5 - Presidential Address | Found in Translation: From the Clinic to the Research Lab and Back Again

Clinical observations often drive research questions. Research findings can improve clinical practice. Relatedly, clinical needs can motivate new research pursuits. In this talk I will review a number of studies from my lab, both on people with multiple sclerosis (MS) and those with sports-related concussion, which illustrate the interchange between research and clinical practice. In our MS work, we started with the clinical observation that depression and cognitive dysfunction appeared common in MS. I will review some studies in which we empirically demonstrated a relationship between these two variables after we gained a better understanding of how neurovegetative depression symptoms were confounded with MS symptoms; these and other findings suggested that treatment of depression, especially by modifying coping strategies, might lead to improved cognitive functioning. In our sports concussion work, we had an acute clinical need to be able to make evidence-based decisions about return-to-play in athletes who had not had baseline testing. This clinical need led to our development of an algorithm, using base rates of impairment, to identify athletes who were not ready to return-to-play. I will review this algorithm and some evidence in support of it. I will also discuss our development of a method for identifying athletes at risk for depression following concussion by using aspects of an already widely-used measure in sports concussion management. Other clinical translational issues will be addressed. I will conclude by emphasizing the need to think about clinical translation in research so that we can continually improve clinical care.