Strategy-Based Training Leads to Gains for Brain Injury Patients

Strategy-based cognitive training may help reduce symptoms of depression and post-traumatic stress disorder, and improve neural health for traumatic brain injury patients, according to a new study from the Center for BrainHealth at UT Dallas. 

In the study, published recently in Neuropsychological Rehabilitation, participants’ cognitive skills and psychological health improved after the training. 

“Veterans and others who have sustained traumatic brain injuries often experience persistent cognitive and psychological difficulties, such as depression and/or post-traumatic stress disorder, which hinder day-to-day life activities,” said Dr. Sandra Bond Chapman, founder and chief director of the Center for BrainHealth and Dee Wyly Distinguished University Chair in the School of Behavioral and Brain Sciences. 

“This study shows that strategy-based cognitive training focusing on abstract and innovative thinking not only improves cognitive areas critical to everyday life success, but also improves brain blood flow to key regions of the brain and lessens depressive and stress-related symptoms.” 

The study featured 60 participants between 19 and 65 years old who had sustained at least one traumatic brain injury. More than two-thirds of them had sustained the injury more than 10 years ago. 

The participants received either a strategy-based brain training program focused on complex abstraction and innovation or an educational, information-based program about how the brain works. Both programs included 18 hours of training that was completed in 12 group sessions over eight weeks. All participants underwent extensive cognitive tests and MRIs. The researchers also measured symptoms of depression and post-traumatic stress disorder. 

For the strategy-based cognitive training group, complex abstraction scores improved more than 20 percent and memory scores more than 30 percent. Also, symptoms of depression fell 60 percent, and symptoms of post-traumatic stress disorder declined almost 40 percent. Blood flow to regions of the brain, including the frontal lobe, anterior cingulate and precuneus, also increased significantly. 

“Previously, reduction in precuneus blood flow has been linked to severity of traumatic brain injury and symptoms of PTSD,” said Dr. Daniel Krawczyk, associate professor of cognitive neuroscience and cognitive psychology at the Center for BrainHealth and principal investigator on the study. 

“Our results show that following the strategy-based training, blood flow increased more than 25 percent to this region, implying the brain is undergoing changes suggestive of improved neural health,” said Krawczyk, Debbie and Jim Francis Chair. 

He said enhanced neural health of the frontal region has been linked to increased abstract thinking, the anterior cingulate to superior cognitive performance, and the precuneus to emotional regulation of stress and the severity of brain injury symptoms. 

Improved abstract thinking and executive functioning appear to result in better moods and fewer stress symptoms for individuals, researchers said. 

For participants, the benefits of the training continued months after it ended, and gains were seen long after the brain injury occurred.

“The benefits of the strategy-based training were experienced months and years after injury suggesting that brain injuries should be treated more like a chronic health condition rather than a single short-term event,” said Chapman, principal investigator on the study.

The study was funded by the U.S. Department of Defense Congressionally Directed Medical Research Programs. Additional supporters included the Lyda Hill Foundation, the Meadows Foundation and the Dee Wyly Endowed Chair fund.