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Improved Mild Closed Head Traumatic Brain Injury Outcomes With a Brain-Computer Interface Amplified Cognitive Remediation Training

This study is a retrospective chart review of 200 clients who participated in a non-verbal restorative cognitive remediation training (rCRT) program between 2012 and 2020. Each client participated in the program for about 16 weeks, and the study as a whole occurred over a five-year period. The progr...

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Autores principales: Cripe, Curtis T, Cooper, Rebecca, Mikulecky, Peter, Huang, Jason H, Hack, Dallas C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121126/
https://www.ncbi.nlm.nih.gov/pubmed/34007777
http://dx.doi.org/10.7759/cureus.14996
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author Cripe, Curtis T
Cooper, Rebecca
Mikulecky, Peter
Huang, Jason H
Hack, Dallas C
author_facet Cripe, Curtis T
Cooper, Rebecca
Mikulecky, Peter
Huang, Jason H
Hack, Dallas C
author_sort Cripe, Curtis T
collection PubMed
description This study is a retrospective chart review of 200 clients who participated in a non-verbal restorative cognitive remediation training (rCRT) program between 2012 and 2020. Each client participated in the program for about 16 weeks, and the study as a whole occurred over a five-year period. The program was applied to effect proper neural functional remodeling needed to support resilient, flexible, and adaptable behaviors after encountering a mild closed head traumatic brain injury (mTBI). The rCRT program focused on improving functional performance in executive cognitive control networks as defined by fMRI studies. All rCRT activities were delivered in a semi-game-like manner, incorporating a brain-computer interface (BCI) that provided in-the-moment neural network performance integrity metrics (nPIMs) used to adjust the level of play required to properly engage long-term potentiation (LTP) and long-term depression (LTD) network learning rules. This study reports on t-test and Reliable Change Index (RCI) changes found within individual cognitive abilities’ performance metrics derived from the Woodcock-Johnson Cognitive Abilities III Test. We compared pre- and post-scores from seven cognitive abilities considered dependent on executive cognitive control networks against seven non-executive control abilities. We observed significant improvements (p < 10(-4)) with large Cohen’s deffect sizes (0.78-1.20) across 13 of 14 cognitive ability domains with a medium effect size (0.49) on the remaining one. The mean percent change for the pooled trained domain was double that observed for the pooled untrained domain, at 17.2% versus 8.3%, respectively. To further adjust for practice effects, practice effect RCI values were computed and further supported the effectiveness of the rCRT (trained RCI 1.4-4.8; untrained RCI 0.­08-0.75).
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spelling pubmed-81211262021-05-17 Improved Mild Closed Head Traumatic Brain Injury Outcomes With a Brain-Computer Interface Amplified Cognitive Remediation Training Cripe, Curtis T Cooper, Rebecca Mikulecky, Peter Huang, Jason H Hack, Dallas C Cureus Neurology This study is a retrospective chart review of 200 clients who participated in a non-verbal restorative cognitive remediation training (rCRT) program between 2012 and 2020. Each client participated in the program for about 16 weeks, and the study as a whole occurred over a five-year period. The program was applied to effect proper neural functional remodeling needed to support resilient, flexible, and adaptable behaviors after encountering a mild closed head traumatic brain injury (mTBI). The rCRT program focused on improving functional performance in executive cognitive control networks as defined by fMRI studies. All rCRT activities were delivered in a semi-game-like manner, incorporating a brain-computer interface (BCI) that provided in-the-moment neural network performance integrity metrics (nPIMs) used to adjust the level of play required to properly engage long-term potentiation (LTP) and long-term depression (LTD) network learning rules. This study reports on t-test and Reliable Change Index (RCI) changes found within individual cognitive abilities’ performance metrics derived from the Woodcock-Johnson Cognitive Abilities III Test. We compared pre- and post-scores from seven cognitive abilities considered dependent on executive cognitive control networks against seven non-executive control abilities. We observed significant improvements (p < 10(-4)) with large Cohen’s deffect sizes (0.78-1.20) across 13 of 14 cognitive ability domains with a medium effect size (0.49) on the remaining one. The mean percent change for the pooled trained domain was double that observed for the pooled untrained domain, at 17.2% versus 8.3%, respectively. To further adjust for practice effects, practice effect RCI values were computed and further supported the effectiveness of the rCRT (trained RCI 1.4-4.8; untrained RCI 0.­08-0.75). Cureus 2021-05-12 /pmc/articles/PMC8121126/ /pubmed/34007777 http://dx.doi.org/10.7759/cureus.14996 Text en Copyright © 2021, Cripe et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Neurology
Cripe, Curtis T
Cooper, Rebecca
Mikulecky, Peter
Huang, Jason H
Hack, Dallas C
Improved Mild Closed Head Traumatic Brain Injury Outcomes With a Brain-Computer Interface Amplified Cognitive Remediation Training
title Improved Mild Closed Head Traumatic Brain Injury Outcomes With a Brain-Computer Interface Amplified Cognitive Remediation Training
title_full Improved Mild Closed Head Traumatic Brain Injury Outcomes With a Brain-Computer Interface Amplified Cognitive Remediation Training
title_fullStr Improved Mild Closed Head Traumatic Brain Injury Outcomes With a Brain-Computer Interface Amplified Cognitive Remediation Training
title_full_unstemmed Improved Mild Closed Head Traumatic Brain Injury Outcomes With a Brain-Computer Interface Amplified Cognitive Remediation Training
title_short Improved Mild Closed Head Traumatic Brain Injury Outcomes With a Brain-Computer Interface Amplified Cognitive Remediation Training
title_sort improved mild closed head traumatic brain injury outcomes with a brain-computer interface amplified cognitive remediation training
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121126/
https://www.ncbi.nlm.nih.gov/pubmed/34007777
http://dx.doi.org/10.7759/cureus.14996
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