Executive Function Training Intervention for Chronic Traumatic Brain Injury
Condition: Traumatic Brain Injury
MeSH terms: Brain Injuries; Brain Injuries, Traumatic; Wounds and Injuries
Study type: Interventional

Summary: 
      Traumatic Brain Injury (TBI) is a prevalent disorder developed by military personnel. While
      some individuals recover function within months after injury, others continue to suffer from
      cognitive problems months to years later and may not become evident immediately, particularly
      for the recently transitioned veteran. Chronic TBI cases may include persistent difficulties
      in cognition that negatively impact employment and personal relationships.

      The investigators will test and evaluate software-based interventions aimed at improving
      cognition in veterans experiencing everyday life cognitive deficits due to TBI. The
      interventions will be administered on a computer using a tele-health approach. Two conditions
      will be compared, an active condition challenging memory, inhibitory control and planning,
      and a context-matched control condition that is lower on these challenge levels.
    

Detailed description: 
      The investigators will evaluate the improvement of chronic TBI symptoms after interventions.
      The investigators will evaluate the improvement of chronic mTBI symptoms using Magnetic
      Resonance Imaging (MRI)-based injury markers, cognitive functions, and real-world functioning
      questionnaires.

      The investigators will recruit military veterans with mild-to-moderate chronic TBI (at least
      3 months post injury). The investigators will gather neuropsychological, cognitive, and
      neuroimaging (functional MRI, resting-state functional MRI) measures. The efficacy of the
      active compared to control intervention will be evaluated in 100 chronic TBI veterans. All
      participants will be randomized to a group to complete four weeks of intervention over 20
      performance sessions. Over the course of training participants will face escalating
      challenges in each of these domains, thereby improving their overall skills. The software
      captures response times and accuracy of performance throughout each task. Evaluations of
      cognition (neuropsychological testing), brain (MRI), real life functional ability (survey
      data), and real life performance data (multiple errands tasks) will be gathered pre- and
      post-intervention to evaluate cognitive, brain-based, and real life functional improvements.
    

Intervention name(s): Expedition
Intervention type(s): Behavioral
Intervention description(s): On a laptop computer participants work on simulated daily life activities including packing for a trip, navigating a transit system, and learning at museum attractions. The intervention increases difficulty as participants accomplish goals. We are testing the effects of this performance challenge on executive function measures.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Two groups run in parallel (active and control)
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: chronic traumatic brain injury; cognition; executive function