A-117 Strategic Memory and Advanced Reasoning Training for Rehabilitation of Warfighters with Mild Traumatic Brain Injury

2021 ◽  
Vol 36 (6) ◽  
pp. 1167-1167
Author(s):  
Jason Bailie ◽  
Paul Sargent ◽  
Sandi Chapman ◽  
Melissa Caswell ◽  
Juan Lopez ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Executive Functioning ◽  
Mild Traumatic Brain Injury ◽  
Cognitive Abilities ◽  
High Stress ◽  
Small Sample ◽  
Cognitive Complaints ◽  
Relevant Effect ◽  
Strategic Memory

Abstract Background Military personnel require a level of cognitive readiness that ensures they function safely and effectively in high-stress situations. Warfighters who experienced a mild traumatic brain injury (mTBI) often complain of persistent cognitive issues that may impact those abilities. This study presents preliminary data on the efficacy of a 4-week Strategic Memory Advanced Reasoning Training (SMART) for warfighter rehabilitation. SMART improves executive functioning in order to enhance overall cognitive abilities. Methods This is part of a randomized clinical trial (Validation of Cognitive Enhancement Therapy for mTBI). 22 Marines with prior mTBI and current cognitive complaints; 7 of whom completed SMART and were included in the analysis. Cognitive tests of interest included the Delis-Kaplan Executive Function System Color Word (CW) and Trail Making (TM). Results Improvements were observed on TM Number Sequencing (Pre: M = 9.71, SD = 2.06; Post: M = 11.86, SD = 1.35, p = 0.011, d = 1.37) and approached significance on Letter Sequencing (Pre: M = 10.29, SD = 1.81; Post: M = 12.57, SD = 1.13, p = 0.066, d = 1.26). Though non-significant, a large clinically-relevant effect size was found for Number-Letter Switching (Pre: M = 8.14, SD = 1.95; Post: M = 9.57, SD = 2.15, p = 0.106, d = 0.72). CW performance improved on Inhibition (Pre: M = 5.29, SD = 3.86; Post: M = 8.86, SD = 2.34, p = 0.034, d = 1.03) and Inhibition/Switching (Pre: M = 4.86, SD = 4.06; Post: M = 8.43, SD = 4.12, p = 0.015, d = 1.26). Conclusions The SMART program resulted in large improvements in the executive functioning of a small sample of warfighters with persistent cognitive complaints following a mTBI. The results support further examination of the efficacy of SMART for warfighter rehabilitation.

scholarly journals Blast-Exposed Veterans With Mild Traumatic Brain Injury Show Greater Frontal Cortical Thinning and Poorer Executive Functioning

2018 ◽  
Vol 9 ◽  
Author(s):  
Alexandra L. Clark ◽  
Victoria C. Merritt ◽  
Erin D. Bigler ◽  
Katherine J. Bangen ◽  
Madeleine Werhane ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Executive Functioning ◽  
Mild Traumatic Brain Injury ◽  
Cortical Thinning

scholarly journals B-72 The Relationship between Anxiety and Postconcussive Symptomology in patients with Mild Traumatic Brain Injury

2019 ◽  
Vol 34 (6) ◽  
pp. 1020-1020
Author(s):  
K Cornett
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Injury Severity ◽  
Small Sample ◽  
Future Research ◽  
Control Group ◽  
Patient Report ◽  
The Relationship ◽  
Report Measure

Abstract Objective Research literature has demonstrated the role that pre-morbid anxiety has in prolonging recovery from mild traumatic brain injury (mTBI). The aim of this investigation is to clarify the degree of the relationship between anxiety and postconcussive symptomology in patients with mTBI. Method This study compared scores from a patient-report measure of anxiety, the General Anxiety Disorder-7 (GAD-7), to scores from a patient-report measure of postconcussion symptom severity, the Neurobehavioral Symptom Inventory (NSI). Participants were recruited from September 2018 to December 2019 who had been referred for clinical evaluation to Rehabilitation Institute of Washington’s Brain Injury Services (a privately-run, interdisciplinary, outpatient clinic). 39 adult participants (30 males and nine females) completed both the GAD-7 and NSI. No control group was used. Injury severity level was ascertained via review of the medical records. Patients underwent an abbreviated evaluation with a clinical neuropsychologist. As a part of this initial evaluation, patients completed an intake packet, which included the NSI and GAD-7. Results The relationship between the ordinal variables (i.e., anxiety and postconscussive symptomology) was assessed using spearman’s rho. Anxiety had a strong, statistically significant relationship with postconcussive symptomology (rho = 0.670, p = 0.000). Conclusions Anxiety and postconcussive symptomology severity are associated in this population of patients with mTBI. Limitations of this current investigation include a small sample size and no control group. This study indicates the need for controlled studies in future research to address the above-encountered limitations. Nevertheless, this study lends support to the prevalence of anxiety in those with elevated postconcussive symptomology and the need to monitor this in assessment and treatment.

scholarly journals Cognitive Training for Mild Traumatic Brain Injury and Posttraumatic Stress Disorder

2020 ◽  
Vol 11 ◽  
Author(s):  
Kristin W. Samuelson ◽  
Krista Engle ◽  
Linda Abadjian ◽  
Joshua Jordan ◽  
Alisa Bartel ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Posttraumatic Stress Disorder ◽  
Brain Injury ◽  
Executive Functioning ◽  
Posttraumatic Stress ◽  
Cognitive Training ◽  
Mild Traumatic Brain Injury ◽  
Stress Disorder ◽  
Control Group ◽  
Clinically Significant

Although there is evidence of mild cognitive impairments for many individuals with mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD), little research evaluating the effectiveness of cognitive training interventions has been conducted. This randomized controlled trial examined the effectiveness of a 9-h group cognitive training targeting higher-order functions, Strategic Memory Advanced Reasoning Training (SMART), compared to a 9-h psychoeducational control group in improving neurocognitive functioning in adults with mTBI and PTSD. A sample of 124 adults with histories of mild TBI (n = 117) and/or current diagnoses of PTSD (n = 84) were randomized into SMART (n = 66) or Brain Health Workshop (BHW; n = 58) and assessed at three time points: baseline, following training, and 6 months later. Participants completed a battery of neurocognitive tests, including a test of gist reasoning (a function directly targeted by SMART) as well as tests of verbal, visual, and working memory and executive functioning, functions commonly found to be mildly impaired in mTBI and PTSD. The two groups were compared on trajectories of change over time using linear mixed-effects models with restricted maximum likelihood (LMM). Contrary to our hypothesis that SMART would result in superior improvements compared to BHW, both groups displayed statistically and clinically significant improvements on measures of memory, executive functioning, and gist reasoning. Over 60% of the sample showed clinically significant improvements, indicating that gains can be found through psychoeducation alone. A longer SMART protocol may be warranted for clinical samples in order to observe gains over the comparison group.

Gray matter volume and executive functioning correlate with time since injury following mild traumatic brain injury

2016 ◽  
Vol 612 ◽  
pp. 238-244 ◽  
Author(s):  
William D.S. Killgore ◽  
Prabhjyot Singh ◽  
Maia Kipman ◽  
Derek Pisner ◽  
Andrew Fridman ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Executive Functioning ◽  
Mild Traumatic Brain Injury ◽  
Gray Matter ◽  
Gray Matter Volume ◽  
Matter Volume ◽  
Time Since Injury

scholarly journals Systematic Review of the Long-Term Neuroimaging Correlates of Mild Traumatic Brain Injury and Repetitive Head Injuries

2021 ◽  
Vol 12 ◽  
Author(s):  
Holly Victoria Echlin ◽  
Alma Rahimi ◽  
Magdalena Wojtowicz
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sex Education ◽  
Mild Traumatic Brain Injury ◽  
Imaging Techniques ◽  
Data Extraction ◽  
Small Sample ◽  
Original Research ◽  
Level Of Evidence

Objective: To systematically review the literature on the long-term neuroimaging findings (≥10 years from exposure) for exposure in adulthood to mild traumatic brain injury (mTBI) and repetitive head impacts (RHIs) using neuroimaging across all available populations.Data sources: Four electronic databases: MEDLINE, SPORTDiscus, PsycINFO, and EMBASE.Study selection: All articles were original research and published in English. Studies examined adults with remote exposure to mTBI and/or RHIs from ten or more years ago in addition to any associated neuroimaging findings.Data extraction: Parameters mainly included participants' population, age, years since head injury, race, sex, education level, and any neuroimaging findings. Scores for the level of evidence and risk of bias were calculated independently by two authors.Results: 5,521 studies were reviewed, of which 34 met inclusion criteria and were included in this study. The majority of adults in these studies showed positive neuroimaging findings one or more decades following mTBI/RHI exposure. This was consistent across study populations (i.e., veterans, athletes, and the general population). There was evidence for altered protein deposition patterns, micro- and macro-structural, functional, neurochemical, and blood flow-related differences in the brain for those with remote mTBI/RHI exposure.Conclusion: Findings from these studies suggest that past mTBI/RHI exposure may be associated with neuroimaging findings. However, given the methodological constraints related to relatively small sample sizes and the heterogeneity in injury types/exposure and imaging techniques used, conclusions drawn from this review are limited. Well-designed longitudinal studies with multimodal imaging and in-depth health and demographic information will be required to better understand the potential for having positive neuroimaging findings following remote mTBI/RHI.

Sign in / Sign up

Export Citation Format

Share Document