Rehabilitation of Prospective Memory Deficits in Individuals with
Alzheimer's Disease
Abstract
This project will investigate the efficacy of prospective memory training
in individuals with Alzheimer's disease. Prospective memory is the ability
to remember to do something at a future time (like buy something at the
store or go to a doctor's appointment). Prospective memory has been
acknowledged by several authors as the most important aspect of memory
for daily life. It is therefore surprising that this aspect of memory has
been rarely studied. As part of this study of prospective memory, three
components of cognitive rehabilitation will be addressed. The first is the
use of a systematic program of cognitive rehabilitation that is
individually tailored to specific problems the individual experiences, and
to the long-term goals of each subject. The second is the use of measures
designed to help elucidate whether successful cognitive rehabilitation is
providing any measurable change in the brain. The premise for this is
based on both animal studies of brain changes after being in a more
stimulating environment and human studies of the effects of practice on
brain organization. In this case, electroencephalogram (EEG) measurement,
specifically that of event-related potentials (P3 and CNV), will be
utilized. Finally, this study will use techniques from cognitive science,
cognitive psychology and education to maximize the goal of generalization
to daily life. Since the rehabilitation techniques are individualized, a
within-subject treatment design will be used so that direct effects of
treatment on each person can be measured. However, since many of the
measures of efficacy, including the EEG measures, are newly being used
for this purpose, a control group will also be used. This study will be used
to gain data on each of these three approaches that will allow us to refine
the assessment and treatment techniques being used. If the data appear
promising, the results will be used to design more long term studies that
not only involve larger numbers of subjects and more specific EEG
measures but continue generalization training into the community.
Background and Significance
Cognitive rehabilitation has emerged as a technique that can improve
cognitive functions in individuals who have experienced traumatic brain
injury (TBI) (Raskin &;Gordon, 1992; Raskin &;Mateer, 1994; Raskin
&;Sohlberg,1996; Sohlberg &;Mateer, 1989)and dementia....... Unfortunately,
cognitive rehabilitation is still limited in its use because the mechanisms
responsible for improvement are unclear. There are two main difficulties
with the current cognitive rehabilitation literature. First, there has been
virtually no attempt to determine whether rehabilitation techniques may
be capable of promoting brain reorganization. If this is proven, the next
step will be to design treatments to maximize this process. Finally, many
studies lack a clear plan for generalization to daily life (Raskin &;Gordon,
1992; Sohlberg &;Raskin, 1996). This proposed study will address each of
these shortcomings.
Prospective memory has been defined as the ability to remember future
events, or the ability to remember that one had previously decided to
carry out a particular action at that moment (Kvavilashvili, 1992). This is
in contrast to retrospective memory which is the recall of past events.
Prospective memory may be based on time (e.g., remembering to return a
phone call at 4:30 pm), or may be prompted by a cue (e.g., remembering to
take a roast out of the oven in response to the oven timer). If the person is
doing something while waiting for the time to come to make the response,
this is referred to as a distractor.
Investigations of Prospective Memory Ability. Prospective memory has
been investigated in the general population and people with Alzheimer's
disease using questionnaires (Hannon, Adams, Harrington, Fries-Dias,
&;Gipson, 1995), checklists or diaries (Sunderland, Watts, Baddeley,
&;Harris, 1986) and laboratory studies (Koriat, Ben-Zur, &;Nussbaum,
1990; McKitrick, Camp &;Black, 1992). Questionnaires provide information
on level of prospective memory functioning in daily life, however,
subjects are limited to the responses provided on the questionnaire.
Checklist and diary approaches allow for the subject to report actual
failures in daily life as they occur, but also suffers from the degree to
which the person is unaware when failures occur. Laboratory tasks suffer
from lack of real-world applicability and, when the same task is used
repeatedly, may involve learning a routine rather than prospective memory
(Cockburn, 1996).
My colleagues and I have begun a systematic investigation of prospective
memory in individuals with brain injury (Sohlberg, White, Evans, &;Mateer,
1992a&b);and prospective memory training is one relatively new line of
inquiry offering promise as a memory rehabilitation technique. In a study
by Raskin and Sohlberg (1996), subjects with TBI were required to execute
actions at future designated times (for example, "In exactly two minutes,
clap your hands.") As subjects became more proficient, the length of time
was systematically increased. Results supported the ability to increase
subjects' prospective memory span. In addition, two measures of
generalization were used. Subjects improved on both naturalistic probes
(laboratory tasks that simulated real-world tasks, such as "When this
session is over, please remind me to call your wife") and performance in
daily life. The latter was measured by having a friend rate the subjects'
performance on ten tasks that needed to be completed in one week (e.g.,
buy socks).
In an attempt to study prospective memory more systematically, the
proposed study will use a newly developed measure recently piloted in
individuals with TBI (N=10), and normal controls (N=20) . The test includes
two real-world tasks (returning a postcard and scheduling an
appointment). This test appears to be a sensitive measure with good
discrimination, but more data is needed to investigate both its validity
and its reliability. However, it needs to be investigated in Alzheimer's
disease.
Investigating Brain Organization
Historically, theories of recovery after brain damage have focused on
short-term processes in the brain (i.e., less than one year after the
injury). In some systems, such as the system that controls movement,
reorganization of the brain may occur automatically allowing for
undamaged areas of the brain to take over the functions of damaged areas.
Luria (1963) provided the first suggestion that recovery in complex
systems could actually be facilitated through practice. Importantly, he
suggested that practice applied systematically can lead to changes in
brain organization.
Animal studies provide evidence that activity does influence changes in
the brain (Bear &;Dudek, 1991; Jenkins, Merzenich, &;Reconzone, 1990;
Pons, Garraghty, Ommaya, Kaas, Taub, &;Mishkin, 1991) and that enriched
environments enhance brain cell recovery after brain damage in rats
(Dalyrimple-Alford &;Kelche, 1985; Kolb &;Elliott, 1987) and cats (Chow
&;Steward, 1972; Cornwell &;Overman, 1981; Feeney, Gonzalez, &;Law,
1982). Morever, practice with a task has been shown to alter cerebral
organization in monkeys (Zohary, Celebrini, Britten, &;Newsome, 1994) and
to change the brain regions mediating the task in humans (Gevins, 1996;
Raichle, Fiez, Videen, MacLeod, Pardo, Fox, &;Petersen, 1994).
Although it is possible that cognitive rehabilitation techniques could be
designed to facilitate post brain-injury brain reorganization (Bach-Y-Rita,
1990), studies have generally not used a measure of brain reorganization.
Instead, human cognitive rehabilitation studies depend on behavioral
measures, such as memory tests, to demonstrate efficacy of training. This
study will build on early studies of EEG measures in individuals with
prospective memory deficits. The EEG measures the electrical activity
from the brain, and is a measure of how different parts of the brain are
functioning as the person does something. Specifically, event-related
potential (ERP) measures will be used. ERP's are patterns of brain
electrical activity that occur at a particular time after the person sees or
hears something. The novelty P300, with largest amplitude measured in
frontal areas, is recorded to unexpected novel stimuli (Knight, 1984;
Fabiani &;Friedman, 1995). Thus, if a person listens to a series of tones
and then hears a dog bark unexpectedly, a positive wave form will occur
after 300 milliseconds (hence P300). This is thought to be related to
frontal lobe aspects of attention and memory. Individuals with frontal
lobe damage demonstrate a novelty P300 potential in posterior regions
(Knight, 1984). In individuals with brain injuries or diseases, such as
Parkinson's disease (Bodis-Wollner, et al., 1995; Pang, et al., 1988),
depression (Bruder et al., 1995), schizophrenia (Bruder et al., 1996) and
TBI (Ford &;Khalil, 1996; Tebano, et al., 1988), this pattern may be late or
small. One other event-related potential that has been related to
functioning of prefrontal cortex is the contingent negative variation
(CNV). This is a slow increase in cortical negativity (Pellegrino &;Wise,
1991). In this case, the person sees something like a dot on a computer
screen and told that this means to get ready. Then, the person must hit the
space bar when a circle appears some time later. Between the dot and the
circle, the CNV is generated (Dywan &;Segalowitz, 1996). This may be
related to attention, memory and planning.
Baribeau, Ethier, &;Braun (1989) used ERP measures before and after
attention training and demonstrated that the classic P300 happened more
quickly following training. In a study of prospective memory training,
Stone and Raskin (1996) used Quantified EEG prior to initiation of the
training and after the completion of the training. Subjects showed
abnormal distribution of alpha activity prior to training and both showed a
return to a more normative distribution after training. Subjects also
demonstrated improvement on treatment tasks and on generalization
measures of prospective memory functioning in everyday life. In a very
preliminary study, Raskin (1996) then measured the classic P300, before
and after prospective memory training. Two subjects with TBI showed a
more normal P300 following training.
Measurement of generalization. The recognition of the importance of
generalization of treatment to daily life is ingrained in clinical practice
(Raskin &;Gordon, 1992). However, an understanding of generalization and
how to facilitate it is sorely lacking in the field of cognitive
rehabilitation. Generalization of cognitive rehabilitation has been
described by Gordon (1987) in three levels. The first level is that the
gains from rehabilitation should hold true on the same materials on
separate occasions. The second is that improvement on the training tasks
is also observed on a similar but not identical set of tasks. The third level
of generalization is that the functions gained in training are shown to
transfer to functions in day-to-day living.
Stokes and Baer (1977) emphasized the need to plan actively for and
program generalization. Most studies that have demonstrated Gordon's
third level of generalization have, in fact, planned actively for
generalization, many taking advantage of the concept of transfer of
learning. Transfer of learning is most likely achieved when the person
must apply the information to multiple situations (Toglia, 1991). In
individuals with TBI, this principle has been applied with success
(Cicerone &;Wood, 1987; Diller, Goldgood, &;Kay, 1987). The repetition of
examples is suggested as one process for transfer but just providing
examples, as has been done in skills training studies, is not effective for
generalization; subgoals or steps must be identified and trained in an
appropriate hierarchy (Catrambone, 1995). These authors stress that
acquiring competence is labor-intensive, suggesting that a large number
of training trials are necessary.
Some researchers have taken the alternative approach that generalization
is best achieved when training takes place solely in the subject's everyday
environment. Although this model is useful for specific skills in specific
contexts, it does not address generalization of broader functions or
ameliorate any underlying processing difficulties that may be responsible
for the deficit. Therefore, the generalization potential of this technique is
more limited.
Recently, Sohlberg &;Raskin (1996) suggested a set of generalization
principles or strategies which could be broadly adapted in both research
and clinical practice in cognitive rehabilitation. These principles are
drawn chiefly from the applied behavioral literature (Stokes &;Baer,
1977), and from the cognitive psychology literature on transfer of
training (Anderson, 1996). Perhaps the most difficult aspect of adhering
to these principles is selecting the measure of generalization. Sohlberg
and Raskin (1996) suggest three approaches. The first is specific to the
treatment targeted and might include a rating form that targets behaviors
that have been specifically trained in sessions, such as a questionnaire of
prospective memory functioning. The second level includes measures of
everyday functioning specific to the area of treatment, such as memory.
The final level applies to the individual's daily life in more general terms
and these measures generally include items such as social interaction,
productive activities, and independence. This project uses each of these
types of measures.
The proposed project will extend previous work by using a more
systematic measure of prospective memory which will allow for the
investigation of the individual aspects of this process that are disrupted
after TBI (e.g., planning, working memory, retrospective recall). In
addition, this study will extend findings of change in EEG measures
following treatment, and begin to investigate which aspects of
prospective memory functioning are related to which EEG markers. This
study also seeks to extend findings of generalization and to formalize a
method for measuring generalization of treatment to everyday life. The
proposed study is thus an attempt to merge the relevant findings in
rehabilitation medicine, neuropsychology, cognitive neuroscience,
developmental neuroscience, cognitive science and education. Assuming
the results of this study are positive, and treatment gains appear to be
able to generalize to daily life, a larger future study will be initiated,
after the period of this grant. This larger future study would involve three
phases. The first would be a laboratory training study replication of the
current proposed pilot project. In the second phase, subjects will be taken
into the community and prospective memory tasks assigned for them to
complete, with a researcher present to supervise and score performance.
Finally, a training period would take place in the subject's daily life
(either home or work according to subject preference) as suggested by the
vocational rehabilitation literature (e.g., Boehm &;Zuger, in press). In this
final phase, training would use actual tasks that the subject was required
to perform. The researcher would serve to train the subjects to identify
these tasks as they arise and to monitor their own performance and would
thus be utilizing metacognitive strategies (Sohlberg &;Raskin, 1996). In
addition, depending on the results of this pilot study, a refinement of ERP
techniques would be made. This would include 1) analyzing early versus
late sections of the CNV separately, and 2) measuring the performance of
subjects on brief, repeated, tasks of prospective memory and on real-time
measures of short-term memory while recording, in order to examine the
effects of practice and automatization.
Goals and Objectives
The specific hypotheses to be tested are:
1. Performance on a task of prospective memory will improve in the
treatment group only after the introduction of training.
2. Performance on the prospective memory test will differ significantly
between the groups prior to training, but will not differ following
training.
3. Performance on neuropsychological measures specific to prospective
memory will improve only in the treatment group and performance on
other neuropsychological measures will not improve in either group.
4. Latency of the novelty P300 will be shorter in the control group prior to
training, but will not differ between groups following training.
5. Amplitude of the CNV will be significantly different between the groups
prior to training, but not following training.
6. The latency and amplitude of the novelty P300 will correlate
significantly with the neuropsychological measures of prefrontal
functioning, and with the prospective memory test.
7. The amplitude of the CNV will correlate significantly with the
neuropsychological measures of prefrontal functioning, and with the
prospective memory test.
8. Performance on the generalization measures (significant other rating
form, prospective memory questionnaire, memory questionnaire,
questionnaire of community integration) will significantly superior in the
treatment group following training as compared to prior to training.
Methodology
Research Design. Individualized rehabilitation in single subject designs
has been stressed by many authors as the only way to allow for analysis
of inter and intrasubject variability (e.g., Raskin &;Gordon, 1992;
Gianutsos &;Gianutsos, 1987; Stein &;Glasier, 1992). Therefore, this study
will use the Multiple-Probe Technique (Horner &;Baer, 1978) within a
Multiple-Baseline Across Subjects Design. The probe will be the telephone
call check-in described below.
Because of some reports of attenuated P300 with repeated testing
(Wesensten, Badia, &;Harsh, 1990) and enhanced CNV with practice (Tecce,
1972), and the unknown reliability or effects of practice on the
experimental measures, a control group will also be employed. Data will
be collected on neuropsychological measures of functions presumed to be
related to prospective memory before initiation of treatment for both
groups. In addition, data will be collected on the latency and amplitude of
the P300 potential and the CNV. Finally, data will be collected on the
performance of each subject on each training task in each training
session. At the completion of the training, the performance on
neuropsychological tests, P300 and CNV data will again be obtained. The
current subject pool (N=30) and ongoing referrals suggest that it will not
be difficult to obtain 20 subjects who are one year post injury and have
not received rehabilitation, but if, after the first two months, adequate
subjects have not been identified, the study will be expanded to include
individuals who have had treatment but have been discharged for a
minimum of six months. There is no a priori reason to assume differences
between subjects according to gender or ethnicity on these measures.
However, if sufficient data is available these will be analyzed separately.
The first month of the study will be spent recruiting and screening
subjects, preparing materials, and programming the EEG tasks. The next
two months will be spent testing subjects on neuropsychological and on
the EEG measures, and beginning the processing of the EEG data. The
following six months will be spent on baseline measures of the probe and
generalization tasks and performing the treatment. The next two months
will be spent re-testing all subjects on EEG and on neuropsychological
measures. The final month will be spent analyzing data and preparing
publications.
Subjects. All subjects will be ages 20-55 from the surrounding
community and will be recruited through local hospitals. In addition,
consecutive admissions to the Hartford Hospital TBI Clinic will be
screened for participation. Demographic information will be collected
from self-report and review of the medical records including age,
education, occupational level, gender, handedness, months since injury,
and age at time of injury, as well as the measures of injury severity:
duration of loss of consciousness, Glasgow Coma Scale score at admission
and duration of post-traumatic amnesia where available. Exclusion
criteria include: previous neurologic or psychiatric illness, significant
history of substance abuse or learning disability, focal injury visualized
via CT or MRI, neurosurgery, significant visual impairment, less than one
year post injury, currently treated for seizure disorder, previous cognitive
rehabilitation, nonfluency in English, illiteracy, family history of
schizophrenia. All subjects will be administered the Brief Psychiatric
Rating Scale (Overall and Gorham, 1962) to screen for psychiatric illness
and so that ratings on the Neurobehavioral Rating Scale (Levin et al.,
1987) items can be obtained. No subject with severe depression (> 21 on
the Beck Depression Inventory) (Beck, 1987) or anxiety (Beck Anxiety
Inventory) (> 30 on the Beck, 1990), global cognitive dysfunction (severe
impairment on four or more of the subscales of the Neurobehavioral
Cognitive Status Examination) (Kiernan, Mueller, Langston, &;Van Dyke,
1987), severe language comprehension deficit (severe impairment on the
language comprehension subtest of the Neurobehavioral Cognitive Status
Examination) or below 10th grade reading level (The Wide Range
Achievement Test-Revised) (Jastak &;Wilkinson, 1984) will be included.
All subjects will be given an audiometric screening, and will only be
included with less than a 10 dB difference between ears and a hearing loss
no greater than 30 dB at 500, 1000, and 2000 Hz. All subjects will have
baseline prospective memory performance of less than 10 minutes.
Materials. The prospective memory tasks will all consist of simple
commands composed of three words (e.g., "touch your nose"). Half of the
sentences will involve an external object and were created by combining
one of five verb terms (touch, lift, turn, move, tap) with one of five
objects (pen, paperclip, cup, key, scissor) and the appropriate article (e.g.,
"touch the pen"). The other half of the sentences will not involve an
external object, but are simple gestures such as snap your fingers, clap
your hands.
The prospective memory tasks are presented on two three by five cards.
One card will indicate the cue which will be either time-based ("In
exactly four minutes") or associative ("When I show you a picture of a
chair"). There will be two sets of time-based cue tasks and two sets of
associative cue tasks presented to each subject. For one set subjects will
be asked to verbally report the task written on the card. For the other set
subjects will be asked to perform the action. Subjects will be told at
presentation which form of recall to be performed. The full set of objects
will be in full view at all times in the center of the table. Location of
objects relative to each other will vary across subjects and be kept
constant within each subject. The delay period will be filled with one of
two tasks. The less distracting task will be a simple repetitive motor
task of finger tapping. This task prevents subjects from watching the
clock continuously and in preliminary studies (TBI N=5, NC N=10), subjects
have performed identically to having no distraction. The second distractor
will be an auditory attention tape which has been used in several previous
studies (Sohlberg, Johnson, Paule, Raskin, &;Mateer, 1994). This task
requires subjects to listen to an audiotape for a single target number (the
number four). The tape presents 30 occurrences of the number four in each
block of 100 numbers. All numbers are between one and nine. Tapes were
generated using Sound Blaster and HyperCard on the Macintosh computer.
All numbers are presented at a rate of one per second.
The order of tasks will be randomized between subjects both for the order
of each type of task and for the specific tasks and cues used. If after
random assignment a subject is given the same task to present twice, a
new item will be assigned. Each subject will receive two trials of each of
the time delays for each type of cuing, for each level of distraction, and
for each type of recall. This will make a total of 12 two minute trials
(associative cue, time-based cue, easy distraction, difficult distraction,
verbal retrieval, action retrieval). Each subject will also then receive 12
ten minute trials identical to the two minute trials above.
In all conditions, performance will be scored on a two-point scale. One
point will be given for either recalling the correct task or for recalling
that a task needed to be performed at the correct time (allowing + 10% of
the time to allow for lack of synchronization of the clocks). Thus,
recalling the correct task at the wrong time (for the time-cued tasks) is
awarded one point. Recalling the incorrect task at the correct time (either
at the elapsed time or at the cue) is awarded one point. Recalling both the
correct task and at the correct time is awarded two points.
Neuropsychological tests were chosen to measure functions of interest
and because either multiple forms are available or practice effects have
been shown to be minimal. All subjects will be administered the following
battery of tests, by an examiner blind to the study, prior to the initiation
of treatment. Consonant Trigrams Test (Peterson &;Peterson, 1959) will
be included as a measure of working memory. Tower of Hanoi (Davis et al.,
1994) will be included as a measure of planning. Time estimation (Cool
Spring Software, 1989) will be included as a measure of time estimation.
National Adult Reading Test-Revised (Blair &;Spreen, 1989) will be
included as a measure of premorbid intellectual functioning. Rivermead
Behavioral Memory Test (Wilson et al., 1991) will be included to measure
both retrospective and prospective memory functions on real-world tasks.
Revised Attention Process Test (Raskin et al., 1994) will be included to
measure several aspects of visual and auditory attention, including
divided attention. Trail Making Test (alternate forms from the Lafayette
Clinic Repeatable Neuropsychological Battery [Lewis, Kelland &;Kupke,
1990]) to test sequencing and shifting mental set. Two verbal fluency
measures, Controlled Oral Word Association Test (COWAT) (Benton
&;Hamsher, 1989) and Animal Naming from the Boston Diagnostic Aphasia
Examination (Goodglass &;Kaplan, 1983) will be included. The story recall
and picture recognition from the Randt Memory Test (Randt &;Brown,
1986) will also be included as measured of visual and verbal retrospective
memory.
Procedure
First informed consent will be obtained. Then, an interview will be
administered with the screening measures to determine whether subjects
meet the study criteria. This will be followed by administration of the
neuropsychological tests and the ERP measures. Then baseline prospective
memory ability will be determined by administering the prospective
memory test five times to each subject. Total testing time will be
approximately four hours per subject. Attempts will be made to test
subjects in two separate two hour sessions. The standard
neuropsychological tests will be performed first and then the prospective
memory tasks. The order of the neuropsychological tests will be
randomized across subjects and the order of the prospective memory
tasks will be randomized across subjects. Breaks will be given if subjects
complain of fatigue. All tests will be administered using standard
procedures, without attempts to test the limits. All testing and test
interpretation will be supervised by a neuropsychologist who is a licensed
psychologist. ERP measures will be taken within one week of the
neuropsychological testing. The baseline measurement of the probe will
follow. The number of baseline measurements taken will vary from two to
six for each of the five subjects in each group.
ERP Measures. All subjects will receive ERP recordings once at the
initiation of the study and once at the termination of the study. The ERP
studies will be performed using Neuroscan SCAN software and a Neuroscan
32 channel multi-amp amplifier. Electrodes will be fixed in the
International 10-20 system via an Electrocap with gold-clip earlobe
electrodes linked as reference. All impedances will be ensured to be less
then 5K ohms. Vertical eye movements will be monitored via electrodes
immediately above and below the eye. Recordings will be made with a
bandpass of 0.01-30 Hz and digitized at 200 samples/s. Eye movement
artifacts will be corrected off-line.
The ERP testing will follow the novelty oddball procedure of Fabiani
&;Friedman (1995). The session will include a practice block, followed by
four blocks of the auditory oddball task, and eight blocks of the novelty
task. The practice block will include 25 trials, with three target and 22
nontarget tones. The oddball testing blocks will consist of 50 pure tones
in random order at 1/second. One tone will be frequent (p=.88, 44 stimuli)
and the other rare. The rare tone will be designated as the target. Subjects
will be instructed to respond to the target tones as quickly as possible by
pressing a button on a keypad. A short break will then be given. The
novelty task session will then consist of eight additional blocks of an
auditory oddball task in which novel sounds (e.g., dog barking) are mixed
with the tones. The standard tones will be presented more frequently
(p=.76, 38 stimuli) and the novel sounds and target tones less frequently
(p=.12, 6 stimuli each). Subjects will be given the identical instructions
to respond to the target tone.
The tones to be used will be 500 and 350 Hz and will be presented for
336ms. All stimuli will be timed, coded, and presented using Neuroscan
STIM software (GENTASK). Tones will be produced from sound files using
STIM. The novel sounds will be imported from other sources, such as the
Cool Spring Similar Sounds Software package and will not exceed 400ms
in duration. They will consist of a variety of sounds including
environmental sounds from nature or mechanical devises, musical
instruments or artificial sounds. Two nonoverlapping sets of 48 novel
sounds will be created. Each subject will receive sounds from one list
pretreatment and sounds from the other list posttreatment. The lists will
be counterbalanced across subjects. The novel sounds presented in each
block will be randomly intermixed with the pure tones but no two novel
sounds, two target tones, or a novel sound and target tone will be
presented consecutively.
The amplitude of each ERP component will be defined as the averaged
voltage within a specified time window, compared to prestimulus
baseline. The latency of each component will be estimated as the latency
of the largest peak within the same window. The time window for P300
will be 250-450ms. However, it is recognized that some subjects may
have longer latencies, so data will be inspected visually to ensure this
window is adequate. The P300 scalp distribution will be defined as the
change in component amplitude across the midline recording sites (Fz, Cz,
and Pz).
To elicit the CNV, the procedure of Tecce (1972) will be used. This is a
reaction time paradigm in which there are two stimuli. The first is the
warning stimulus (S1) and is followed by a stimulus indicating that some
activity must be performed (S2). In this study S1 will be a square flashed
on a computer screen for 500 ms and S2 will be a pure tone. The
interstimulus interval will be 5000 ms. The subject will be instructed to
press a button on a keypad to terminate the tone and will be encouraged to
not only be accurate but to press as quickly as possible. The CNV will be
measured at Fz, Cz, and Pz and will be the average amplitude from 300ms
after S1 until 120ms after S2.
Measures of Generalization. To measure generalization of potential
changes in prospective memory ability, two generalization probes will be
administered. The first probe will involve initiating the prospective
memory task of making a telephone call at a target time. The examiner
will give each subject a specific date and time in which to call to "check
in". This will be performed from two to six times (one subject two times,
one subject three times, one subject four times, etc.) for each group to
determine baseline performance. Then it will be repeated at each session
of treatment. Phone mail allows for precise measurement of accuracy. The
second probe will consist of using a pre- post-test format to measure
performance on prospective memory tasks in the subjects' day to day
living. For each subject, a person will be identified and trained to
complete a diary study of prospective memory functioning. The diary study
will be conducted once prior to initiating the experiment and again at the
conclusion. The diary study will involve keeping data for one week on ten
prospective memory tasks which are part of the subjects' regular daily
routine and which are identified by the subject and examiner prior to the
measurement week. Two points will be given for completing each of the
10 prospective memory tasks, using the scale described previously, with a
total score possible of 20 points.
The next measure of generalization will be The Prospective Memory
Questionnaire designed by Hannon et al.(1995). The self-report used by
these authors as well as a significant other version created by the current
authors will be used. In addition, an everyday memory questionnaire will
be employed (Mateer, Sohlberg, &;Crinean, 1987) to measure all aspects of
memory functioning in daily life. Finally, the Community Integration
Questionnaire (CIQ) (Willer &;Corrigan, 1994) will be used to measure
overall daily functioning.
Training Procedures. At the beginning of training, a program adaptation
phase will be used to familiarize the subject to the techniques. All
subjects will receive training in one hour sessions, two times per week,
for a total of six months. The TBI group will begin prospective memory
training at one minute beyond their baseline ability. They will be given a
task to perform in that period of time. The distraction will be visual
cancellation tasks from the APT-II (Sohlberg et al., 1994). As a subject
becomes proficient at a time span (defined as five consecutive trials of
getting both the time and task correct), the delay time will be increased
by one minute. For the control condition a task judged to be highly
analogous to the prospective memory training, but which has been
demonstrated not to improve performance will be used (Raskin &;Sohlberg,
1996). This requires subjects to perform a task identical to that used in
the prospective memory training, then after waiting a specific period of
time, the examiner asks the subject to recall the task performed. Because
of difficulty with consistent scheduling of subjects, training will be
terminated when a subject has received a total of 48 sessions with no
more than one week of non-training occurring during the training block.
Protection of Human Subjects
This study has been approved by the Institutional Review Boards at Trinity
College and Hartford Hospital. All subjects will be required to indicate
informed consent. The consent form includes information on what they
will be asked to do in the study, stresses the ability of subjects to
terminate participation at any time, and discusses confidentiality.
Confidentiality will be maintained by giving each subject a code number.
Only the code numbers will be entered on the test sheets. The key which
links the numbers to the subjects will be kept in a locked file cabinet,
accessible only to the principle investigator. There is no risk to subjects
in participating. There is no deception.
Organization
Trinity College is a community united in a quest for excellence in liberal
arts education. Our paramount purpose is to foster critical thinking, free
the mind of parochialism and prejudice, and prepare students to lead
examined lives that are personally satisfying, civically responsible, and
socially useful. 1,877 full-time undergraduates were enrolled in the fall
of 1996. Approximately 180 students are in enrolled in programs leading
to master's degrees. Trinity has been rated in the top 25 colleges in the
United States by U.S. News and World Report for many years. Trinity has
180 full time faculty members, 95 percent of whom hold the highest
academic degree in their field. The faculty at Trinity excel in their dual
vocation as teachers and scholars, actively engaged in intellectual inquiry.
The Institute for Scientific Information recently ranked Trinity as one of
the top five liberal arts colleges in the nation in the number of scholarly
publications by faculty in the biomedical sciences. The campus
environment provides state-of-the-art research facilities. In addition,
both long-standing and new alliances have been forged with the
neighborhood institutions of Hartford Hospital and the Institute of Living.
The neuroscience program, in particular, is an interdisciplinary program
involving the Departments of Biology, Chemistry, Engineering, Philosophy,
and Psychology. Current research projects include the effects of neonatal
stress on brain chemistry in rats, and the effects of learning on the
hippocampus of the brain. More specifically, the cognitive neuropsychology
laboratory includes up-to-date computer facilities, including a silicon
graphics computer and a full array of computerized and paper-and-pencil
neuropsychological tests. The Neuroscan Quantified EEG machine includes
a 32 channel amplifier. Typically, the lab includes the principle
investigatory, one or two master's level research assistants, and
seven-ten undergraduate research assistants.
Project Director
Sarah A. Raskin, Ph.D. received her B.A. from Johns Hopkins in Behavioral
Biology. She received her doctorate in Neuropsychology from the City
University of New York Graduate Center, having attended the program at
Queens College. She completed postdoctoral training and then continued on
staff at the Mount Sinai Medical Center Department of Rehabilitation
Medicine in New York City. There she performed cognitive rehabilitation of
individuals with a variety of neurological disorders, while maintaining an
active research program in rehabilitation. She then went to work with
Catherine Mateer at the Good Samaritan Neuropsychological Services in
Puyalllup, Washington. She continued to perform cognitive rehabilitation
on an outpatient basis, both in individual sessions and as part of a mileau
therapy setting. She also continued to perform research into effective
methods of cognitive rehabilitation. She is currently Assistant Professor
of Psychology and Neuroscience at Trinity College. She has given numerous
presentations at professional meetings, authored over twenty articles and
chapters on neuropsychology and cognitive rehabilitation and has a book
coming out with Oxford University Press on neuropsychological
management of mild traumatic brain injury. She has also been active in
various brain injury organizations, facilitating brain injury support groups
for over ten years, and is currently on the Board of Directors of the Brain
Injury Association of Connecticut.Dissemination
Sarah Raskin has consistently presented research at professional
conferences over the past ten years. In particular, she has given numerous
presentations at the International Neuropsychological Society and the
Cognitive Neuroscience Society. It is likely that the results of this study
will be appropriate for presentation at these meetings as well. She has
also published in journals such as Journal of Head Trauma Rehabilitation,
Journal of Clinical and Experimental Neuropsychology, Neuropsychology,
and Brain Injury. The results of this study are likely to be acceptable for
publication in one of these journals. More locally, she is the north
secretary and the speaker coordinator of the Connecticut
Neuropsychological Society. Thus, she will present the data from this
study while in progress, as well as at completion, to this body. She is also
on the Board of Directors for the Brain Injury Association of Connecticut
and is currently in charge of organizing their annual conference. This
conference will be attended by professionals, survivors and family
members. She will be able to present this study there and would invite the
study participants to volunteer to appear at the conference on a panel
discussion. She has a frequently visited web page
(http://www2.trincoll.ed:80/~raskin/) that includes a listing of her
current publications. This study would be summarized there. She would
also want to prepare a pamphlet on prospective memory and memory
management techniques based on the results of this study to be
distributed by BIA. She frequently speaks at local hospitals and
rehabilitation facilities. Finally, she continues to facilitate support
groups and to work with individual survivors. She will thus be able to
discuss any promising findings directly with them. One of the groups she
facilitates, together with a group of students, is planning an educational
video on TBI to be shown on a local access cable station. Subjects in this
study would asked to participate and to discuss prospective memory in
particular. This video could also be distributed by BIA.
Literature Cited
Anderson, J. (1996). ACT: A simple theory of complex cognition. American
Psychologist, 51, 355-365.
Bach-Y-Rita, P. (1990). Brain plasticity as a basis for recovery of function
in humans. Neuropsychologia, 28, 547-554.
Baribeau, J., Ethier, M., &;Braun, C. (1989). A neurophysiological
assessment of selective attention before and after cognitive remediation
in patients with severe closed head injury. Journal of Neurologic
Rehabilitation, 3, 71-92.
Bear, M. &;Dudek, S. (1991). Stimulation of phosphoinositide turnover by
excitatory amino acids: pharmacology, development, and role in visual
cortical plasticity. Annals of the New York Academy of Sciences, 627,
42-56.
Beck, A. (1987). Beck Depression Inventory. San Antonio, TX: The
Psychological Corporation.
Beck, A. (1990). Beck Anxiety Inventory. San Antonio, TX: The
Psychological Corporation.
Ben-Yishay, Y. &;Diller, L. (1993). Cognitive remediation in traumatic brain
injury: Update and issues. Archives of PhysicalMedicine and Rehabilitation,
74, 204-213.
Benton, A. &;Hamsher, K. (1989). Multilingual Aphasia Examination. Iowa
City, Iowa: AJA Associates.
Blair, J. &;Spreen, O. (1989). Predicting premorbid IQ: A revision of the
National Adult Reading Test. The Clinical Neuropsychologist, 3, 129-136.
Bodis-Wollner, I., Borod, J., Cicero, B., Raskin, S., Falk, A., Mylin, L., &;Yahr,
M. (1995). Modality dependent changes of event-related potentials
correlate with specific cognitive dysfunction in non-demented patients
with Parkinson's disease. Journal of Neural Transmission, 9, 197-209.
Boehm, M. &;Zuger, R. (in press). Issues in the vocational rehabilitation of
individuals with traumatic brain injury. In: S. Raskin &;C. Mateer:
Neuropsychological Management of Mild Traumatic Brain Injury. New York:
Oxford University Press.
Bruder, G., Tenke, C., Rabinowicz, E., Towey, J., Malaspina, D., Amador, X,
Kaufman, C., &;Gorman, J. (1996). EEG studies of brain activity in
schizophrenia. In C. Kaufman and J. Gorman (Eds.): Schizophrenia: new
directions for clinical research and treatment. New York: Mary Ann Liebert
Publishers.
Bruder, G., Tenke, C., Stewart, J., Towey, J., Leite, P., Voglmaier, M.,
&;Quitkin, F. (1995). Brain event-related potentials to complex tones in
depressed patients: relations to perceptual asymmetry and clinical
features. Psychophysiology, 32,373-381.
Catrambone, R. (1995). Improving examples to improve transfer to novel
problems. Journal of Educational Psychology, 87, 5-17.
Chow, K. &;Steward, D. (1972). Reversal of structural and functional
effects of long-term visual deprivation in cats. Experimental Neurology,
34, 409.
Cicerone, K., &;Wood, J. (1987). Planning disorder after closed head injury:
a case study. Archives of Physical Medicine and Rehabilitation, 68,
111-115.
Cockburn, J. (1995). Task interruption in prospective memory: A frontal
lobe function? Cortex, 31, 87-97.
Cockburn, J. &;Smith, P. (1994). Anxiety and errors of prospective memory
among elderly people. British Journal of Psychology, 85, 273-282.
Cornwell, P. &;Overman, W. (1981). Behavioral effects of early rearing
conditions and neonatal lesions of the visual cortex in kittens. Journal of
Comparative Physiological Psychology, 6,848-862.
Dalyrimple-Alford, J. &;Kelche, C. (1985). Behavioral effects of
pre-operative-post-operative differential housing in rats with brain
lesions: A review. In B. Will, P. Schmitt, &;J. Dalyrimple-Alford (Eds.):
Brain Plasticity, Learning and Memory. Advances in Behavioral Biology, 28,
441-458.
De Renzi, E. &;Vignolo, L. (1962). The Token Test: A sensitive test to
detect disturbances in aphasics. Brain, 85, 665- 678.
DePellegrino, G. &;Wise, S. (1991). A neurophysiological comparison of
three distinct regions of the primate frontal lobe. Brain, 114, 951-978.
Diller, L., Goldgood, J. &;Kay, T. (1987). Final report to
NIDRR-Rehabilitation Research and Training Center in Head Trauma and
Stroke. Department of Rehabilitation Medicine, New York University
Medical Center.
Donchin, E. (1981). Surprise! Surprise? Psychophysiology, 18, 493-513.
Dywan, J. &;Segalowitz, S. (1996). Self- and family ratings of adaptive
behavior after traumatic brain injury: Psychometric scores and frontally
generated ERPs. Journal of Head Trauma Rehabilitation, 11, 79-95.
Einstein, G., Holland, L, McDaniel, M., &;Guynn, M. (1992). Age-related
deficits in prospective memory: the influence of task complexity.
Psychology and Aging, 7, 471-478.
Einstein, G. &;McDaniel, M. (1990). Normal aging and prospective memory.
Journal of Experimental Psychology: Learning,Memory and Cognition, 16,
717-726.
Fabiani, M. &;Friedman, D. (1995). Changes in brain activity patterns in
aging: the novelty oddball. Psychophysiology, 32, 579-594.
Feeney, D., Gonzalez, A. &;Law, W. (1982). Amphetamine, haloperidol, and
experience interact to affect rate of recovery after motor cortex injury.
Science, 217, 855-857.
Ford, M. &;Khalil, M. (1996). Evoked potential findings in mild traumatic
brain injury 1: Middle latency component augmentation and cognitive
component attenuation. Journal of Head Trauma Rehabilitation, 11, 1-15.
Francis, W. &;Kucera, H. (1982). Frequency Analysis of English Usage.
Boston, MA: Houghton Mifflin Company.
Fuster, J. (1980). The Prefrontal Cortex. New York: Raven Press.
Gagne, J. (1966). The Conditions of Learning. New York: Holt, Rinehart
&;Winston.
Gevins, A. (1996). Practice related modulation of the human EEG while
learning to perform working memory tasks. Paper presented at the Second
International Conference on Functional Mapping of the Human Brain,
Boston, MA.
Gianutsos, R &;Gianutsos, J. (1987). Single-case experimental approaches
to the assessment of interventions in rehabilitation psychology. In B.
Kaplan (Ed.): Rehabilitation Psychology Desk Reference. Rockville, IL:
Aspen.
Glisky, E. (1996). Prospective memory and the frontal lobes. In: M.
Brandimonte, G. Einstein, and M. McDaniel (Eds.). Prospective Memory:
Theory and Applications. Mahwah, NJ: Lawrence Erlbaum Associates.
Glisky, E. &;Schacter, D. (1987). Acquisition of domain-specific knowledge
in organic amnesia: training for computer- related work.
Neuropsychologia, 25, 893-906.
Goldman-Rakic, P. (1993). Specification of higher cortical function.
Journal of Head Trauma Rehabilitation, 8, 13-23.
Goldstein, F., Levin, H., Boake, C., &;Lohrey, J. (1990). Facilitation of
memory performance through induced semantic processing in survivors of
severe closed head injury. Journal of Clinical and Experimental
Neuropsychology, 12, 286-300.
Goldstein, G., Beers, S., Longmore, S., &;McCue, M. (1996). The Clinical
Neuropsychologist, 10, 66-72.
Goodglass, H. &;Kaplan, E. (1983). Boston Diagnostic Aphasia Examination.
Philadelphia: Lea &;Febiger.
Gordon, W. (1987). Methodological considerations in cognitive remediation.
In M. Meier, A. Benton, L. Diller (Eds.): Neuropsychological Rehabilitation.
Hannon, R., Adams, P., Harrington, S., Fires-Dias, C., &;Gipson, M. (1995).
Effects of brain injury and age on prospective memory self-rating and
performance. Rehabilitation Psychology, 40, 289-298.
Harris, J. &;Wilkens, A. (1982). Remembering to do things: a theoretical
framework and illustrative experiment. Human Learning, 1, 123-136.
Horner, R. &;Baer, D. (1978). Multiple-probe technique: A variation of the
multiple baseline. Journal of Applied Behavior Analysis, 11, 189-196.
Huppert, F. &;Beardsall, L. (1993). Prospective memory impairment as an
early indicator of dementia. Journal of Clinical and Experimental
Neuropsychology, 15, 805-821.
Jastak, S. &;Wilkinson, G. (1984). Wide Range Achievement Test-Revised.
Wilmington, DE: Jastak Assessment Systems.
Jenkins, W., Merzenich, M., &;Roconzone, G. (1990). Neocortical
representational dynamics in adult primates: Implicationsfor
neuropsychology. Neuropsychologia, 28, 573-584.
Kesner, R. (1989). Retrospective and prospective coding of information:
role of the medial prefrontal cortex. Experimental Brain Research, 74,
163-167.
Kiernan, R., Mueller, J., Langston, J., &;Van Dyke, C. (1987). The
Neurobehavioral Cognitive Status Examination: A brief but differentiated
approach to cognitive assessment. Annals of Internal Medicine, 107,
481-485.
Knight, R. (1984). Decreased response to novel stimuli after prefrontal
lesions in man. Electroencephalograpy and Clinical Neurophysiology, 59,
9-20.
Kolb, B. &;Elliott, W. (1987). Recovery from early cortical damage in rats.
II. Effects of experience on anatomy and behavior following frontal lesions
at 1 or 5 days of age. Behavioral Brain Research, 26, 47-56.
Koriat, A., Ben-Zur, H., &;Nussbaum, A. (1990). Encoding information for
future action: memory for to-be-performed tasksversus memory for
to-be-recalled tasks. Memory and Cognition, 18, 568-578.
Kvavilashvili, L. (1992). Remembering intentions: A critical review of
existing experimental paradigms. Applied Cognitive Psychology, 6,
507-524.
Levy, R. &;Loftus, G. (1984). Compliance and memory. In J.Harris and P.
Morris (Eds.): Everyday memory, actions, and absent-mindedness. London:
Academic Press.
Lewis, R., Kelland, D. &;Kupke, T. (1990). A normative study of the
Repeatable Cognitive-Perceptual-Motor Battery. Archives of Clinical
Neuropsychology, 5, 201.
Luria, A. (1963). Restoration of Function After Brain Injury. Pergamon
Press: New York, NY.
Mateer, C., Sohlberg, M., &;Crinean, J. (1987). Perceptions of memory
functions in individuals with closed head injury. Journal of Head Trauma
Rehabilitation, 2, 74-84.
Maylor, E. (1996). Age-related impairment in an event-based
prospective-memory task. Psychology and Aging, 11, 74-78.
McKitrick, L., Camp, C., &;Black, F. (1992). Prospective memory
intervention in Alzheimer's disease. Journal of Gerontology: Psychological
Sciences, 47, P337-P343.
Meacham, J. (1982). A note on remembering to execute planned actions.
Journal of Applied Developmental Psychology, 3, 121-133.
Pang, S., Borod, J., Hernandez, A., Bodis-Wollner, I., Raskin, S., Mylin, L.,
Coscia, L., &;Yahr, M. (1990). The auditory P300 correlates with specific
cognitive deficits in Parkinson's disease. Journal of Neural Transmission
[PD Sect], 2, 249-264.
Peterson, L. &;Peterson, M. (1959). Short-term retention of individual
verbal items. Journal of Experimental Psychology, 58, 193-198.
Pons, R., Garraghty, P., Ommaya, A., Kaas, J., Taub, E., &;Mishkin, M. (1991).
Massive cortical reorganization after sensory deafferentation in adult
macaques, Science, 252, 1857-1860.
Raichle, M., Fiez, J., Videen, T., MacLeod, A., Pardo, J., Fox, P. &;Petersen, S.
(1994). Practice-related changes in human brain functional anatomy
during nonmotor learning. Cerebral Cortex, 4, 8-16.
Randt, C. &;Brown, E. (1986). Randt Memory Test. New York: Life Science
Associates.
Raskin, S. (1996). P300 as a measure of efficacy of cognitive
rehabilitation. Poster presented at the Cognitive Neuroscience Society,
San Francisco, CA.
Raskin, S. and Gordon, W. (1992). The impact of different approaches to
cognitive remediation on generalization. NeuroRehabilitation, 2(3), 38-45.
Raskin, S. &;Mateer, C. (1993). Neuropsychological rehabilitation of
individuals with exposure to neurotoxins. Presented at the Society for
Cognitive Rehabilitation, Atlanta, GA.
Raskin, S. and Mateer, C. (1994). Rehabilitation of cognitive impairments.
In Good (ed.): Handbook of NeuroRehabilitation. Marcel-Dekker: New York.
Raskin, S., Rearick, E., &;Mateer, C. (1994). Revised Attention Process Test
(RAPT). Association for
Neuropsychological Research and Development: Puyallup, WA.
Raskin, S. and Sohlberg, M. (1996). An investigation of prospective memory
training in two individuals with traumatic brain injury. Journal of Head
Trauma Rehabilitation, 11, 32-51.
Sohlberg, M., Johnson, L., Paule, L., Raskin, S. &;Mateer, C. (1994). Attention
Process Training-II. Association for Neuropsychological Research and
Development: Puyallup, WA.
Sohlberg, M. and Mateer, C. (1989). Introduction to Cognitive
Rehabilitation. Guilford: New York.
Sohlberg, M., White, O., Evans, E, &;Mateer, C. (1992a). Background and
initial case studies into the effects of prospective memory training. Brain
Injury, 6, 129-138.
Sohlberg, M. White, O., Evans, E., &;Mateer, C. (1992b) An investigation into
the effects of prospective memory training. Brain Injury, 6, 139-154.
Sunderland, A., Harris, J. &;Baddeley, A. (1983). Do laboratory tests predict
everyday memory? A neuropsychological study. Journal of Verbal Learning
and Verbal Behavior, 22, 341-357.
Stein, D., &;Glasier, M. (1992). An overview of developments in research on
recovery from brain injury. In F. Rose and D. Johnson (Eds.): Recovery from
Brain Damage. New York: Plenum Press.
Stokes, T. &;Baer, D. (1977). An implicit technology of generalization.
Journal of Applied Behavioral Analysis, 10, 349- 367.
Stone, S. &;Raskin, S. (1996). Prospective memory training in anoxic brain
damage and traumatic brain injury. Paper presented at the International
Neuropsychological Society, Chicago, IL.
Tebano, M., Cameroni, M., Gallozzi, G., Loizzo, A., Palazzino, G., Pezzini, G.,
&;Ricci, G. (1988). EEG spectral analysis after minor head injury in man.
Electroencephalography and clinical neurophysiology, 70, 185-189.
Terry, W. (1988). Everyday forgetting: Data from a diary study.
Psychological Report, 62, 299-303.
Toglia, J. (1991). Generalization of treatment: a multicontext approach to
cognitive perceptual impairments in adults with brain injury. American
Journal of Occupational Therapy, 45, 505-516.
West, R. (1984). An analysis of prospective everyday memory. Paper
presented at the meeting of the American Psychological Association,
Toronto, Canada.
Whiteneck, G., Charlifue, S., Gerhart, K. Overholser, J., &;Richardson, G.
(1992). Quantifying handicap: A new measure of long-term rehabilitation
outcomes. Archives of Physical Medicine and Rehabilitation, 73, 519-526.
Wilkens, A. &;Baddeley, A. (1988). Remembering to recall in everyday life:
An approach to absent mindedness. In M. Gruneberg, P. Morris, and R. Sykes
(Eds.): Practical Aspects of Memory: Current Research and Issues (vol. 1).
London: John Wiley and Sons.
Will, B. &;Kelche, C. (1992). Environmental approaches to recovery of
function from brain damage: A review of animal studies (1981-1991). In F.
Rose and D. Johnson: Recovery from Brain Damage. New York: Plenum Press.
Willer, B. &;Corrigan, J. (1994). Whatever it takes: a model for community
based services. Brain Injury, 8, 647-659.
Wilson, B., Cockburn, J., &;Baddeley, A. (1985). The Rivermead Behavioral
Memory Test. Reading England: Thames Valley Test Co.
Winograd, E. (1988). Some observations on prospective memory. In M.
Gruneberg, P. Morris, and R. Sykes (Eds.): PracticalAspects of Memory:
Current Research and Issues (vol. 1). London: John Wiley and Sons.
Zohary, E., Celebrini, S., Britten, K., &;Newsome, W. (1994). Neuronal
plasticity that underlies improvement in perceptual performance. Science,
263, 1289-1292.
Budget
Salaries and Benefits
Principle Investigator salary 10605
fringe benefits 811
Research Associate salary 32000
fringe benefits 9600
Consultant stipend 1600
Research Assistant salary 2830
fringe benefits 107
TOTAL SALARY AND WAGES 57,553
Expenses and Supplies
Payment of Subjects 2000
Test materials 3000
EEG supplies 1000
Preparation of slides for presentations 1000
Travel to conferences 3000
50% student summer housing 350
TOTAL EXPENSES 10,350
TOTAL DIRECT COSTS 67,903
INDIRECT COSTS (10%) 6,790
TOTAL REQUESTED 74, 693
Trinity College Cost Share
Indirect not requested (DHHS rate 77% salaries) 28230
Computer Services and EEG Equipment 1000
Miscellaneous Materials and Supplies 1000
Travel support for Principle Investigator 1500
5% of benefits for Research Associate 1600
50%student summer housing
TOTAL COST SHARE 33,680
Budget Justification
Salary:
This includes salary for two summer months for the Principle Investigator
at 2/9 of her annual salary of 47, 725. Although she will be committed to
the project throughout the year, she receives support fromTrinity College
for the remainder of the year. Benefits are calculated at 7.65% of salary.
The principle investigator will be responsible for overseeing all aspects
of the study, including recruitment of subjects, performing
neuropsychological and EEG tests, performing treatment and analyzing the
data. She will train each of the research assistants and supervise their
work. (Salary = 2/9 x 47,725 = 10,605; Fringe benefits = 10,605.00 x
7.65% = 811.00)
Undergraduate Research Assistant.
January 1998-May 1998: An undergraduate research assistant will be
hired from Trinity College to work a total of 13 weeks in the Spring
semester. The research assistant's responsibilities will include helping
with recruiting of subjects, creation of test materials and training
materials. (Salary = 10 hours/week, x 13 weeks x 5.50/hour =715.00).
May 1998-September 1998: An undergraduate research assistant (the
same assistant if available) will be hired from Trinity College to work a
total of 13 weeks in the summer. The research assistant's responsibilities
will be administering neuropsychological test materials and conducting
EEG studies. (Salary = 20 hours/week, x 13 weeks x 7.00/hour = 1400.00;
Fringe Benefits =1820.00 x 7.65% = 107).
September 1998-December 1998. An undergraduate research assistant
(the same assistant if available) will be hired from Trinity College to
work a total of 13 weeks in the Fall semester. The research assistant's
responsibilities will include ongoing assessment of subjects. (Salary = 10
hours/week, x 13 weeks x 5.50/hour =715.00).
Research Associate.
Carol Buckheit, MS in Neuroscience, MA CCC-SLP will be hired for 40 hours
per week. Her responsibilities will include helping to design the treatment
materials, performing the treatment of the subjects, and helping to
prepare the final manuscripts. (Salary = 32,000; Fringe Benefits =32,000 x
33% =9600).
Consultant.
Craig Tenke, an electrophysiology research scientist will be hired to
program the EEG stimuli, ensure that the procedures are working, and
analyze the data. (Stipend=80 hours x 20/hour).
Supplies:
Electrode gel, foam cushions, syringes, 32 channel electrode cap
purchased from Neuromedical Supplies, Inc. (Cost = 1000.00).
Neuropsychological tests purchased from a variety of companies (3000).
Travel for P.I. and research associate to International Neuropsychological
Society in Budapest July 1998, to Cognitive Neuroscience Society in
Boston March 1998, and Brain Injury Association National Symposium in
New Orleans, November 1998.
Each subject to be paid 100.00 for participation and to cover cost of
transportation to Trinity College (20 x 100 = 2000).
Preparation of slides for professional presentations (1000.00).
Trinity College Cost Share
Trinity College's DHHS rate is 77% of salaries and wages. Instead of the
allowable amount, $34985,Trinity is requesting 10% of the direct costs,
or $6,755. The difference, $28230, is listed as cost share.
Computer Services and EEG Equipment have been estimated at $1,000
Miscellaneous Materials and Supplies, $1,000, will be charged to the
Psychology Department budget.
Travel Support to Conferences for the P.I. is $1,500, funded by the office
of the Dean of the Faculty.
The College will support 5% of Research Associates' benefits.
The College will fund 50% of the room cost for the summer months for the
Research Assistant.
Other sources of funding
This project will also be funded, in part, by a Faculty Research Committee
Grant to the P.I. This will cover the cost of the materials needed to
produce the prospective memory test.
This project will also be funded, in part, by a pilot grant from the James
McDonnell Foundation to the P.I. This grant is ongoing and will run
concurrent with the proposed project. Thus, the proposed project will
serve as an extension to the ongoing pilot grant. As a result, subject
recruitment is well underway, allowing for a faster start-up time on the
proposed budget. All EEG equipment and software has already been
purchased. Oe-ninth of the P.I.'s salary also comes from this grant. Finally,
this grant was designed to foster collaboration between different fields
to design adequate cognitive rehabilitation studies. The McDonnell grant
covers the cost of meetings between scientists from rehabilitation
medicine, cognitive science, neuroscience and psychology which will also
be used to inform the proposed grant.