Gerald Voelbel joins Steinhardt as Assistant Professor of Occupational Therapy

by Alison Fanous

Professor Gerald Voelbel joined NYU as Assistant Professor in the Department of Occupational Therapy in September 2008.  He has a PhD in Psychology with a concentration in Neuropsychology.  Coming from outside the field of occupational therapy, Professor Voelbel brings increased perspective to the OT Department; he brings insight into the value of conversation and connection between neuroscience, neuropsychology and occupational therapy.

"The crossover is trying to understand the neural science part of it, cognitive as well as brain aspects, and then linking it to rehabilitation."

In fact, much of Professor Voelbel's work is focused on translational research.  Professor Voelbel describes his research in three stages: first, understanding the cognitive deficits that occur as a result of an event such as traumatic brain injury or a condition such as multiple sclerosis; second, gaining an understanding of what parts of the neural system are affected by the disorder.  The third aspect involves cognitive rehabilitation: trying to give cognitive tools to people with disorders so that they can have richer life experiences and return to their normal lives.

Professor Voelbel's research focuses on patients who have suffered traumatic brain injuries and people diagnosed with multiple sclerosis. Functional neuroimaging tools are used to see what parts of the neural system are affected in such patients.  Professor Voelbel uses a neuroimaging tool named functional near-infared spectroscopy (fNIRS), which employs light of a specific wavelength that can penetrate bone and detect changes in oxygenated and deoxygenated blood.  Using this tool, researchers are able to see when the brain is active in a specific region: active regions have more oxygenated blood and vasodilation, and after the cells use it the blood becomes deoxygenated. "We can see where the oxygenated blood is going and where it is used.  We can see what parts of the brain are active and which are not."

The clinical relevance of this tool is significant, says Professor Voelbel.  Through his research, he observes that there are specific brain disorders (such as in mild traumatic brain injury) for which there are very few good diagnostic tools because there is no damage to brain tissue, no contusion, or no hematoma. "However we do know there is disruption in the cellular mechanism in the acute phase.  PET scans show this over 10 days: cells are working harder but being deprived of glucose and oxygen as the vascular system is constricted."  The ability of fNIRS to detect and show the oxygenation level of blood in the brain means that it may be utilized as an emergency room tool to diagnose mild traumatic brain injury or concussion.  This tool is also mobile so it can be used to perform bedside evaluations of whether or not a patient is aware, has cognitive faculties, or is emerging from a coma. 

Using fNIRS, Professor Voelbel is investigating executive dysfunction in mild traumatic brain injury. This study investigates the cognitive function of problem solving, attention as well as working memory, with the view to helping with treatment protocols for mild traumatic brain injury.  Professor Voelbel has another specific goal for this ongoing research: "I hope to utilize the fNIRS tool in diagnosing concussions in athletes, from recreational athletes all the way to professional athletes." This technology may become useful for deciding when the appropriate time is for the athlete's return to play. He is a co-investigator of a NIH Small Business Technology Transfer (STTR) grant mechanism, which is investigating the utility of fNIRS technology in moderate and severe traumatic brain injury. "Using this technology we can target interventions that can help with the recovery of cognitive functions."  Professor Voelbel is also conducting research in a similar fashion with people diagnosed with multiple sclerosis, investigating the neural mechanisms that are affected by MS that consequently affect working memory and concentration.

Another pending trajectory of Professor Voelbel's research is to start a speed of processing intervention study: one with multiple sclerosis and one with traumatic brain injury.  "Speed of information processing is one of the primary sequela of these conditions, which can impact people in their everyday lives and the functions of everyday living.  The goal here is to create an enhanced treatment protocol to benefit such patients."

A background in neuroscience and neuropsychology, which is both clinical and experimental, helps to guide Professor Voelbel's research toward turning something that is experimental into something clinically relevant. This of course is what translational neuroscience is all about.  "I'm not just working on the bench, rather I am doing experimental research that can be applied to treat, or diagnose or to understand at a clinical level what is happening with people with MS or traumatic brain injury."

Professor Voelbel teaches Neuroscience and the Medical and Psychiatric Conditions courses in the OT Department.  Both are critical to the education of occupational therapists. For, without an understanding of neural science and the nervous system, he says, occupational therapy practitioners will have difficulty treating patients.  "Most of the interventions that occupational therapists create are ameliorating a disorder of the CNS (central nervous system).  Therefore, understanding the mechanism of the disorder is crucial.  Students in OT are taught to treat the whole person. What I try to teach them is some of the basic fundamentals of neuroscience from the cellular level to a functional level. That is the course that I want them to understand: the movement from the cellular level to the whole person, which is integral to occupational therapy."