. This involved demonstrating the tasks to the audience as well as talking individual groups through why we do what we do. It was great to get the public on board with our message about clinical tools development and so motivating to see the reactions and enthusiasm of people for our research. A great experience for our lab-members who got to practice explaining their research in an accessible way. A great experience all round!

FESN – Milan

The Translational Neuropsychology Group traveled to Milan this month to present several new research projects at the Federation of European Societies for Neuropsychology’s 2019 conference (FESN 2019). This conference featured researchers from around Europe presenting on many related topics in Cognitive and Clinical Neuropsychology. The conference itself was hosted by the Catholic University of the Sacred Heart or Universita Cattolica del Sacro Cuore. For our time in Milan we stayed in the cities heart and visited the Piazza del Duomo which was host to a famous study about representational neglect which is still talked about even though it was published over 40 years ago by Bisiach & Luzzatti. Considering research moves quickly and this study is still discussed we felt we had to go there and check it out. 

 

 

The program itself was packed with excellent symposia and speakers from across the globe, including our very own Margaret Moore who presented her work. Her talk focused on her theoretical research teasing apart whether having attentional/spatial issues with words is part of the same cognitive mechanism as attentional/spatial issues with visual space. Turns out whether we can definitively say they are one shared mechanism or different is contentious and stirred up a lot of discussion and lively talk, and led to new potential collaborations with other neglect researchers. So her talk certainly was a winner for us.

 

Sam Webb also presented a poster on our COMPASS project,  sharing one of the Translational Neuropsychology Group’s newest tools, the COMPASS, a brief neuropsychological screen to supplement and guide mental capacity assessment. The poster presentation gave Sam a unique opportunity to share this new tool with other groups and gain thoughtful feedback, some of which has now influenced the research pathway we intended, which was fantastic. Of course there were plenty of speakers who we had not collaborated with who were very interesting to listen to, and thought provoking symposia. For instance, there were many (at least 3) symposia/talks on spatial neglect, others on body movements and how they are represented in the brain, and plenty on memory loss, including discussion of Alzheimer’s disease and dementia.

 

 

All in all FESN 2019 was a fantastic conference in an inspiring venue, located in a city which has historical routes in neglect research (see photo of the Piazza del Duomo – famous for being the base for the first paper to investigate attentional issues towards our mental representation of a place/object), and has allowed us to bridge new international collaborations and fine tune our research.

 

Paper reporting on OCS-Care study now available

Our paper on the multi-site OCS-Care study is now available on AMRC open research, an open access and open review pre- and post-print service by F1000 Research. The study was one of the last large projects led by the late Prof Humphreys, to whom the grant by the Stroke Association was awarded. Prof Humphreys designed and led the majority of this project and unfortunately was unable to see its completion. Although it has taken us a while to curate all the data, we finally completed the data cleaning and analysis with visiting MSc student Shuo Sun and are now closing this study by publishing this overall report.

The study found a null result in the primary registered, outcome measure:  in a comparison of patients screened with MoCA or OCS, overall broad stroke outcomes after 6 months did not differ. Exploratory analyses highlight the varying trajectories post stroke in a large group of 467 stroke survivors for who data was collected acutely and 6 month post stroke with a proportion of patients demonstrating stable cognitive performance, most demonstrating recovery, and around a fifth of patients showing cognitive decline.

The paper reflects some of our core values, in collaborative and open research:

This study ran in 37 different hospital sites with the help of UKCRN, and with the excellent coordination by the Study Management Team of Dr Tracy Nevatte and Mrs Alison Buttery. The analysis and write up was a true collaborative effort in the lab, and we set time aside as a group to work on this, kick-starting the write up with the ‘paper in a day’ approach (thanks to Prof Jennifer Tackett for inspiration!), organised by our postdoctoral fellow Dr Kathleen Vancleef. 

The experience of submitting our first paper to AMRC Open Research was very positive. Clear instructions, clear ways of presenting data, all data openly available in a public repository for other groups to use and all code attached and available (all available under the project on Figshare). The paper even includes one of Shuo’s beautiful interactive Figures. AMRC Open also uses CRediT statements to make author contributions fully transparent. Finally, we look forward to the open and signed reviews, which will be a first for us too.

The lay summary of the paper can be found here.

Sam Webb appointed as Research Assistant on EEG collaboration

Sam Webb, who completed his MSc project in the lab is starting a new role as research assistant on a collaboration of our lab with Monash University’s Prof Mark Bellgrove‘s group (including Dr Méadhbh Brosnan) and University of Queensland’s Prof Jason Mattingley‘s lab.

This project uses recent advances in electroencephalography (EEG) to investigate a new test of visual attention difficulties in chronic stroke survivors. EEG is a technique which measures brain waves by recording from electrodes on the head. This new EEG-based test will distinguish between different processes in the brain that may be contributing to visual attention difficulties. These include how alert and attentive an individual is, how well they can select and process visual information, and how well they can signal motor movements.

Across 3 sites (Melbourne, Dublin and Oxford), we will recruit 100 stroke survivors (with and without attentional difficulties) and assess how they process and respond to visual information using EEG. We will explore how these EEG signals relate to standardised assessments currently used in clinical practice.

Kathleen Vancleef awarded Christ Church College funding

Kathleen Vancleef has been awarded a grant from the Christ Church Research Centre to develop and validate a visual perception screening app suitable for stroke patients at Acute Stroke Units. This translational project complements her Stroke Association Fellowship, and you can read more about the project here.