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Restor Neurol Neurosci. 2019;37(1):71-86. doi: 10.3233/RNN-180856.

Dynamic cognitive remediation for a Traumatic Brain Injury (TBI) significantly improves attention, working memory, processing speed, and reading fluency.

Author information

1
Department of Cognitive Neuroscience, Perception Dynamics Institute, Encinitas, CA, USA.
2
Radiology and Research Services, VA San Diego Healthcare System, San Diego, CA, USA.
3
Department of Radiology, Radiology Imaging Laboratory, University of California at San Diego, San Diego, CA, USA.

Abstract

BACKGROUND:

In the U.S. 3.8 million people have a Traumatic Brain Injury (TBI) each year. Rapid brain training exercises to improve cognitive function after a mild TBI are needed.

OBJECTIVE:

This study determines whether cognitive remediation by discriminating the direction a test pattern moves relative to a stationary background (movement figure-ground discrimination) improves the vision and cognitive deficits that result from a TBI, providing a paradigm shift in treatment methods.

METHODS:

Movement-discrimination neurotraining was used to remediate low-level visual timing deficits in the dorsal stream to determine whether it improved high-level cognitive functions, such as processing speed, reading fluency, and the executive control functions of attention and working memory in four men with a TBI between the ages of 15-68. Standardized tests, as well as Magnetoencephalography (MEG) brain imaging, were administered at the beginning and end of 8-16 weeks of intervention training to evaluate improvements in cognitive skills.

RESULTS:

Movement-discrimination cognitive neurotraining remediated both low-level visual timing deficits and high-level cognitive functioning, including selective and sustained attention, reading fluency, processing speed, and working memory for all TBI patients we studied. MEG brain imaging, using the Fast-VESTAL procedure, showed that this movement-discrimination training improved time-locked activity in the dorsal stream, attention, and executive control networks.

CONCLUSIONS:

Remediating visual timing deficits in the dorsal stream revealed the causal role of visual movement discrimination training in improving high-level cognitive functions such as focusing and switching attention, working memory, processing speed, and reading. This study found that movement-discrimination training was very rapid and effective in remediating cognitive deficits, providing a new approach that is very beneficial for treating a mild TBI.

KEYWORDS:

MEG; Traumatic brain injuries; attention; brain exercise; cortical plasticity; dorsal stream; neurorehabilitation; perceptual learning; processing speed; reading; visual timing; working memory

PMID:
30741708
PMCID:
PMC6481540
DOI:
10.3233/RNN-180856
[Indexed for MEDLINE]
Free PMC Article

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