UBC researchers develop new interventions for those who have suffered a stroke
Strokes are a leading cause of death in Canada, affecting hundreds of thousands of people a year. The treatments that help reduce the effects of a stroke are time-sensitive and understanding the signs and symptoms can help save lives.
Stroke Month, which takes place every June, is a campaign to spread the word about what communities and individuals can do to stay healthy and identify potential strokes.
At the University of British Columbia’s Okanagan campus, a team of researchers is investigating strokes and stroke outcomes to help healthcare providers better understand the cognitive function of their patients.
We spoke with Assistant Professor of Psychology Dr. Maya Libben, whose research areas include cognitive neuroscience and clinical neuropsychology, to learn more about the new Psychopathology Lifespan and Neuropsychology (PLAN) Lab at UBC Okanagan, and how her team of researchers is advancing rehabilitation plans for those who have suffered a stroke.
Q: Tell us about the PLAN Lab. What are your research areas, and what do you and the team focus on?
ML: The PLAN Lab is a new research space at the UBC Okanagan campus funded by the Canadian Foundation for Innovation. One of our primary areas of research is the investigation of stroke and stroke outcomes. A stroke is a cerebrovascular accident that occurs when there is a disturbance in the blood supply to the brain, due to either a lack of blood flow or a haemorrhage.
We’re interested in the cognitive effects of stroke, which often include impairments in memory, planning, language, perception, attention and problem solving and as well, the emotional consequences which can include depression and anxiety. Our research combines state-of-the-art technology with traditional neuropsychological measures to evaluate and develop new methods of assessing the cognitive consequences of stroke, investigate the cognitive factors that predict recovery and good functional outcome following a stroke, and develop cognitive rehabilitation interventions to improve functional outcome following a stroke.
Q: Describe the partnership with the Kelowna General Hospital. How does this relationship forward your research?
ML: Our relationship with the Kelowna General Hospital (KGH) is essential to our research. Me and Dr. Harry Miller are the lead investigators for the PLAN Lab’s research on stroke, and our close partnership with KGH allows us to work with stroke patients while they are receiving acute clinical care, perform testing at the hospital, and access valuable neuropsychological assessment data and measures.
Student members of the PLAN Lab have the opportunity to gain clinical exposure within a medical environment. Both undergraduate and graduate students are offered training in the assessment of cognitive and emotional function among stroke patients, and are able to develop new research projects to investigate the cognitive consequences of stroke.
Q: Let’s talk about the lab facilities. Equipment ranges from behavioural testing computers, eye-tracking devices, and an eletroencephalography system, offering hands-on training for students. How important are these applications to your research and what kind of data can you collect?
ML: The integration of state-of-the-art methodological techniques is what makes the research in the PLAN Lab different from traditional neuropsychological investigations of stroke. For example, we are currently doing some very exciting research using eye-tracking to investigate hemispatial neglect, which is a condition that typically occurs after a right hemisphere stroke. Someone who suffers from hemispatial neglect often fails to perceive the left side of their body and sensory space. This means that they might only eat off of the right side of their plate, apply make-up to the right side of their face, not attend to the left side of space and only dress the right side of their body. This is clearly a debilitating condition that severely impacts the individual’s quality of life and is a significant barrier to return to independent living, but to date, there is still much we don’t know about hemispatial neglect.
Jennifer Upshaw is a clinical psychology graduate student in the PLAN Lab who is currently using eye-tracking to evaluate how we assess and classify hemispatial neglect, as well as to develop new ways of predicting functional outcome among people who suffer from this condition. Jennifer showed that techniques such as eye-tracking provide us with a significantly more sensitive measure of attentional deficit in hemispatial neglect, and allow us to better classify and predict functional outcome among individuals who suffer from this condition.
Q: How does the research conducted at the PLAN Lab benefit patients who have suffered from strokes? How does your research help these individuals?
ML: Research in the PLAN Lab benefits patients by improving our ability to accurately assess cognitive and emotional deficits following a stroke. Through our research, we are better able to guide rehabilitation efforts and ultimately develop new interventions for those who have suffered a stroke.
Damian Leitner, another graduate student in the PLAN Lab, has done amazing research on the use of neuropsychological assessment batteries to predict how well stroke patients will recover and what their functional limitations might be. In other words, his research facilitates our ability to look at a patient’s neuropsychological test results and predict what kinds of challenges that patient may face when they are discharged back home. This information will allow us to make better rehabilitation plans for the patient.
In another line of research, we hope to use the technological equipment we have available at the PLAN Lab to not only improve assessment techniques, but also to develop new clinical interventions for stroke patients. There is a lot of promise in the use of eye-tracking to re-train attention deficits seen among patients with hemispatial neglect. Ultimately, we hope to develop new user-friendly cognitive tasks for stroke patients that will significantly speed the recovery process and improve their overall quality of life.
Q: In terms of stroke awareness, what are the top warning signs? How can we better educate the community?
ML: The cardinal feature of stroke is a sudden onset of one or more neurological problems. The individual might notice that half of their body becomes weak. Symptoms might include the sudden inability to walk, drooping on one side of the face, or a sudden change in the ability to speak. Either the individual can't say the words properly or they have difficulty retrieving the word they want to say. Lastly, there might be a change in vision where the individual will lose vision in one eye or half of their vision disappears suddenly.
Health care practitioners often use the acronym F.A.S.T when talking about stroke warning signs. This stands for: Face drooping – Arm weakness – Speech difficulty – Time to call 911. This highlights the importance of seeking immediate medical care when there might be evidence of a stroke.
The key factor in minimizing the amount of damage to brain tissue, as well as the long-term effects of stroke, is immediate medical attention.