Category: Brain Injury; Athlete Development & Sports Rehabilitation; Neuroplasticity (includes neuroscience)
To examine cognitive change and its neural correlates following cognitive rehabilitation training for post-concussion syndrome in a student-athlete.
An intervention single case study using a pre-post trial design.
The study intervention was delivered in a generall community setting at the patient's home.
Participants (or Animals, Specimens, Cadavers) :
20-year-old male with post-concussion syndrome who was 12-months post-injury self-referred to our clinic. He met study inclusionary criteria of age 15 -60 and having suffered a brain injury at least six months prior to enrollment.
Interventions : The ThinkRx cognitive training program was delivered as 40 training sessions each lasting 90 minutes over five months. Training was delivered face-to-face using a 230-page structured curriculum sequenced by difficulty and complexity. The clinician utilized a metronome, timer, and manipulative to deliver intense, fast-paced tasks while providing dynamic feedback and motivation.
Main Outcome Measure(s) :
Training-induced changes in brain function was assessed using resting-state functional MRI of the Default Mode Network. Neuropsychological assessment was completed using full scale IQ and individual cognitive constructs measured by the Woodcock Johnson IV. Executive functioning was measured by the Comprehensive Executive Function Inventory and emotional competency was measured by the Patient Competency Rating Scale for TBI
Results included normalization of the Default Mode Network with increased connectivity between the right parietal node and the medial prefrontal cortex. Full scale IQ score improved by 24 points along with gains in all individual constructs. Executive function improved by 30 points. Self-reported impairment in emotional competency improved from moderate to mild.
The improvements across outcome measures suggest the use of a comprehensive, clinician-delivered one-on-one cognitive rehabilitation training program may be a viable option for remediating the cognitive and neural deficits associated with post-concussion syndrome in an otherwise healthy young athlete.
Christina Ledbetter– Research Fellow, LSUHSC Shreveport, Shreveport, Louisiana
Amy Moore– Research Director, Gibson Institute of Cognitive Research, Colorado Springs, Colorado
Terissa Miller– Research Associate, Gibson Institute of Cognitive Research, Colorao Springs, Colorado
Mark Taylor– Cognitive Trainer, Gibson Institute of Cognitive Research, Colorado Springs, Colorado