New Center Proposal: Neural Injury Center
Purpose
The proposed Neural Injury Center (NIC) will be a collaborative of faculty and facilities
located on the campus of the University of Montana – Missoula (UM). The focus of the Center is
to integrate existing scientific, educational and clinical expertise within different UM academic
units to provide a centralized and unique combination of personnel and resources dedicated to
serving military veterans with neurological injury (e.g. traumatic brain injury [TBI], stroke,
spinal cord injury etc.) as they progress from in-patient rehabilitation to the college campus,
vocational training, employment and community living. The NIC will also offer support and
education for family members and caregivers through on-campus opportunities and follow-up
support. The NIC will provide veterans, on- and off-campus, with information regarding post
traumatic stress disorder (PTSD) and TBI and provide an opportunity for anonymous screening,
consultation, ongoing treatment if needed, and networking with existing community resources. In
addition, the NIC will support basic and clinical research to translate laboratory discoveries into
improved care for patients with TBI. The NIC will not duplicate existing services, but rather
provide new opportunities and support for veterans, particularly those wishing to engage in the
pursuit of educational goals. Currently no Center or facility provides a singular location for
supporting the needs of the veteran and caregivers during their educational and vocational
pursuits. The integration of these activities in an environment that also encompasses clinical
trials and translational research among the Center’s collaborating scientists also sets the NIC
apart from other programs.
The Center will be housed and administered within The College of Health Professions and
Biomedical Sciences. Academic programs centrally involved will include the School of Physical
Therapy and Rehabilitation Science, Department of Biomedical and Pharmaceutical Sciences,
Department of Pharmacy Practice, Center for Structural and Functional Neuroscience,
Department of Communicative Sciences and Disorders, Department of Health and Human
Performance, School of Social Work and The Department of Psychology. The Center will be
closely affiliated with The Nora Staael Evert Physical Therapy Clinic, which includes three
integrated programs, UMPT Sports & Orthopedics, UMPT Neurological and Mobility
Impairments, and the UMPT New Directions Wellness Center. The latter is a facility dedicated
to providing fitness programs and education for the disabled.
Collaborating programs will likely include, but are not limited to, UM’s Veterans Office, UM’s
Department of Health and Human Performance, UM’s Rural Institutes on Disabilities, UM’s
Western Montana Health Education Center, the Community Medical Center Bridges Program,
The Montana Neuroscience Institute Foundation, and the Montana Brain Injury Center. It is also
anticipated that Center staff will form a close relationship with healthcare professionals at the
Veteran’s Hospital in Fort Harrison, Providence St. Patrick Hospital and Community Medical
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Center in Missoula, and provide unique opportunities for the State’s newly accredited Family
Medicine Residency of Western Montana..
Initial research focus:
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Molecular mechanisms associated with brain injury.
The development of physical and pharmacological interventions for brain injury.
Cognitive and communication dysfunction following TBI.
Cognitive rehabilitation following TBI.
Understanding the relationships between concussion and TBI.
Vestibular and musculoskeletal impairments following TBI.
Neurophysiological examination of movement coordination deficits associated
with brain injury.
Center Objectives
The Center’s objectives focus on service to, but are not limited to, military veterans, providing
education to clients and families, and conducting research targeting TBI and associated
disorders.
The service component will include coordinating evaluative services for veterans, as indicated.
Evaluative services may include neuropsychological evaluations for the presence of cognitive
impairment, and examinations for speech and movement disorders. As needs are identified, the
veteran will be offered treatment within the physical therapy, speech pathology and/or clinical
psychology clinics on campus or referred to appropriate off-campus facilities.
The School of Pharmacy will be closely associated with the Center. Survivors of traumatic brain
injury, stroke and spinal cord injury often present with complex medication regimens and unique
therapy challenges. Clinical pharmacy expertise incorporated within neurorehabilitation teams
can help ensure maximum efficacy of medications, identify important drug interactions,
minimize adverse effects and provide patients and family members with education and support.
It is expected that faculty and students in Pharmacy will expand their present efforts in the NSE
Clinic to include this population.
The educational component will be multi-faceted. In addition, Center personnel will serve as
veteran advocates and assist with organizing classroom and rehabilitation schedules. Education
pertaining to the veteran’s disability will be available to family members, in an effort to increase
understanding of the many factors that can contribute to a family member’s struggles, and in so
doing, give family members the tools necessary to provide support in the most efficient
and effective manner. Importantly, the Center will also embark on programs aimed toward
increasing public awareness of TBI.
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Research efforts will be enhanced by the Center. The Research Program Director will ensure
that there is communication among the various laboratories engaged in brain injury research.
Monthly meetings and seminars among the investigators will occur and guidance will be
provided to researchers relating to establishing collaborative teams, developing injury models,
seeking funding opportunities, providing technical assistance, increasing translational research
efforts and progressing work through preclinical development and clinical trials.
Center’s Activities and Productivity Expectations
A) Expectations of Center personnel (Departmental affiliation)
Center Director
The Director will be responsible for all daily operations and management of the Center. The
Director will oversee and encourage research collaborations, seek Center funding, participate in
ongoing personnel recruitment and oversee community public relations. The Director will also
be responsible for coordinating on- and off-campus programs and developing collaborations
regionally and nationally. The Director will report to the Dean of the College of Health
Professions or his/her designate, which may initially be the Chair of The School of Physical
Therapy and Rehabilitation Science.
Dr. Charles Leonard, a tenured professor and current Director of The Motor Control Research
Laboratory will serve as the interim Director of the Center. Dr. Leonard received his Master’s
degree from Duke University in Physical Therapy, and a Doctorate in Neuroscience from The
Medical College of Pennsylvania. He received a National Institutes of Health post-doctoral
fellowship to study at The Nobel Institute of Neurophysiology in Stockholm, Sweden. Prior to
his academic career, Dr. Leonard founded and directed Tri-County Rehabilitation Centers, a
series of out-patient physical rehabilitation centers located in Pennsylvania, New Jersey and
Delaware that employed over 20 therapists and consulting physicians. Dr. Leonard has been at
The University of Montana since 1990. His work uses clinical neurophysiological techniques
such as electromyography and transcranial magnetic stimulation to examine neural mechanisms
in the human that control muscle and joint coordination. He has developed several treatment
interventions for neurological injury including a unique upper extremity robotic device with
telerehabilitation capabilities that was built in collaboration with Montana State University
engineering faculty and students. He has patented a computerized electronic device that
quantifies muscle properties and began a University spinoff medical device company,
Neurogenic Technologies, Inc. in 2001. His work has been funded by The MJ Murdock
Charitable Trust Foundation, NIH, NSF and NASA.
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Research Program Director
The Research Program Director will be responsible for oversight of all research directives within
the Center. With the exception of clinical trials, research will be done in existing UM
laboratories and independently driven by each laboratory’s principal investigator (PI). Each PI
will be responsible for personnel, equipment and space needs. The Director will be responsible
for communication among the laboratories and be especially vigilant to potential collaborations
and funding opportunities. The Director will be actively engaged in research with an emphasis
in translational studies. Individual investigators will be responsible for alerting The Director to
any work that has progressed to a need for clinical trials. The Director will then be responsible
to organize this facet of the research program in collaboration with the PIs involved. The
Director will also prepare a yearly report on the research efforts of the Center to be submitted to
the Center Director. The Director will also facilitate the sharing of worldwide-published
research relating to TBI. These periodic reviews will be distributed to Center personnel,
Montana Neuroscience Institute Foundation members and Veterans’ organizations within the
state.
Director of Community Outreach
The Director of Community Outreach will be responsible for public relations and
communication. This will include, but is not limited to, communications with all veteran
organizations within the state and region, the Montana University System and legislators. The
Director will be responsible for creating and distributing content describing the Center’s
activities. The Director will also be responsible for website development.
Clinical Director
The Clinical Director is responsible for coordinating integrated service and treatment
opportunities between campus entities and the community, including specific treatment programs
in The Nora Staael Evert Physical Therapy Clinic and New Directions Wellness Center. Working
with the on-campus veteran’s office and appropriate on-campus experts, the Clinical Director
will develop and promote a program designed to evaluate veterans for possible PTSD and TBI
related problems. They will also oversee on-site treatment or arrange for off-campus treatment
as needed. The Director will ensure that each veteran is assigned a patient advocate who will
organize the veteran’s medical appointments and assist with compliance. The Director will also
be the point person to link veterans with clinical researchers and appropriate clinical trials.
NOTE: At the outset, the Director of Community Outreach and the Clinical Director may be
served by the same person.
B) Expectations of personnel without a departmental affiliation
Board of Directors/Scientific Advisory Committee
The Board will be comprised of academic, scientific, and medical personnel. At least one
member will be an ethicist. The Board will advise on a number of topics including public
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relations, research directives, funding opportunities and facility development. The Board will
provide a written report to the Center’s Director. It is expected that members will be appointed
from the aforementioned groups on page one, but will also include other stakeholders as
indicated.
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Organization’s reporting line within the University
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Relationship to the institutional mission, Departments involved, and how the Center will
contribute to academic programs with respect to teaching, research and service
The Center’s focus on research and community service fit extremely well with the University’s
mission.
The NIC will contribute to teaching, research and service in numerous ways. Teaching will be
enhanced especially in clinically-related areas. One of the challenges for non-medical school
based physical therapy, pharmacy, communication science, and clinical neuropsychology
curriculums are the lack of daily contact with patient populations. As students rotate through our
on-campus clinics it is anticipated that they will have the opportunity for observation and handson treatment of our wounded veterans. This experience will be invaluable.
Research will be a primary focus of the Center and it will facilitate increased interactions among
scientists engaged in various aspects of brain injury. To our knowledge, there is no similar
facility in the Northwest region that houses scientists engaged in such a wide range of research
interests (from molecular to translational) within a single center devoted to TBI. It is anticipated
that collaborations will result in increased funding opportunities and entrepreneurial activity. The
Center will establish a new research emphasis on TBI and related brain injury.
Service to the community, the state of Montana and military veterans is another major focus and
strength of the proposed Center. While many disparate services are available to veterans within
the state, no single location or service provides the veteran with guidance for both their medical
and educational needs. Importantly, our public outreach and educational efforts will seek to
reach those veterans who may not know that they are experiencing a treatable problem. It is
well-reported that many veterans believe cognitive and coordination problems are normal
impairments post-combat. Others fear the stigma of asking for help. We hope to reach these
individuals by providing public outreach and a facility where anonymous screening can take
place. If needed, the Center can provide ongoing treatment without compromising their
educational and vocational efforts. The Center’s location on the University of Montana campus
and being in close proximity to Missoula College creates a perfect opportunity of convenience
for the veteran and ease of collaborative efforts on the veteran’s behalf of medical and
educational personnel. Center personnel will serve as the veteran’s medical advocate
coordinating medical care and compliance. Further, it is envisioned that, using the Montana
University System, the NIC could be a model established throughout the state to address clients
with similar issues engaged in higher education.
The Center will also provide the opportunity to combine research and service by developing
telerehabilitation technologies. Telerehabilitation and teletherapy are methods by which a
patient’s physical, occupational and speech therapies can be monitored and progressed off-site
(e.g. at home) by Center therapists and physicians.
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Departments Involved:
School of Physical Therapy and Rehabilitation Science
Department of Biomedical and Pharmaceutical Sciences
Department of Pharmacy Practice
Department of Communicative Sciences and Disorders
Department of Health & Human Performance
Department of Psychology
School of Social Work
Center for Structural and Functional Neuroscience
Similar programs in Montana and surrounding region
The following programs are similar to the proposed Center only in that they provide services to
military veterans. The Center’s Director and personnel will provide outreach and liaisons to all
associated programs.
University of Montana Veterans’ Office (umt.edu/veterans) - Provides campus lounge for
veterans and advice on GI bill.
VA Montana Health Care System (Montana.va.gov) - Provides TBI in-patient rehabilitation
services (Fort Harrison, MT); Project ARCH (Access Received Closer to Home). Part of VA
Montana health care system.
Veteran Services (wsd.dli.mt.gov/veterans) - Retraining and job service
VA Primary Care Telehealth Outreach Clinic, Hamilton, MT - Clinic provides computers to
allow email contact with primary health provider in Missoula so veteran does not have to travel.
Montana Veterans’ Affairs (montanadma.org) - Centralized information service center.
Wounded Warrior Project
Community Hospital Bridges Program
The Montana Neuroscience Institute Foundation and the Montana Brain Injury Center Comprised of health care professionals and University researchers dedicated to building a
comprehensive resource for brain injury within the state of Montana.
University of Montana Rural Institute on Disabilities - Rural Health Research
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Area Health Education Centers
Affiliated Faculty
Research
Douglas R. Allington, PharmD, BCPS Professor of Pharmacy Practice. Survivors of traumatic
brain injury, stroke and spinal cord injury often present with complex medication regimens and
unique therapy challenges. Clinical pharmacy expertise on neurorehabilitation teams can help
ensure maximum efficacy of medications, identify important drug interactions, minimize adverse
effects and provide patients and family members with education and support.
Richard Bridges, PhD, Professor and Chair Dept of Biomedical & Pharmaceutical Sciences
The role of central nervous system (CNS) transporters in CNS injury and protection. Transport
mechanisms can contribute to excitotoxic changes post TBI. The work identifies pathological
mechanisms enabling the identification of potential therapeutic interventions.
Matthew Bundle, PhD, Department of Health & Human Performance. Dr. Bundle’s work
involves human biomechanics that includes evaluation of lower-extremity prosthetics in the
disabled population, including world-class athletes.
Alessander dos-Santos, PT, PhD, Assistant Professor Physical Therapy and Rehabilitation
Science - Neural processes involved in multi-muscle coordination of the human body for posture
control. Individuals with TBI develop impairments in their ability to control balance. The work
seeks to identify the causes of these impairments and possible ways to treat their effects.
Michael Kavanaugh, PhD, Dept of Biomedical & Pharmaceutical Sciences
The study of glutamate receptors and transporters in the brain. Glutamate is the most abundant
neurotransmitter in the healthy brain, but several disease processes including TBI disrupt its
regulation and lead to neuropathology. Dr. Kavanaugh has been funded continuously by the NIH
for over twenty years for studies of glutamate transporters.
James Laskin, PT, PhD - School of Physical Therapy & Rehabilitation Science. Dr. Laskin is
Co-Director of the Applied Physiology Laboratory; his interests include sports and recreation for
people with physical disabilities; physical fitness for disabled populations; health promotion and
secondary condition risk reduction.
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Josh Lawrence, PhD, Dept of Biomedical & Pharmaceutical Sciences
The role of inhibitory neuron subtypes in normal brain function and in pathological states. Dr.
Lawrence is particularly interested in inhibitory neurons that are vulnerable following TBI and
the underlying mechanisms of vulnerability. Studies include the role of the septohippocampal
system in learning deficits and endocannabinoid regulation after TBI.
Chuck Leonard, PT, PhD, Professor Physical Therapy and Rehabilitation Science
The use of clinical neurophysiological techniques to examine neural mechanisms in the human
that control muscle and joint coordination. The laboratory has developed several treatment
interventions for neurological injury including telerehabilitation compatible devices.
Yoonhee Jang, PhD, Psychology Department - Using behavioral methods and computational
modeling to study human cognitive processes, such as learning, memory, and confidence
judgments; metacognition (knowledge about one’s own cognition); and the relation between
cognition and emotion in neurologically typical individuals and those with neurological
impairment.
Craig McFarland, PhD, Psychology Department, Clinical Psychology Program - Cognitive
rehabilitation of disorders of memory and executive functioning. Dr. McFarland’s work has
focused on identifying the cognitive mechanisms underlying prospective memory (i.e.,
remembering to do things in the future), and subsequently to developing strategies to improve
prospective memory.
Ryan Mizner, PT, PhD – School of Physical Therapy & Rehabilitation Science. Dr. Mizner is
Director of the Movement Science Laboratory; his interests include orthopedic and sports
practice, knee impairment, use of electrical stimulation in physical therapy, and work-related
disorders of the upper extremity and spine.
Catherine Off, PhD, CCC-SLP,Director – UM Big Sky Aphasia Laboratory
Department of Communicative Sciences and Disorders
Investigation of two principles of neuroplasticity: (1) treatment intensity, and (2) repetition.
Understanding how treatment protocols impact language functions and how they impact the
individual’s participation in life roles (e.g., vocation, recreation, etc.).
Sarj Patel, PhD/Tom Rau, PhD, Assistant Professors Dept of Biomedical & Pharmaceutical
Sciences - The development of a rat model model of chronic traumatic encephalopathy (CTE;
associated with repetitive concussive injuries) to study changes in regulation and expression of
oxidative stress genes.
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David J. Poulsen, PhD, Dept of Biomedical & Pharmaceutical Sciences - The development of
neuroprotective agents to be used as acute treatments (within 12 hrs after injury) to prevent the
cognitive and behavioral deficits that occur as a consequence of traumatic brain injury. Expertise
with the rat lateral fluid percussion injury model of TBI. The lab is developing a gene therapy
based treatment for post-traumatic epilepsy.
Clinical Staff
James Laskin, PT, PhD
Sue Ostertag, DPT
Anthony Kinney, PT, DPT, MBA
Annie Kennedy, MS, CCC-SLP
Craig McFarland, PhD
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NIH-related comments on translational research
Scientists practicing clinical and translational research strive to transform laboratory discoveries
into new therapies for patients. It can take more than a decade, however, before a basic scientific
finding can advance through preclinical and clinical studies to result in a new treatment, medical
device or prevention method.
Accelerating this process is a top priority for NCATS as part of its mission to catalyze the
generation of innovative methods and technologies that will enhance the development, testing
and implementation of diagnostics and therapeutics across a wide range of human diseases and
conditions.
The NCATS Division of Clinical Innovation is charged with transforming the translational
research process. The Clinical and Translational Science Awards (CTSA) program, which is part
of this division, funds a national consortium of medical research institutions dedicated to
improving clinical and translational research. This program serves as an essential component in
addressing these research challenges.
Clinical trials and research studies with patients also play an important role. Researchers need
access to tools, expertise and resources that can expedite this often lengthy process while
ensuring patient safety. NIH offers many tools that can provide assistance to researchers who
need help designing clinical trials, recruiting appropriate patients for their studies and engaging
the community in the research process.
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