Retraining Neural Pathways to Improve Cognitive Skills after a Mild Traumatic Brain Injury (mTBI)

NIH RePORTER · NIH · R43 · $55,000 · view on reporter.nih.gov ↗

Abstract

This study seeks to address the challenge of how to deliver targeted interventions that address the individualized cognitive needs of mild traumatic brain injury (mTBI) patients. The overall objective of our predicate SBIR Phase I grant is to determine the feasibility of a timing intervention (PATH neurotraining) to significantly improve visual working memory, processing speed (primary outcomes) and auditory working memory, selective attention, cognitive flexibility, sustained attention, reading speed, and reading proficiency (secondary outcomes) in mTBI patients more than after either Sham or conventional N-Back Working Memory (WM) training (Aim 1). The present work is a critical step towards establishing feasibility of PATH training and determining early stage data demonstrating efficacy and understanding individual differences regarding which participants with mTBI may be the best targets for these types of timing interventions. Currently, there are no proven solutions to remediate cognitive deficits prevalent in those with a mild TBI. We seek to remedy this in the current study by conducting research to better understand perceptual and cognitive etiologies of mTBI and how these may be differentially treated by cognitive training approaches that specifically target different core components of cognitive control. We achieve our objectives by: 1) administering neuropsychological tests of cognitive skills before and after 30 minutes of intervention training three times a week for 12 weeks, and 2) Use Magnetoencephalography (MEG) brain imaging to test whether dorsal stream, attention, and memory networks improve in function significantly more following PATH neurotraining than following N-Back WM training (Exploratory Aim 2), and 3) Examine moderators that may determine training outcome (Aim 3). We will determine if individual differences at initial assessment predict improvements following training for different subpopulations: 1) Veterans vs. civilians, 2) different age groups, and 3) different loci and extent of the mTBI deficit. We will determine whether timing-based deficits predict cognitive skill deficits, that are moderated by individual factors. Studies with a MEG biomarker component, a neural correlate, will be used to determine the pre-post timing and functional capabilities of different cortical areas in the visual, attention and executive control pathways, in conjunction with behavioral pre-post standardized tests of cognitive abilities. This exploratory aim will be used to determine whether different treatments should be explored during Phase II for different types of mTBI and different ages. PATH neurotraining is designed from the ground up to incorporate theory driven, empirically supported, approaches to vision training into an entertaining video game. The challenge is to have PATH neurotraining be distributed by centers aimed at cognitive remediation for mTBI patients, such as neurologists, rehab centers, and learning centers, whi...

Key facts

NIH application ID
10985529
Project number
3R43NS132718-01S1
Recipient
PERCEPTION DYNAMICS INSTITUTE
Principal Investigator
TERI A LAWTON
Activity code
R43
Funding institute
NIH
Fiscal year
2024
Award amount
$55,000
Award type
3
Project period
2024-03-15 → 2024-04-23