Cognitive Recovery after Traumatic Brain Injury

描述（由申请人提供）：创伤性脑损伤（TBI）是一种公共卫生关注的疾病，不仅对个人，而且对他们的家庭，公共卫生系统和经济产生影响。大多数TBI影响到处于职业生产力黄金时期的人。尽管在认知康复领域进行了数十年的工作，但最近的一份证据报告总结了TBI后认知补救的有效性研究，结果主要是负面的。这部分是因为目前还没有经验支持的理论，从TBI的认知恢复，以指导干预策略。这项研究将提供更好的科学证据，以指导认知补救更充分地表征TBI患者的潜在早期学习机制，并通过前瞻性地评估自动和控制的认知过程的恢复轨迹。TBI患者将完成旨在评估视觉搜索，语义启动和记忆的自动和更多控制组件的实验任务。这些任务将在TBI患者从创伤后遗忘症中出现后进行，然后以2个月、6个月和12个月的间隔再次进行。对照组参与者将在基线测试后以相似的时间间隔完成任务。基于感知的内隐学习能力和基于记忆的技能学习能力也将在受伤后进行急性评估。如果自动化过程的功能恢复发生在恢复的早期和控制过程之前，那么利用剩余的自动化技能或利用可以通过实践自动化的过程的训练技术可能对早期干预至关重要，促进恢复并改善最终的认知结果。此外，了解自动化过程的恢复轨迹有助于改进预测康复收益的模型，并有助于康复规划和资源分配，因为自动化过程通常可以作为更受控过程的“数据库”。

DESCRIPTION (provided by applicant): Traumatic brain injury (TBI) is a disorder of public health concern that has ramifications not only for the individual, but also for their family, the public health system, and the economy. The majority of TBIs affect people in the prime of their vocational productivity. Despite decades of work in the area of cognitive rehabilitation, a recent evidence report summarizing research on the efficacy of cognitive remediation after TBI revealed predominately negative results. This is partly because there is currently no empirically supported theory about cognitive recovery from TBI to guide intervention strategies. This study will provide better scientific evidence to guide cognitive remediation by more fully characterizing the potential early learning mechanisms of TBI patients, and by prospectively evaluating the recovery trajectories of both automatic and controlled cognitive processes. TBI patients will complete experimental tasks designed to assess automatic and more controlled components of visual search, semantic priming, and memory. These task will be administered following the TBI patients emergence from post-traumatic amnesia, and then again at 2-, 6-, and 12-month intervals. Control participants will complete the tasks at similar intervals following baseline testing. Perceptually-based implicit learning abilities and memory-based skill learning abilities will also be evaluated acutely following injury. If restitution of function of automatic processes occurs early in recovery and before controlled processes, then training techniques that tap into residual automatic skills or capitalize on processes that can be made automatic through practice could prove vital for early interventions, facilitating recovery and improving ultimate cognitive outcome. Furthermore, an understanding of the recovery trajectories of automatic processes could help refine models for predicting rehabilitative gains and aid in rehabilitative planning and resource allocation as automatic processes often serve as a "data base" for more controlled processes.