Brain Markers of Improvements in Cognitive Functioning
Condition: TBI (Traumatic Brain Injury); Brain Injuries; Stress; Attention Deficit; Executive Dysfunction
MeSH terms: Brain Injuries; Brain Injuries, Traumatic; Wounds and Injuries
Study type: Interventional

Summary: 
      Some of the most common, persistent, and disabling consequences of traumatic brain injury
      affect an individual's ability to achieve personal goals. Interventions that strengthen
      abilities such as being able to concentrate, remember, stay calm and overcome challenges,
      could have far reaching benefits for Veterans. One challenge in rehabilitation is that
      response to training can be highly variable, and a better understanding of the neural bases
      for this variability could inform care. This pilot project will test the clinical behavioral
      effects of a cognitive skill training intervention and explore to what extent changes in
      markers of the brain's electrical activity (using the non-invasive technique of
      electroencephalograms, EEG) can explain differences in responses to skill training.
    

Detailed description: 
      Detailed Description: Traumatic brain injuries (TBI) can impair cognitive functioning long
      after the initial trauma. Some of the most common, persistent, and disabling consequences of
      traumatic brain injury are deficits in higher order cognitive functions that direct more
      basic processes based on an individual's goals. Symptoms such as distractibility and
      difficulty holding goal-relevant information in memory can affect achievement of personal and
      professional goals. These cognitive problems can be exacerbated by post-traumatic stress
      (PTS) symptoms, commonly observed in the Veteran population. Interventions that strengthen
      goal-directed regulation of cognitive-emotion states could have far reaching benefits for
      Veterans.

      One challenge in rehabilitation is that response to training can be highly variable, and a
      better understanding of the neural bases for this variability could inform patient care.
      Investigators have developed a system for training neurocognitive skills that can be used in
      rehabilitation neuroscience studies to elucidate the neural bases of improvements in
      cognitive functioning. The training system is designed to help patients improve goal-directed
      brain state regulation, and preliminary work has investigated brain network parameters that
      may predict response to training. Electroencephalography (EEG) potentially provides easily
      accessible markers for the neural bases of improvements with training.

      Objectives in this pilot study are to investigate the potential of EEG markers to: (1)
      explain differential responses to attention regulation training; and (2) predict responses to
      training.
    

Intervention name(s): State regulation skill training; Treatment-as-usual
Intervention type(s): Behavioral; Other
Intervention description(s): Participants complete seven supervised training sessions. Training sessions last 2 hours, and participants are requested to complete approximately 2.5 hours of additional skill practice over the course of each week outside of session (total ~4.5 hours per week).; Participants receive clinical care as usual over a matched time period.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: training in brain state regulation compared to treatment-as-usual
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: cognitive rehabilitation; EEG; TBI; brain networks; attention; memory; executive function