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January 31 , 2005
Stringer's Attached

BY Eric rangus

Neuropsychology, the scientific coupling of neurology and psychology, is a young, vibrant and growing area of study. At the forefront of the practice at Emory is Anthony Stringer.

"I was interested in psychology in high school, but it was a bit of a disappointment as an undergraduate," said Stringer, professor and director of neuropsychology in the School of Medicine's Department of Rehabilitation Medicine. "It always seemed like the major theoretical issues in psychology were never resolved, but the one course I really did find challenging was a course in physiological psychology," he said. "I had no idea that psychologists even studied the brain."

So after earning his doctorate in clinical psychology at Wayne State University (a Detroit native, Stringer also has bachelor's and master's degrees from his hometown institution), he pursued a career in neuropsychology, a discipline that dates to just after World War II.

"This is such a fascinating area," he said. "I've been doing this for 20 years, and I still learn something about how the brain works from literally every patient I see."

Neuropsychologists study brain dysfunction and its effects on cognitive behavior. In rehabilitation medicine, they work with patients experiencing memory loss from a variety of physical ailments including stroke, epilepsy, surgery and disease.

Stringer's research includes studying how the brain recovers from injuries; traumatic brain injury (TBI) is the leading cause of disability in the United States. TBI can encompass anything from a mild concussion to a debilitating injury suffered in an auto accident. For several years, Stringer served as principal investigator of the GAMBIS (Georgia Model Brain Injury System) Program. Until the project closed in 2003, GAMBIS (based at Emory in partnership with the Shepherd Center, a catastrophic care hospital) explored clinical aspects of TBI and new methods of rehabilitation.

GAMBIS provided a great deal of new information about brain injury, but since its completion Stringer's work has focused on another type of brain injury: epilepsy.

"We are part of a national clinical trial looking at surgical treatment for epilepsy," he said. "Temporal-lobe epilepsy doesn't respond well to medications; most of the patients with this diagnosis will eventually need surgery to take out that part of the brain. But we sometimes wait 10-15 years before that's done. After 10 years, patients often have serious memory impairments. So, a natural question arises: Why don't we do the surgery sooner?" Through his current work Stringer (he is co-investigator on the study; neurology's Thomas Henry is the primary) hopes to find out.

Stringer has been keeping busy in other ways as well. Last year he was the first African American to earn board certification in neuropsychology. While board certification is standard for medical doctors, it is an exception for psychologists; the United States has just 500 board-certified neuropsychologists (Stringer is just the seventh in Georgia).

Stringer wasn't aware that he was the first African American to earn certification, though he knew minorities were underrepresented in his field. His unique status was confirmed when a student from a listserv for minorities in neuropsychology (Stringer was not a subscriber) e-mailed him congratulations."

"I've heard from a number of other minorities in the field, and I think they are encouraged by the fact that one of us has done it," Stringer said. "So there will be more coming along in the next few years.

Earning board certification is about a two-year process (although individuals can take as much as six), and it is not something a neuropsychologist can do halfway. Stringer began by submitting his CV and support materials. Then he was invited to take a 100-question multiple-choice exam, which weeds out many candidates with a failure rate approaching 40 percent. Stringer was provided with a reading list, but he set it aside, preferring to work on his own.

"I did a month of intensive preparation and got a good score," said Stringer, adding that he took a month off from Emory--with the support of his colleagues--so he could concentrate on his studies.

Following the written exam, Stringer submitted samples of his work--write-ups of two cases he had seen. That submission was reviewed by three board-certified neuropscyhologists.

After passing that stage, Stringer was invited to sit for an oral exam, the last step to certification and perhaps the most nerve racking. Not only was he verbally probed by three board-certified Neuropsychologists, but he was given a clinical scenario and asked to respond adequately to the exam board's questions. He had no problems--not that it wasn't a lot of work.

"It felt worse than my dissertation defense when I got through it," he said.

Certification has not been Stringer's only recent project. In 2002 he co-edited Pathways to Prominence in Neuropsychology: Reflections of Twentieth Century Pioneers , which in many ways is a definitive volume on the history of the practice. The contributors included many of the neuropsychologists who developed the bases of neuropsychology.

"It was a learning experience," Stringer said. "Part of the reason for doing this was uncovering the history of the field as well as learning more about that history."

Stringer not only has great interest in neuropsychology's past, but also its present and future. "The core of our division is our training programs," Stringer said, though that wasn't the case when Stringer came to Emory in 1986. In the years since, opportunities have grown.

Across the Emory system, there are four interns in psychology with one focused in neuropsychology. The division also trains two to four externs a year and administers a two-year fellowship program. Soon, Stringer said, the program will expand to two fellows for two years.

Those fellows and interns enhance a division that encompasses 16 people, including five full-time faculty and two adjunct faculty. "I think neuropsychology attracts some of the brightest people who are interested in psychology in general," Stringer said. "We've never had any trouble getting applications."

Stringer has vibrant interests outside the clinic and classroom as well. He has been politically active since he was a student, when he volunteered for the mayoral campaign of Coleman Young, who eventually was elected the first African American mayor of Detroit. "I was at the lowest possible level," Stringer said, self-effacingly. "Like, at the level of hanging leaflets."

In the social sphere, Stringer chairs the board of The Mountain, a cabin conference center in Highlands, N.C., focused on peace initiatives and leadership training for youths and young adults. He found out about the place when he and his family stayed there for Easter vacation several years ago.

"I was just taken with the beauty," Stringer said. He joined The Mountain's board about 10 years ago and became its chair in 2000.

Stringer also has ties to Amnesty International and through that relationship initiated a program in 2003 called "From Conflict To Contact," connecting Atlanta high school students with youths in Africa who have been forced against their will to serve as soldiers.

"After they have been rescued and attempts are being made to integrate them into a more normal life--hopefully into their home communities--they are very vulnerable," Stringer said, speaking of the children in Africa, who many times have not even reached their teenage years before they are told to pick up a weapon.

"The idea is to put them in contact with youth in the United States. who can offer different perspectives on the world," he continued. "It's also a great educational opportunity for high school students here. These kids in Central Africa are leading such different lives; kids growing up here just can't imagine it."

Stringer said From Conflict To Contact is much more than a pen-pal program; the communication is deeper than that. Not only can students in Atlanta write to children in Africa, but they also have opportunities to become involved in fund raising and other support activities.

Stringer has no direct funding for his efforts, although he hopes to apply for some grant money in the future. All his visits to Atlanta-area high schools are on his own time. "Most of the kids in Africa involved in this correspondence are French speaking, so we go to French classes and offer this as a way of expanding the viewpoint of students here--and it's also a practical way to teach French," Stringer said. "I think this eventually will have a powerful impact both ways."

In addition to these many other interests, Stringer is an amateur musician. He plays the djembe , an African hand drum. And while he considers himself an amateur, Stringer already has played live for an audience of billions. He participated in the opening ceremonies for the 1996 Olympic Games in Atlanta as one of the many musicians chasing the memorable" drum towers" during the ceremony.

"That was the first time I played a musical instrument that was a moving target," he laughed. "It was a challenge--and a lot of fun."

 

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