Behavioral and Neuroimaging Changes After Cognitive Rehab in Traumatic Brain Injuries (TBI) and Mild Cognitive Impairment (MCI)

Study Overview
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Brief Summary
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Memory deficits are common after traumatic brain injuries (TBI) and are characteristic of various forms of dementia, such as Alzheimer's disease and its common precursor mild cognitive impairment (MCI). This project intends to assess the efficacy of cognitive rehabilitation in these patient populations. We will also use neuroimaging (functional magnetic resonance imaging - fMRI) to assess changes in brain activity that occur following cognitive rehabilitation.

Official Title
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Behavioral and Neuroimaging Changes After Cognitive Rehab in TBI and MCI

Conditions
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Mild Cognitive Impairment, Alzheimer's Disease, Traumatic Brain Injury

Intervention / Treatment
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* Behavioral: Mnemonic strategy training (MST)
* Behavioral: Repeated exposure (XP)
* Behavioral: Subtracting Cues training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: General inclusion criteria (all patients): A minimum of 12 years of education or attainment of a Graduation Equivalency Diploma; All medications stable for approximately 3 months; No history of severe mental illness; No current untreated alcohol or substance abuse/dependence; English as native and preferred language; MRI-compatible if taking part in fMRI studies 7) Able to give informed consent. MCI Inclusion Criteria: Diagnosis of amnestic MCI based on criteria set forth by Petersen (2004). Additionally, other potential causes of cognitive deficit ruled out by the referring physician; 55 years of age or older. TBI Inclusion criteria: History of a mild to moderate TBI; No history of other neurological disease or injury; A minimum of 6 months and maximum of 5 years post-onset of TBI; 18 - 45 years old. Exclusion Criteria: History of neurological disease or injury (other than TBI) History of severe mental illness Current untreated alcohol or substance abuse Other conditions may exclude; please discuss with contact

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 88 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: MST healthy older adults Stage 1<br>Mnemonic strategy training | Behavioral: Mnemonic strategy training (MST)<br> <br> |
| Active Comparator: MST MCI Stage 1<br>Exposure training | Behavioral: Mnemonic strategy training (MST)<br> <br> |
| Active Comparator: XP healthy older adults Stage 1<br>XP healthy older adults Stage 1 | Behavioral: Repeated exposure (XP)<br> <br> |
| Active Comparator: XP MCI Stage 1<br>XP MCI Stage 1 | Behavioral: Repeated exposure (XP)<br> <br> |
| Active Comparator: MST healthy older adults Stage 2<br>MST healthy older adults Stage 2 | Behavioral: Mnemonic strategy training (MST)<br> <br> |
| Active Comparator: SCT healthy older adults Stage 2<br>SCT healthy older adults Stage 2 | Behavioral: Subtracting Cues training<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Memory Test Accuracy on Trained Stimuli | Accuracy (Percent correct) for trained stimuli. Stage 1: Object location association test Stage 2: Face name association test | Pre-training, post-training, 1 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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veterans, cognitive rehabilitation, explicit memory training, mild cognitive impairment, Alzheimer's disease, traumatic brain injury