Postscript: International Neuropsychological Society Annual Meeting 2018

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INS 2018 was a refreshing look at the tradition of neuropsychology and continued refinement of it’s tools sweetened with talks about exciting new developments in neuroscience and neuroimaging. This juxtaposition of tradition with innovation appeared to be designed to beckon neuropsychology practitioners to imagine a more audacious future for their discipline.

I enjoyed meeting members of the INS, including young investigators, and established influencers in the field. The INS program committee did a great job putting together plenary sessions with well-known speakers and topics of importance to neuropsychology practitioners, scientists, policy makers and even the general public!

 

Personal Highlights of the Plenary Sessions

Earl Miller: Rule+Rhythms=Cognition

 

beta and gamma interplay allows the brain to juggle multiple stimuli

beta and gamma interplay

Earl Miller of MIT illustrated a) beta and gamma interplay allows the brain to juggle multiple stimuli in working memory b) the interplay between beta and gamma rhythms may underlie the volitional control of working memory. Miller has a new paper in Nature Communication entitled “Gamma and beta bursts during working memory readout suggest roles in its volitional control” and in it he proposes complementary roles for  these oscillators in relation to readout and control mechanisms of working memory. The approach he describes could be extremely exciting for human research if the beta and gamma effects prove to be measurable measured at the scalp in humans.

 

Obviously, numerous other authors have written about the functional role of these oscillations, but Miller’s clear and succinct explanation reminded me of a similarly enlightening talk by Pascal Fries at the 2016 SPR conference in which he gave an overview of his 2015 Neuron article, proposing that “several rhythms and their interplay render neuronal communication effective, precise, and selective”, and further that alpha-beta oscillators (8-20 Hz) exert top-down control over gamma oscillators that are directed by bottom-up factors in visual attention. It’s exciting to see such compelling work linking brain oscillations to cellular architecture and functional roles in attention and memory. To me, it feels like an entirely new era for EEG and electrophysiology.

Miguel Nicolelis: Linking Brains to Machines: From Basic Science to Neurological Neurorehabilitation

BMI-based rehabilitation

Miguel Nicolelis of The Nicolelis Lab at Duke University gave an exciting talk in which he jumped right into a series of a few slides summarizing the evolution of his intracranial recordings from clunky wired setup to wireless 2000 channel recordings in primates with chronic implants lasting several years! I guess I should have known that he would not reveal the punchline in the first few slides of the talk. Nevertheless, I was surprised when he launched into the story about developing the BMI-controlled exoskeleton that his collaborative project Walk Again developed to help a paralyzed patient kick the ball at the FIFA (soccer) World Cup.  But, these innovative and highly collaborative projects were not exciting enough to take Dr. Nicolelis away from his extremely busy schedule: the most exciting news came in the last few minutes of his talk in which he outlined serendipitous rehabilitative benefits observed with the several patients who endured the long training process to be considered for the FIFA event already mentioned. From an article on Nicolelis.net:

 

“The Walk Again Project (WAP) is publishing its first clinical report, describing the findings obtained after the first year of training of the eight paraplegic patients, from January to December 2014. In this clinical study, the international team of neuroscientists, engineers, and neurorehabilitation personnel reports the discovery that the group of patients who have continued to train with  the brain-controlled system, including a motorized exoskeleton, have regained the ability to voluntarily move their leg muscles and to feel touch and pain in their paralyzed limbs — despite being originally diagnosed as having a clinically complete spinal cord injury, in some cases more than a decade earlier. The patients also regained important degrees of bladder and bowel control, and improved their cardiovascular function, which in one case resulted in a significant reduction in hypertension. As such, this is the first study to report that long-term BMI use may lead to significant recovery of neurological functions in patients suffering from severe spinal cord injuries.”

Sarah Lisanby: Where Neuromodulation and Neuropsychology Meet – Promoting Plasticity to Enhance Brain Health

TMS with behavioral therapy induces plasticity

At a breakneck pace, Dr. Lisanby, Director of the National Institute of Mental Health’s Division of Translational Research, gave a thorough overview of neuromodulation technology and techniques using TMS and tDCS.  For me, Dr. Lisanby’s talk was a helpful window into the thinking of NIMH regarding the important role that neuromodulation might take in “multi-modal strategies that combine neuromodulation with cognitive behavioral interventions”. We are all familiar with the use of TMS to treat depression, but what I did not know was the serious consideration being given to funding urgent research on applications of tDCS to treat addictions, including opioids. Look for NIMH funding opportunities in this vein to be announced soon.

 

Where is Neuropsychology Headed?

I have always thought that poster sessions give great insight into the direction the members, especially young investigators, feel a given scientific society should be headed. There were too many interesting posters to mention, but what I can say is that as an experimental psychologist and someone involved in configuring, setting-up and training  scientists to use EEG/ERP, fNIRS, TMS, and tools for fMRI, I see a great opportunity ahead for work relating traditional neuropsychological tests and phenomena to current work in cognitive neuroscience and functional neuroimaging. There were lots of creative combinations, statistical treatments of, and computerized versions of well-known standardized tests, but off the top of my head, I can think of only a few presentations at this year’s INS illustrating creative combinations of neuroimaging, traditional neuropsych, and mainstream rehabilitation techniques in an intensive and closed-loop fashion. The Nicolelis and Lisanby talks were excellent high-profile illustrations that can serve as beacons for the field.  Another good example was the poster presented by members of the CognitiveFX team. I had hoped to see more posters along these lines as evidence the field is rising to the challenge INS leadership seems to be laying out for the organization.

The INS 2018 program connected the audience to an amazing range of fast-paced developments in science that should be informing clinical practice.  As an example of the challenges neuropsychology faces, several posters bluntly illustrated that traditional neuropsychology methods are simply unable to measure many immediate and lasting effects of concussion. This, among other highly motivating challenges facing society are squarely in the wheelhouse of neuropsychology and, to me, they beg for the creative application of EEG, fNIRS and other objective neuroimaging methods to aid in detection and differential diagnosis as well as effective rehabilitation. Looking forward to see how many investigators take up these important challenges at next year’s event.