TY - JOUR
T1 - Reasoning training in veteran and civilian traumatic brain injury with persistent mild impairment
AU - Vas, Asha
AU - Chapman, Sandra
AU - Aslan, Sina
AU - Spence, Jeffrey
AU - Keebler, Molly
AU - Rodriguez-Larrain, Gisella
AU - Rodgers, Barry
AU - Jantz, Tiffani
AU - Martinez, David
AU - Rakic, Jelena
AU - Krawczyk, Daniel
N1 - Publisher Copyright:
© 2015 Taylor & Francis.
PY - 2016/7/3
Y1 - 2016/7/3
N2 - Traumatic brain injury (TBI) is a chronic health condition. The prevalence of TBI, combined with limited advances in protocols to mitigate persistent TBI-related impairments in higher order cognition, present a significant challenge. In this randomised study (n = 60), we compared the benefits of Strategic Memory Advanced Reasoning Training (SMART, n = 31), a strategy-based programme shown to improve cognitive control, versus an active learning programme called Brain Health Workshop (BHW, n = 29) in individuals with TBI with persistent mild functional deficits. Outcomes were measured on cognitive, psychological health, functional, and imaging measures. Repeated measures analyses of immediate post-training and 3-month post-training demonstrated gains on the cognitive control domain of gist reasoning (ability to abstract big ideas/goals from complex information/tasks) in the SMART group as compared to BHW. Gains following the SMART programme were also evident on improved executive function, memory, and daily function as well as reduced symptoms associated with depression and stress. The SMART group showed an increase in bilateral precuneus cerebral blood flow (CBF). Improvements in gist reasoning in the SMART group were also associated with an increase in CBF in the left inferior frontal region, the left insula and the bilateral anterior cingulate cortex. These results add to prior findings that the SMART programme provides an efficient set of strategies that have the potential to improve cognitive control performance and associated executive functions and daily function, to enhance psychological health, and facilitate positive neural plasticity in adults with persistent mild impairment after TBI.
AB - Traumatic brain injury (TBI) is a chronic health condition. The prevalence of TBI, combined with limited advances in protocols to mitigate persistent TBI-related impairments in higher order cognition, present a significant challenge. In this randomised study (n = 60), we compared the benefits of Strategic Memory Advanced Reasoning Training (SMART, n = 31), a strategy-based programme shown to improve cognitive control, versus an active learning programme called Brain Health Workshop (BHW, n = 29) in individuals with TBI with persistent mild functional deficits. Outcomes were measured on cognitive, psychological health, functional, and imaging measures. Repeated measures analyses of immediate post-training and 3-month post-training demonstrated gains on the cognitive control domain of gist reasoning (ability to abstract big ideas/goals from complex information/tasks) in the SMART group as compared to BHW. Gains following the SMART programme were also evident on improved executive function, memory, and daily function as well as reduced symptoms associated with depression and stress. The SMART group showed an increase in bilateral precuneus cerebral blood flow (CBF). Improvements in gist reasoning in the SMART group were also associated with an increase in CBF in the left inferior frontal region, the left insula and the bilateral anterior cingulate cortex. These results add to prior findings that the SMART programme provides an efficient set of strategies that have the potential to improve cognitive control performance and associated executive functions and daily function, to enhance psychological health, and facilitate positive neural plasticity in adults with persistent mild impairment after TBI.
KW - Brain plasticity and repair
KW - CBF
KW - Cognitive training
KW - Gist reasoning
KW - Mild-spectrum TBI in adults
KW - Veterans
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UR - http://www.scopus.com/inward/citedby.url?scp=84930145069&partnerID=8YFLogxK
U2 - 10.1080/09602011.2015.1044013
DO - 10.1080/09602011.2015.1044013
M3 - Article
C2 - 26018041
AN - SCOPUS:84930145069
SN - 0960-2011
VL - 26
SP - 502
EP - 531
JO - Neuropsychological Rehabilitation
JF - Neuropsychological Rehabilitation
IS - 4
ER -