# Multi-level assessment and rehabilitation of combat mild traumatic brain injury

> **NIH VA I01** · VETERANS AFFAIRS MED CTR SAN FRANCISCO · 2022 · —

## Abstract

Combat-related mild traumatic brain injury (mTBI) and co-morbid conditions are prevalent in returning Veterans
with the reported rates ranging from 14- 22%. Chronic sequela of mTBI can be highly debilitating due to
deficits in the cognitive control processes, including attention, executive functions, and memory. In prior
studies, individuals with chronic acquired brain injury who participated in a cognitive training program, Goal-
Oriented Attentional Self-Regulation (GOALS), which targets executive control functions of applied
mindfulness-based attention regulation and goal management, improved cognitive performance in areas of:
complex attention/executive function and memory, complex functional task performance, and daily functioning.
Furthermore, functional MRI (fMRI) results after training indicated significantly enhanced modulation of neural
processing. Preliminary data from recently completed randomized-control GOALS study in 32 Veterans with
chronic TBI also show both short and longer term (up to 2 years) improvements in attention and executive
function, complex real-life tasks, and emotional regulation.
The primary objectives of this study are to investigate the potential short and longer term effects of GOALS
cognitive training program, and to use advanced MRI to investigate changes in brain structure and function in
the circuits that regulate attention, memory, executive function and emotion in Veterans with chronic mTBI.
We postulate that 1) GOALS training will improve neurocognitive function in attention and executive function
domains, complex functional task performance, and emotional regulation in Veterans with chronic mTBI; 2)
improved neurocognitive function will be correlated with macrostructural, microstructural and functional
changes in the corresponding brain networks on high field (3T) and ultra-high field (7T) structural MR imaging,
diffusion tensor imaging (DTI) and resting state fMRI performed pre- and post-training; 3) Changes in both
behavioral function and imaging measures will be maintained at 6 months post-training and be associated with
improvements in activities and participation.
AIM 1: To determine the short and long term effects of GOALS training on neuro-cognitive performance and
neural plasticity of attention and executive control networks in mTBI.
AIM 2: To determine the short and long term effects of GOALS training on complex functional task
performance and daily functioning, and on plasticity in pathways related to memory function, in mTBI.
AIM 3: To determine the short and long term effects of GOALS training on measures of emotional regulation,
and on plasticity of frontolimbic networks related to emotion processing, in mTBI
In a randomized, controlled interventional study design, 36 Veterans with a history of chronic (> 6 month) mTBI
and residual cognitive difficulties will be randomized to participate in 5 weeks of cognitive training (GOALS) or
a treatment as usual (TAU) comparison. At baseline, week 5 (p...

## Key facts

- **NIH application ID:** 10568984
- **Project number:** 5I01RX002300-06
- **Recipient organization:** VETERANS AFFAIRS MED CTR SAN FRANCISCO
- **Principal Investigator:** Pratik Mukherjee
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-02-01 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10568984

## Citation

> US National Institutes of Health, RePORTER application 10568984, Multi-level assessment and rehabilitation of combat mild traumatic brain injury (5I01RX002300-06). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10568984. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*