Neurocognitive outcomes following reasoning training in adults with mild TBI [Abstract]
Objective: The current study compared cognitive and functional benefits of two programs in adults with mTBI (GOS-e-7, BDI < 20). One training program, SMART, focused on complex reasoning using strategies of strategic attention, integration, and innovation. The second program (Brain Health Workshop, BHW) focused on understanding brain health through education of brain anatomy and effects of lifestyle behavior on brain health. Both group-programs were comparable in training hours, engagement in group discussions, and assignments. Benefits of the programs were compared pre- vs. post-training on complex reasoning, executive function, memory, and daily life skills.
Participants and Methods: The current sample is a subset of a larger DoD funded randomized control trial. Fourteen mTBI participants (3 veterans and 11 civilians) in chronic stages of recovery (> 1yr post-TBI) between 19-60yrs (M=34.07, SD=11.87) received one of the training programs. Out of the 14, 7 received SMART and 7 participated in BHW. Both groups were comparable (p>0.1) on participant characteristics of current age, IQ, chronicity, and SES.
Results: Results showed significant (p<.05) group X time interaction gains in the SMART group on switching and mental flexibility. The BHW group showed significant gains only in processing speed. Group x time analyses also found positive trends (p< 0.1) in the SMART group as compared to BHW on complex reasoning, inhibition, memory, and daily function. Ongoing imaging analyses suggest significant increases resting state cerebral blood flow in SMART participants who were responders as compared to those who were not at an individual level of comparison.
Conclusions: Current findings provide preliminary evidence that adults with mTBI could benefit from complex reasoning training that enhances cognitive performance and functional abilities. Furthermore, the findings highlight the need for higher-order cognitive training even in chronic stages of recovery for the growing number of mild TBIs.