Compassion, curiosity fuel research
Barry Willer’s fascination with injuries of the brain originated, as academic interests often do, outside the laboratory, in life. About 25 years ago, Willer was a researcher studying developmental disabilities when a young friend—a 17-year-old he had coached in hockey—was hit by a drunk driver while crossing the street.
“The injury to the brain was very severe, just very severe,” Willer, a professor of psychiatry and rehabilitation medicine, remembers. “He was in a coma for, oh gosh, at least a month after that. And his family kept looking to me because they knew I taught at the medical school at UB. And they looked to me for answers. And I didn’t have them. But being in a medical school means you can go and get access to information very easily, and it didn’t take too long before I seemed to know at least enough to help.”
Since then, Willer has established himself as an internationally recognized researcher on brain injuries, focusing on social issues, such as how people who have suffered damage can re-integrate themselves into the community. He approaches his work today with the same compassion and curiosity that brought him to the field. Current projects include testing a program to help brain-injured adults regain their ability to recognize emotions, and pioneering a treatment that speeds recovery of people with post-concussion syndrome.
Willer, who grew up north of Toronto, joined the UB faculty in 1976 after earning a doctorate in psychology at York University in Canada. At the time, he was interested in developmental disabilities, inspired, in part, by experiences at an institution serving people with severe mental retardation.
“In one of my psychology classes, I was supposed to carry out an experiment,” Willer says. “I was trying to teach a person with severe mental retardation shapes and colors. And when I saw how the person lived, it seemed like the most irrelevant thing I could imagine doing. What difference would it make in his life if he learned the difference between a triangle and a square? The institution was a horrible place, with a de-stimulating environment that was, frankly, inhumane.”
Following the accident that sent his friend into a coma, Willer’s interests turned to brain injury. He read what he could on the subject, and soon after, landed a grant from the National Institute on Disability and Rehabilitation Research (NIDRR) to create a research-and-training center focusing on the reintegration of people with brain injury into society. One product resulting from that funding was a community integration questionnaire Willer developed. Scientists around the world have used the questionnaire, which asks about aspects of daily life, such as who is responsible for chores and finances in a household, to gauge how well individuals with traumatic brain injuries are re-adapting to society.
A more recent area of inquiry has been affect recognition. Experts say as many as half of patients with traumatic brain injury lose the ability to interpret and express emotion. Partnering with a graduate student, Willer designed a computer-based, diagnostic-and-treatment program to help brain-injured adults relearn these skills. Promising results led to a $600,000 grant—again from the NIDRR—to carry out a three-year controlled trial of the program, an ongoing project.
“We have demonstrated already that individuals with brain injury can be retaught to recognize emotions, which I think is very exciting,” Willer says.
He recounts how the research affected one married couple, a woman who had suffered a relatively mild traumatic brain injury, and her husband, whom she described as “indifferent,” despite his attempts to support her as best he could. When a sad, angry or surprised face appeared on a computer screen, the wife saw “indifferent.”
“His wife didn’t know she wasn’t recognizing his emotions,” Willer says, “and he had no idea what was going on.”
And this is part of what makes Willer remarkable. In describing his research, he places each discovery in the context of how it is making a difference for someone. His work seems inextricably intertwined with the people in his life, including strangers who approach him with problems. He reports, for instance, that his interest in concussion, a relatively mild form of brain injury, stems from an encounter with a man—the father of two professional hockey players—who contacted him with questions about one of his son’s injuries.
“He asked me about his issues, which I knew very little about,” Willer says. “So I decided to become educated about this issue.”
Now, Willer’s research on the topic is changing lives. Typically, doctors tell patients with post-concussion syndrome—symptoms that linger for more than three weeks after an injury—that resting is the fastest way to recover. But a treatment Willer and John Leddy, director of UB’s Concussion Clinic, have pioneered calls for people with post-concussion syndrome to complete an individually tailored program of progressively intensive exercise. Over time, the approach relieves nearly all symptoms, the researchers reported in the January issue of the Clinical Journal of Sport Medicine.
As Willer discusses the results, his thoughts turn, again, to whom the treatment could help. Veterans returning from Iraq and Afghanistan with head wounds could benefit. Already, high school, college and professional athletes have taken advantage of the novel approach. Watching their progress has been gratifying.
“After their concussion,” Willer says, “these people were depressed and were becoming de-conditioned because they were athletes being asked to do nothing. The first thing we saw was athletes went from depressed to not depressed overnight because they were given an opportunity to do something. So that in itself was worthwhile. And then their symptoms improved. The program is not only for athletes, but to see these players become healthier and return to play was remarkable.”