Computerized Attention Training for Individuals With Acquired Brain Injury
Condition: Acquired Brain Injury; Stroke; Hemispatial Neglect
MeSH terms: Brain Injuries; Perceptual Disorders; Wounds and Injuries
Study type: Interventional
Phase: Phase 1

Summary: 
      Problems with attention are a common and debilitating consequence of brain injury. Studies
      show that poor attention is the number one predictor of poor cognitive functioning one year
      post-injury. This is due to the fact that attention is a necessary component of more complex
      cognitive functions such as learning & memory, multi-tasking and problem solving. In many
      cases, individuals may exhibit problems with spatial attention known as 'hemi-spatial neglect
      syndrome' or simply 'neglect'. Many studies now show that the processing machinery of the
      brain is plastic and remodeled throughout life by learning and experience, enabling the
      strengthening of cognitive skills or abilities. The investigators own research has shown that
      brief, daily computerized cognitive training that is sufficiently challenging, goal-directed
      and adaptive enables intact brain structures to restore balance in attention and compensate
      for disruptions in cognitive functioning.
    

Detailed description: 
      Participants will first engage in an assessment process to determine current level of
      cognitive function. This process consists of paper-pencil surveys and computerized tests.
      Following the assessment process, participants will engage in Internet browser-delivered
      training sessions conducted on any internet-accessible computer. These trainings can be done
      up to 7 times a week (once a day) or at participant's convenience (the investigators
      recommend 4-5 times a week). Following the completion of training, participant's cognitive
      function will be re-assessed. Participation is voluntary and participants may withdraw from
      the study at any time.
    

Intervention name(s): Tonic and Phasic Attention Training; Active Comparator
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The Tonic and Phasic Alertness treatment task (TAPAT) consist of two consecutive rounds of a 12-minute continuous performance task in which continually varying, rich visual (e.g., scenes, objects, faces) or auditory stimuli (tones or complex sounds) are briefly displayed and participants are required to respond via a button press when they see a non-target item (90% of trials) or withhold button-press responding when the item is a pre-determined target item (10% of trials). Presentation of the target item is non-predictive and infrequent, disallowing the development of an executive strategy. Participants simply sustain attention to the task over a prolonged period of time (tonic attention), ignoring distractions, and inhibiting the pre-potent motor response when they see a target item (phasic attention).
Following the 24 minutes of TAPAT treatment participants will undergo one additional computer-based cognitive exercise, Multiple Object Tracking (MOT), for an additional 12 minutes.; Computer games chosen from a list of progressive visual/audiovisual games from the top-100 game list: sporcle.com. Training duration will be similar to that of experimental training.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Care Provider)