Neuroplasticity (includes neuroscience)
Military and Veterans Affairs
We present the results of the first mild traumatic brain injury (mTBI) clinical trial to achieve a Class I rating from the American Academy of Neurology. In particular, we find that, compared to active control training, computer-based cognitive training targeting sensory processing, attention, processing speed, and memory improved objective neuropsychological performance in OEF/OIF/OND Veterans suffering from mTBI with objective and subjective cognitive dysfunction. We found that this effect persisted after a 3-4 month no-contact period.
Objective : Mild traumatic brain injury (mTBI) is highly prevalent in returning OEF/OIF/OND Veterans and has been associated with self-reported as well as objective cognitive dysfunction. The goal of the current study was to determine if a multi-componential at-home cognitive training program could improve cognitive performance and functional outcomes in individuals suffering from mTBI.
Design : The trial was a prospective, parallel arm, double-blind, randomized controlled trial with five participating sites. The comparison of interest was 12 weeks of an experimental training program (65 hours) vs. 12 weeks of a control training program (65 hours) that was matched for level of engagement. Validated computer-based/paper-and-pencil cognitive assessments and functional outcomes were administered before training, within two weeks after completing experimental (ET) or active control training (AT), and again after a three-month no-contact period.
Setting : The five study sites included US military hospitals as well as Veterans Affairs hospitals.
Participants (or Animals, Specimens, Cadavers) : Participants included 86 individuals who suffering an mTBI with either objective or self-reported cognitive dysfunction.
Interventions : The experimental training program included several adaptive tasks targeting sensory processing, attention, processing speed, and memory. The active control training program included several engaging games (e.g., hangman) that did not intensively target these specific cognitive mechanisms.
Main Outcome Measure(s) : The primary outcome measures were 1) a cognitive composite measure composed of validated measures of attention, executive function, and memory and 2) a functional outcome measure - timed instrumental activities of daily living.
Results : Participants randomized to cognitive training showed significantly superior improvements in the cognitive composite measure at post-training and follow-up relative to active control. Significant improvements were not found on the TIADL.
Conclusions : These results suggest that it is possible to improve cognitive performance in individuals with mTBI suffering from objective and subjective cognitive dysfunction.