John Whyte, MD, PhD
Director

Moss Rehabilitation Research Institute
Korman Suite 204
1200 West Tabor Road
Philadelphia, PA 19141-3099
Telephone: 215-456-5924
Fax: 215-456-5926
E-mail: jwhyte@einstein.edu

I've been interested in research my whole life, driven by a curiosity about how nature, and the human brain in particular, work. In order to pursue those interests, I completed medical school at the University of Pennsylvania, along with a doctorate in experimental psychology. What particularly interested me in my graduate studies was how people and other animals recover from brain damage, both through biological healing and by learning ways to compensate for their impairments. This led me to specialty training in Physical Medicine and Rehabilitation, a specialty unique in its focus on the process of recovery from injury and disease.

Since completing my residency training, my career has been a fascinating mixture of clinical work with individuals with traumatic brain injury and research on the types of cognitive problems that they experience. This mixture has allowed my research experience to influence my clinical care, and the problems that arise in the clinic to shape my research.

Research Focus

• Attention problems that occur in traumatic brain injury: Following brain injury, individuals often complain of distractibility and difficulty concentrating, doing two things at once, or working in busy or noisy environments. These attention problems interfere with the rehabilitation process and with returning to work. Dr. Whyte's research on attention in TBI has attempted to develop measures that are sensitive to the specific types of attention deficits common after TBI and to develop clinically useful measures of attention deficits, particularly for patients whose level of impairment precludes formal neuropsychological testing. His laboratory has also been interested in using psychoactive drugs as probes to understand how different attention networks are controlled. This research has demonstrated that different neurochemical agents affect distinct aspects of the attention systems of the brain. This work, in turn, paves the way for clinical trials of promising agents, by suggesting where their therapeutic impacts may lie. In addition, pharmacologic probes are used in functional imaging research, to characterize their effects on the activation levels of various attention networks.
• Patients recovering from coma, the vegetative state (VS), and the minimally conscious state (MCS): Patients with very severe brain injury often remain unconscious for weeks or months, and sometimes permanently. Dr. Whyte and colleagues have worked to develop very sensitive assessment tools that can detect the earliest signs of return of consciousness.These assessments have already been used to convince health insurance companies that patients who appear unconscious to the casual observer are, in fact, in need of rehabilitation services. In addition, Dr. Whyte led the organization of a multi-center research network, the "Consciousness Consortium", composed of facilities with specialization patients with severe disorders of consciousness. This network initially characterized the nature of spontaneous recovery from the VS and MCS, and identified key clinical predictors of recovery of consciousness. The Consciousness Consortium is now engaged in a multicenter randomized controlled trial of a psychoactive medication, to determine its effects on the recovery process.
• Rehabilitation research methods: Dr. Whyte is interested in the special methodologic problems inherent in rehabilitation research. Rehabilitation is interested in complex real-world functional skills. But cognitive neuroscience, psychopharmacology, and other relevant basic sciences address much more "micro" levels of analysis that have a tenuous and distant relationship to these functional abilities. Thus, rehabilitation research walks a tightrope between precision on the one hand, and clinical relevance on the other. Dr. Whyte has published extensively on research methods, including the selection of appropriate outcome measures, the definition of rehabilitation treatments, and aspects of rehabilitation patient case mix. In addition, he has been Principal Investigator of two large NIH grants that are intended to help disseminate state of the art cognitive rehabilitation research methods to the broader research community.

 

Funding Sources
Dr. Whyte has received funding for his research from the National Institutes of Health (NIH), including the National Institute of Neurologic Diseases and Stroke (NINDS) and the National Center for Medical Rehabilitation Research (NCMRR), as well as the Department of Education/National Institute on Disability and Rehabilitation Research (NIDRR), the Department of the Army and the James McDonnell Foundation. He has also received seed money grants from the Albert Einstein Society and the Moss Rehabilitation Research Institute Peer Review Committee.

 

Selected Publications

Attention Problems

• McDowell SK, Whyte J, D'Esposito M: Working memory impairments in traumatic brain injury: evidence from a dual-task paradigm.  Neuropsychologia 35(10):1341-1353, 1997
• McDowell S, Whyte J, D'Esposito M: Differential effect of a dopaminergic agonist on prefrontal function in traumatic brain injury patients.  Brain (121):1155-1164, 1998
• Whyte J, Schuster K, Polansky M, Adams J, Coslet HB: Frequency and duration of inattentive behavior after traumatic brain injury: effects of distraction, task and practice.  Journal of the International Neuropsychological Society 6:1-11, 2000
• Whyte J, Hart T, Bode RK, Malec JF: The Moss attention rating scale (MARS)ã for traumatic brain injury: Initial psychometric assessment.  Archives of Physical Medicine and Rehabilitation 84(2):268-276, 2003
• Alban JP, Hopson MM, Ly V, Whyte J:  Effect of methylphenidate on vital signs and adverse effects in adults with traumatic brain injury.  American Journal of Physical Medicine and Rehabilitation, 83(2):131-137, 2004
• Whyte J, Hart T, Vaccaro M, Grieb-Neff P, Risser A, Polansky M, Coslett HB: The effects of methylphenidate on attention deficits after traumatic brain injury: A multi-dimensional randomized controlled trial.  American Journal of Physical Medicine and Rehabilitation, 83(6):401-420, 2004

 

Patients Recovering from Coma, the Vegetative State and the Minimally Conscious State

• Whyte J, DiPasquale M: Assessment of vision and visual attention in minimally responsive brain injured patients.  Archives of Physical Medicine and Rehabilitation 76(9):804-810, 1995
• Giacino J, Ashwal S, Childs N, Cranford R, Jennett B, Katz D, Kelly J, Rosenberg J, Whyte J, DiPasquale M., Vaccaro M: Assessment of command-following in minimally conscious brain injured patients.  Archives of Physical Medicine and Rehabilitation 80:1-8, 1999
• Phipps E, DiPasquale M, Blitz C, Whyte J: Interpreting responsiveness in persons with severe traumatic brain injury: beliefs in families and quantitative evaluations. Journal of Head Trauma Rehabilitation 12(4):52-67, 1997
• Laborde A, Whyte J: Update on Pharmacology. Two dimensional, quantitative data analysis: its role in assessing the functional utility of psychostimulants in minimally conscious patients. Journal of Head Trauma Rehabilitation 12(4):90-92, 1997
• Whyte J, Zafonte R, Zasler N: The minimally conscious state: Definition and diagnostic criteria.  Neurology 12;58(3):349-353, 2002
• Giacino JT, Kalmar K, Whyte J: The JFK coma recovery scale-revised: measurement characteristics and diagnostic utility.  Archives of Physical Medicine and Rehabilitation, 85(12):2020-2029, 2004
• Whyte J, Katz D, Long D, DiPasquale MC, Polansky M, Kalmar K, Giacino J, Childs N, Mercer W, Novak P, Maurer P, Eifert B: Predictors of outcome and effect of psychoactive medications in prolonged posttraumatic disorders of consciousness: A multicenter study. Archives of Physical Medicine and Rehabilitation, 86;(3):453-462, 2005
• Giacino J, Whyte J: The vegetative and minimally conscious states: current knowledge and remaining questions.  The Journal Head of Trauma Rehabilitation, 20;(1):30-50, 2005

 

Rehabilitation Research Methods

• Whyte J: Assessing medical rehabilitation practices: Distinctive methodologic challenges.  In Fuhrer MJ (ed.), The Promise of Outcomes Research, Baltimore: Brookes, (2):43-59, 1997
• Narayan RK, Michel ME, and the Clinical Trials in Head Injury Study Group, including Whyte J: Clinical trials in head injury.  Journal of Neurotrama 19;5:503-557, 2002
• Whyte J: Traumatic brain injury rehabilitation: Are there alternatives to randomized clinical trials? Commentary, Archives of Physical Medicine and Rehabilitation 83;1320-1322, 2002
• Whyte J: Pharmacologic treatment of cognitive impairments: Conceptual and methodological considerations.  In Eslinger PJ (ed.), Neuropsychological Interventions, New York: Guilford Publications, Inc., 2002;59-79
• Whyte J:  Clinical trials in rehabilitation: what are the obstacles?  American Journal of Physical Medicine and Rehabilitation, 82(10 Suppl):S16-S21, 2003
• Whyte J, Hart T.  It's more than a black box; it's a Russian doll: Defining rehabilitation treatments.  American Journal of Physical Medicine and Rehabilitation 82(8):639-652, 2003