Research theme: Promotion of Brain Science Research toward Effective Rehabilitation
Our research group consists of one faculty member from the Faculty of Health Sciences and graduate students (five students as of 2015) belonging to the Rehabilitation Program/Comprehensive Health Sciences Program of the Graduate School of Health Sciences. The Faculty of Health Sciences is a teachers’ organization encompassing seven disciplinary fields, and I belong to the Department of Functioning and Disability. The field of Functioning and Disability provides education to undergraduate students in the Division of Occupational Therapy at the School of Medicine’s Department of Health Sciences, and graduate students in the Rehabilitation Program (master’s degree program) and Comprehensive Health Sciences Program (doctor’s degree program) of the Graduate School of Health Sciences. Our graduate school is quite a new organization established in 2008 and we produced our first Ph.D. graduates in 2012. In our research group, nine students have completed the master’s degree program and three students have completed the doctor’s degree program.
Members in our research group, students and teachers alike, are occupational therapists and we engage in research based on neuropsychology to help with effective rehabilitation. The following is a brief overview of our research activities.
Clarification of the Functions and Roles of the Dorsal Stream in the Brain
It is considered that the human brain has two major mechanisms to process visual information. One is the ventral stream, which is a route from the occipital lobe to the temporal cortex, and that analyzes the color and shape of objects and gives such information meanings. The other is the dorsal stream, which is a route from occipital lobe to the parietal lobe, and that relates to the analysis of the orientation, shape, gradient, and movement of objects and the linking of such information with motion (e.g., reaching, grasping) based on online processing. Our research group estimates the functions of the dorsal stream by observing priming effects by giving stimulus using Continuous Flash Suppression (CFS), which is a technique involving binocular competition. Many researchers, including Almeida et al. (2008), have suggested the possibility of the dorsal stream processing a tool category; however, we have suggested another possibility (Sakuraba et al., 2012). We also engage in research into the processing of faces (Sakuraba et al., 2013) and letters in the dorsal stream.
Attention Functions of Patients with Traumatic Brain Injury: Creation of the Japanese Version of the Moss Attention Rating Scale (MARS) and Clarification of Active Attention Control and Its Neural Basis
We have created a Japanese version of the Moss Attention Rating Scale (MARS), which evaluates the attention deficit displayed by patients with traumatic brain injury (TBI) based on behavior observation (Sawamura et al., 2012). MARS is a scale with high reliability, validity and sensitivity developed by Whyte (who is a professor of the Department of Rehabilitation Medicine at Thomas Jefferson University and the director of the Moss Rehabilitation Research Institute) et al. in 2008, and the same outcomes have been achieved with the Japanese version. Currently, our research group is collaborating in an international research project with Professor Whyte and other researchers to develop a MARS applicable to patients with cerebrovascular disorders.
When humans engage in an activity they shut off unnecessary information (e.g., noise) consciously and intentionally and focus their attention on necessary information to maintain their performance. This mechanism is called active inhibition. Many patients with attention deficit after TBI are easily distracted by surrounding noise. A possible reason for this is a dysfunction with active inhibition. We explore the characteristics and neural basis of the attention deficit of patients with TBI through experiments using functional near-infrared spectroscopy (fNIRS) and functional magnetic resonance imaging (fMRI) methods.
This research is a collaborative project with the Department of Rehabilitation, Hokkaido University Hospital and Department of Rehabilitation Medicine, Hokkaido University.
Effect of Flow State on Rehabilitation Outcomes: Development of a Flow State Scale for Occupational Tasks; Clarification of the Neural Basis of Flow; and Rehabilitation Outcomes Research in Consideration of Flow
Flow is a concept proposed by Csikszentmihalyi (1975) and defined as a comprehensive sense that produces intense feelings of enjoyment when people are in a state of complete absorption with an activity and an optimal psychological state to engage in an activity that relates to high performance. In providing occupational therapy, it is considered that higher therapeutic effects can be achieved if the patient is put in a flow state; however, there has been no research clarifying this. Accordingly, we have developed an assessment scale (Flow State Scale for Occupational Tasks) to determine the flow state (Yoshida et al., 2013) and work to clarify the neural basis of flow using fNIRS. Currently, we are involved in a collaborative research project with the Department of Rehabilitation, Hokkaido University Hospital and Department of Rehabilitation Medicine, Hokkaido University to study rehabilitation effects in consideration of flow in patients with attention deficit after TBI (a randomized controlled study).
Visual Assessment of Children with Cerebral Visual Impairment (CVI) and Severe Motor and Intellectual Disabilities (SMID): Measurement of Contrast Sensitivity Using Optokinetic Nystagmus and the Development of a the Visual Severity Scale for patients with SMID and CVI
Approximately 60% of children with cerebral palsy are said to have cerebral visual impairment (CVI). Children with severe motor and intellectual disabilities (SMID) are estimated to have CVI at a higher rate; however, there were no methods for the visual assessment of such children. We have developed a method enabling the measurement of contrast sensitivity based on luminance and colors by observing optokinetic nystagmus in children with CVI and SMID (Sakai et al., 2002, 2008). In addition, we have developed a the Visual Severity Scale for patients with SMID and CVI which is a simple method that can be used in clinical practice. The scale has been confirmed to have an intermediate degree of reliability and validity. The scale consists of eight items (pupil response, gaze, tracking and others) selected in reference to visual development stages identified by visual development research in children mainly up to three years old. As the assessment does not involve special tools it can be implemented following simple instructions in the manual using 11 pictures for eye-tracking targets printed using an inkjet printer.
Research of Driving Assessment based on Human Brain Functions
Based on a neuroscientific approach, we try to clarify the brain activities and behavioral characteristics of people when driving a car. Using a research driving simulator installed in the new building of the Faculty of Health Sciences in 2014, we aim to develop equipment to assess the driving aptitude of people with cognitive disorders. Currently, we are collaborating with Tokachi Rehabilitation Center in Obihiro, conducting research into driver’s judgment of danger using fNIRS.
Besides the five themes above, we have conducted research on themes such as the “Effects of Cosmetics Use and Gaze Direction on Facial Attractiveness: An fMRI Study,” “Characteristics of the Visual Search and Pupil Response of the Dementia with Lewy Bodies,” “Verbal and behavioral Assessment Scale for Patients with Anosognosia for Hemiplegia :Reliability and Validity,” “Creation of Milestones for Communication Development in Children with Spinal Muscular Atrophy Type I,” and “Effects of Short-wavelength Light on Motion Sickness.” We cover diversified study themes; however, most of these themes are related to brain science research for the purpose of improving rehabilitation effects. For evidence-based rehabilitation, we, health science professionals, must play active roles to promote such research.