Bio

Education & Certifications


  • Fellowship, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Aging/Dementia (2013)
  • Fellowship, Sierra-Pacific Mental Illness Research, Education, and Clinical Center, VA Palo Alto Health Care System, Aging/Dementia (2013)
  • Ph.D., University of Miami (2010)
  • Internship, VA Palo Alto Health Care System, Geropsychology/Neuropsychology (2009)
  • M.S., University of Miami (2007)
  • B.S., University of Miami (2003)

Projects


  • VA Cultivating Access to Resources, Education, and Skills for Dementia Caregivers (VA CARES)

    According to VA estimates, nearly 500,000 Veterans suffer from dementia. There is currently no cure for dementia. Ultimately, dementia will have a large impact on quality of life in Veterans and families, lead to expensive nursing home placement, and decrease life expectancy for patients and family caregivers. The experience of high burden in a caregiver for a Veteran with dementia increases the likelihood of permanent nursing home placement and can separate Veterans from their families. To address the high burden of caring for a Veteran with dementia, we aim to study the effect of a low-cost, rehabilitative intervention for family caregivers of Veterans with dementia. Our novel approach uses video technology that can reach caregivers in rural areas who do not have easy access to major VA medical centers. If this rehabilitative intervention proves successful, it may represent an approach to Veteran- and family-centered dementia care that can be used throughout VA with low staff, resource, and cost burdens.

    The VA CARES project studies the effects of an education and skill-building rehabilitation (ESBR) intervention, designed to be low-cost and clinically translatable through video telehealth, on family caregivers of Veterans with dementia. The trial will consist of 150 family caregivers coping with all causes of dementia who will be randomized to our ESBR intervention (n=50 in-clinic, ESBR-i; n=50 via video telehealth, ESBR-v) or to usual care plus supplemental educational materials on dementia (n=50, UC). Intervention effects will be examined longitudinally at six, 12, and 24 months post-intervention. Advanced statistical techniques will be used to determine the impact of the intervention on: quality of life in caregivers of Veterans with dementia (Primary Aim 1), depressive symptoms in caregivers (Secondary Aim 2), and community tenure, time to long-term care placement, and survival (Secondary Aim 3). The proposed study will utilize the infrastructure of the Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC) to investigate this innovative method of caregiver intervention. This award creates an ideal environment where Dr. Scanlon can wholly focus his time on Veteran- and family-centered clinical research and enables him to pursue his long-term career objective: developing a fully independent research program investigating low-cost, pragmatic and clinically translatable methods for improving rehabilitation and management of neurodegenerative disease and dementia.

    Location

    3801 Miranda Ave. Palo Alto, CA 94304

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Publications

Journal Articles


  • An accelerometry-based study of lower and upper limb tremor in Parkinson's disease. Journal of clinical neuroscience Scanlon, B. K., Levin, B. E., Nation, D. A., Katzen, H. L., Guevara-Salcedo, A., Singer, C., Papapetropoulos, S. 2013; 20 (6): 827-830

    Abstract

    Over the past two decades, several studies have aimed to quantify the kinetic properties of tremor with primary focus on the upper limbs. However, there is a lack of investigation into the properties of tremor in the lower limbs. The objective of this preliminary study was to investigate the properties of oscillatory movement, at rest and in posture, in both the upper and lower limbs of Parkinson's disease (PD) patients with clinically undetectable to modest rest/postural tremor and healthy controls. PD patients (N=16) and controls (N=8) were examined clinically by a movement disorders specialist and oscillatory movements in all four extremities were evaluated using a portable biaxial accelerometer. While tremor intensity and frequency did not differ between groups, the intraindividual variability of rest and postural tremor frequency in the dexterity-dominant lower limb was lower in people living with PD than in healthy adults. Additionally, rest tremor frequency was discrepant between upper and lower limbs in PD. Our work introduces the possibility that minute variations in lower limb movements, which are imperceptible upon expert clinical exam, can be used to differentiate a diseased sample from a healthy one. These preliminary findings suggest that additional work using objective tremor measurement may improve our understanding of lower limb motor dysfunction in PD and lead to the refinement of current, and the development of new, metrics to enhance early diagnosis, differential diagnosis, and symptom quantification.

    View details for DOI 10.1016/j.jocn.2012.06.015

    View details for PubMedID 23639618

  • Modeling the effects of obstructive sleep apnea and hypertension in Vietnam veterans with PTSD SLEEP AND BREATHING Kinoshita, L. M., Yesavage, J. A., Noda, A., Jo, B., Hernandez, B., Taylor, J., Zeitzer, J. M., Friedman, L., Fairchild, J. K., Cheng, J., Kuschner, W., O'Hara, R., Holty, J. C., Scanlon, B. K. 2012; 16 (4): 1201-1209

    Abstract

    The present work aimed to extend models suggesting that obstructive sleep apnea (OSA) is associated with worse cognitive performance in community-dwelling older adults. We hypothesized that in addition to indices of OSA severity, hypertension is associated with worse cognitive performance in such adults.The PTSD Apnea Clinical Study recruited 120 community-dwelling, male veterans diagnosed with PTSD, ages 55 and older. The Rey Auditory Verbal Learning Test (RAVLT) and Color-Word Interference Test (CWIT) were measures of auditory verbal memory and executive function, respectively. Apnea-hypopnea index (AHI), minimum and mean pulse oximeter oxygen saturation (min SpO(2), mean SpO(2)) indicators were determined during standard overnight polysomnography. Multivariate linear regression and receiver operating characteristic (ROC) curve analyses were performed.In regression models, AHI (??=?-4.099; p?

    View details for DOI 10.1007/s11325-011-0632-8

    View details for Web of Science ID 000311301700038

    View details for PubMedID 22193972

  • Pilot Expertise and Hippocampal Size: Associations with Longitudinal Flight Simulator Performance AVIATION SPACE AND ENVIRONMENTAL MEDICINE Adamson, M. M., Bayley, P. J., Scanlon, B. K., Farrell, M. E., Hernandez, B., Weiner, M. W., Yesavage, J. A., Taylor, J. L. 2012; 83 (9): 850-857

    Abstract

    Previous research suggests that the size of the hippocampus can vary in response to intensive training (e.g., during the acquisition of expert knowledge). However, the role of the hippocampus in maintenance of skilled performance is not well understood. The Stanford/Veterans Affairs Aviation MRI Study offers a unique opportunity to observe the interaction of brain structure and multiple levels of expertise on longitudinal flight simulator performance.The current study examined the relationship between hippocampal volume and three levels of aviation expertise, defined by pilot proficiency ratings issued by the U.S. Federal Aviation Administration (11). At 3 annual time points, 60 pilots who varied in their level of aviation expertise (ages ranging from 45 to 69 yr) were tested.At baseline, higher expertise was associated with better flight simulator performance, but not with hippocampal volume. Longitudinally, there was an Expertise x Hippocampal volume interaction, in the direction that a larger hippocampus was associated with better performance at higher levels of expertise.These results are consistent with the notion that expertise in a cognitively demanding domain involves the interplay of acquired knowledge ('mental schemas') and basic hippocampal-dependent processes.

    View details for DOI 10.3357/ASEM.3215.2012

    View details for Web of Science ID 000307919100002

    View details for PubMedID 22946348

  • Statistical analysis and mapping of the unified Parkinson's Disease rating scale to Hoehn and Yahr staging PARKINSONISM & RELATED DISORDERS Tsanas, A., Little, M. A., McSharry, P. E., Scanlon, B. K., Papapetropoulos, S. 2012; 18 (5): 697-699
  • Whole-Brain Proton MR Spectroscopic Imaging in Parkinson's Disease. Journal of neuroimaging : official journal of the American Society of Neuroimaging Levin, B. E., Katzen, H. L., Maudsley, A., Post, J., Myerson, C., Govind, V., Nahab, F., Scanlon, B., Mittel, A. 2012

    Abstract

    BACKGROUND AND PURPOSE: To examine the distributions of proton magnetic resonance spectroscopy (MRS) observed metabolites in Parkinson's disease (PD) throughout the whole brain. METHODS: Twelve PD patients and 18 age-matched controls were studied using neuropsychological testing, MRI and volumetric MR spectroscopic imaging. Average values of signal normalized metabolite values for N-acetyl-aspartate, total-creatine, and total-choline (NAA, total-Cre, total-Cho, respectively) and their ratios were calculated for gray matter (GM) and white matter (WM) in each lobar brain region. RESULTS: Analyses revealed altered metabolite values in PD subjects relative to controls within the GM of the temporal lobe (right: elevated Cre, P= .027; decreased NAA/Cre, P= .019; decreased Cho/Cre, P= .001 and left: decreased NAA/Cre; P= .001, decreased Cho/Cre, P= .007); the right occipital lobe (decreased NAA, P= .032 and NAA/Cre, P= .016); and the total cerebrum GM (decreased NAA/Cre, P= .029). No meaningful correlations were obtained between abnormal metabolite values and the neuropsychological measures. CONCLUSIONS: PD is associated with widespread alterations of brain metabolite concentrations, with a primary finding of increased creatine. Higher creatine values in our PD sample may reflect greater neuronal energy expenditure early in the disease process that is compensatory. This is the first whole brain MRS study of PD that has examined metabolite changes across a large fraction of the brain volume, including the cortical mantle.

    View details for PubMedID 23228009

  • Initial Cognitive Performance Predicts Longitudinal Aviator Performance JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES Yesavage, J. A., Jo, B., Adamson, M. M., Kennedy, Q., Noda, A., Hernandez, B., Zeitzer, J. M., Friedman, L. F., Fairchild, K., Scanlon, B. K., Murphy, G. M., Taylor, J. L. 2011; 66 (4): 444-453

    Abstract

    The goal of the study was to improve prediction of longitudinal flight simulator performance by studying cognitive factors that may moderate the influence of chronological age.We examined age-related change in aviation performance in aircraft pilots in relation to baseline cognitive ability measures and aviation expertise. Participants were aircraft pilots (N = 276) aged 40-77.9. Flight simulator performance and cognition were tested yearly; there were an average of 4.3 (± 2.7; range 1-13) data points per participant. Each participant was classified into one of the three levels of aviation expertise based on Federal Aviation Administration pilot proficiency ratings: least, moderate, or high expertise.Addition of measures of cognitive processing speed and executive function to a model of age-related change in aviation performance significantly improved the model. Processing speed and executive function performance interacted such that the slowest rate of decline in flight simulator performance was found in aviators with the highest scores on tests of these abilities. Expertise was beneficial to pilots across the age range studied; however, expertise did not show evidence of reducing the effect of age.These data suggest that longitudinal performance on an important real-world activity can be predicted by initial assessment of relevant cognitive abilities.

    View details for DOI 10.1093/geronb/gbr031

    View details for Web of Science ID 000293251900007

    View details for PubMedID 21586627

  • Objective Quantification of Neuromotor Symptoms in Parkinson's Disease: Implementation of a Portable, Computerized Measurement Tool PARKINSONS DISEASE Papapetropoulos, S., Katzen, H. L., Scanlon, B. K., Guevara, A., Singer, C., Levin, B. E. 2010
  • Visual Hallucinations in Neurodegenerative Disorders In K. Miyoshi, Y. Morimura & K. Maeda (Eds.), Neuropsychiatric Disorders: Springer Verlag Papapetropoulos, S., Scanlon, B. K. 2010
  • Objective quantification of neuromotor symptoms in Parkinson's disease: implementation of a portable, computerized measurement tool. Parkinson's disease Papapetropoulos, S., Katzen, H. L., Scanlon, B. K., Guevara, A., Singer, C., Levin, B. E. 2010; 2010: 760196-?

    Abstract

    Quantification of neuromotor symptoms with device-based measures provides a useful supplement to clinical evaluation. Research using the CATSYS has established its utility as a computerized measurement system to quantify neuromotor function. The primary objective of this study is to provide technical guidance on the use of the CATSYS in Parkinson's disease (PD). Forty-four patients with idiopathic PD and 28 healthy controls were prospectively recruited and evaluated with CATSYS, a portable, Windows-based system consisting of a data logger and four different sensors (tremor pen, touch recording plate, reaction time handle, and force plate for balance recording) for quantification of neuromotor functions. CATSYS discriminated between PD and controls on measurements of rest/postural tremor, pronation/supination, finger tapping, simple reaction time, and postural sway intensity and velocity. CATSYS measurements using the proposed test battery were associated with relevant clinician-rated Unified Parkinson's disease rating scale (UPDRS) items assessing tremor and bradykinesia. More work is warranted to establish CATSYS as a diagnostic/monitoring instrument in movement disorders using the proposed technical approaches.

    View details for DOI 10.4061/2010/760196

    View details for PubMedID 20976095

  • A revised formula for the conversion of UPDRS-III scores to Hoehn and Yahr stage Parkinsonism and Related Disorders Scanlon BK, Katzen HL, Levin BE, Singer C, Papapetropoulos S 2010; 16 (2): 151-2
  • Subthreshold depression in Parkinson's disease INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Nation, D. A., Katzen, H. L., Papapetropoulos, S., Scanlon, B. K., Levin, B. E. 2009; 24 (9): 937-943

    Abstract

    It is estimated that 40% of patients with Parkinson's disease (PD) are clinically depressed, however, little is known about the frequency and associated features of subthreshold depression in PD. The current study sought to determine the prevalence of subthreshold depression (sD) and to further characterize the associated features in a sample of 111 nondemented patients with moderate to severe PD.Patients were classified into the following groups: diagnostic depression (DD), subthreshold depression (sD), or nondepressed (ND) by applying the Diagnostic and Statistical Manual, 4th edn criteria for depression and previously reported criteria for sD to items from the Beck Depression Inventory, 2nd edn. These groups were compared on clinical and demographic variables. The symptom profile of the sD group is also described.Fifty participants (45.0%) were classified as ND, 32 (28.8%) as sD, and 29 (26.1%) as DD. Patients with sD were younger (approximately 5 yrs) than nondepressed patients, but did not differ in disease stage or any other demographic variables. Patients with sD tended to endorse mood symptoms that overlap with PD, including fatigue, sleep difficulties, appetite dysfunction, and concentration difficulties. These symptoms were also endorsed with high frequency by the other groups.These findings suggest that sD is not uncommon in PD and may be more prevalent among younger patients. The finding that sD patients report mood symptoms that overlap with the PD symptomatology suggests that these two entities share common features and may be difficult to disentangle.

    View details for DOI 10.1002/gps.2199

    View details for Web of Science ID 000269428100007

    View details for PubMedID 19212967

  • A questionnaire-based (UM-PDHQ) study of hallucinations in Parkinson's disease BMC NEUROLOGY Papapetropoulos, S., Katzen, H., Schrag, A., Singer, C., Scanlon, B. K., Nation, D., Guevara, A., Levin, B. 2008; 8

    Abstract

    Hallucinations occur in 20-40% of PD patients and have been associated with unfavorable clinical outcomes (i.e., nursing home placement, increased mortality). Hallucinations, like other non-motor features of PD, are not well recognized in routine primary/secondary clinical practice. So far, there has been no instrument for uniform characterization of hallucinations in PD. To this end, we developed the University of Miami Parkinson's disease Hallucinations Questionnaire (UM-PDHQ) that allows comprehensive assessment of hallucinations in clinical or research settings.The UM-PDHQ is composed of 6 quantitative and 14 qualitative items. For our study PD patients of all ages and in all stages of the disease were recruited over an 18-month period. The UPDRS, MMSE, and Beck Depression and Anxiety Inventories were used for comparisons.Seventy consecutive PD patients were included in the analyses. Thirty-one (44.3%) were classified as hallucinators and 39 as non-hallucinators. No significant group differences were observed in terms of demographics, disease characteristics, stage, education, depressive/anxiety scores or cognitive functioning (MMSE) between hallucinators and non-hallucinators. Single mode hallucinations were reported in 20/31 (visual/14, auditory/4, olfactory/2) whereas multiple modalities were reported in 11/31 patients. The most common hallucinatory experience was a whole person followed by small animals, insects and reptiles.Using the UM-PDHQ, we were able to define the key characteristics of hallucinations in PD in our cohort. Future directions include the validation of the quantitative part of the questionnaire than will serve as a rating scale for severity of hallucinations.

    View details for DOI 10.1186/1471-2377-8-21

    View details for Web of Science ID 000257494500001

    View details for PubMedID 18570642

  • A formula for the conversion of UPDRS-III scores to Hoehn and Yahr stage PARKINSONISM & RELATED DISORDERS Scanlon, B. K., Katzen, H. L., Levin, B. E., Singer, C., Papapetropoulos, S., Scanlon, B. K., Levin, B. E., Katzen, H. L. 2008; 14 (4): 379-380

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