Sleep and Word Learning Over Time in Adults with Moderate-Severe Traumatic Brain Injury

项目摘要 单词学习严重依赖于记忆系统和过程，而这些系统和过程在创伤性大脑中通常会受损 损伤（TBI）（例如，声明性记忆系统）。学习新单词和概念的能力对一个 一个人从治疗中受益或从事学术，职业和人际交往领域的潜力。 然而，TBI中单词学习缺陷的性质和严重程度尚不清楚。检查单词学习， 考虑到认知神经科学文献的进展，TBI后的时间特别关键， 健康人的记忆和学习能力。尽管大约一半的TBI患者报告睡眠不足， 虽然睡眠障碍的影响，但TBI后睡眠在学习中的作用尚未得到测试。这项研究将是第一个 研究TBI后随着时间的推移单词学习，并将在研究睡眠如何影响 受伤后的学习我们的方法是新颖的领域和桥梁理论的心理语言学，认知 记忆的神经科学和创伤性脑损伤的康复。我们将联合收割机完善的单词学习协议与 将腕动记录仪作为睡眠的客观测量的新用途。处于慢性阶段的中度- 严重TBI和人口统计学匹配的未受伤健康对照（NC）同龄人将在一组 新的单词，然后立即评估他们对这些单词的编码。接下来，他们将参加 持续评估他们在固定的时间间隔内巩固的新单词， 包括睡眠。在目标1中，我们将通过对比 组词学习表现在一个即时的后测试。在目标2中，我们将确定TBI患者是否 通过比较有和没有睡眠的测试后的表现，获得了与NC同龄人相似的睡眠学习益处。 睡眠的过渡期。在探索性目标3中，我们将研究睡眠之间的关系， 随着时间的推移，通过活动记录仪，以及短期（测试后24小时）和长期（测试后1周）的单词学习。 探索睡眠作为TBI后学习中介的作用将提高对因果关系的基础知识。 TBI，睡眠和单词学习之间的关系。这些发现将推动理论和临床 关于TBI的睡眠，记忆和学习的知识，将直接有助于我们的长期目标， 改进学习缺陷的临床管理，以改善损伤后的功能结果。因为 记忆和学习对于个体从干预中获益的能力至关重要， 在支持学习方面的作用可能是未来直接睡眠干预和靶向治疗试验的基础 改进跨领域学习的时间表。该项目代表了TBI研究的一个新方向， 为PI提供了一个独特的培训机会，是研究计划的第一步 专注于改善TBI后记忆和学习的基础和临床知识， 改善治疗效果，重返社区和独立。

PROJECT SUMMARY Word learning relies heavily on memory systems and processes that are routinely impaired in traumatic brain injury (TBI) (e.g., the declarative memory system). The ability to learn new words and concepts is critical to a person’s potential to benefit from therapy or engage in academic, vocational, and interpersonal spheres. However, the nature and severity of word learning deficits in TBI are unknown. Examining word learning over time following TBI is particularly critical given advances in the cognitive neuroscience literature linking sleep to memory and learning in healthy individuals. Although approximately half of individuals with TBI report sleep disturbance, the role of sleep in learning following TBI has not been tested. The proposed study will be the first investigation of word learning over time after TBI and will break new ground in examining how sleep affects learning after injury. Our approach is novel to the field and bridges theories of psycholinguistics, cognitive neuroscience of memory, and rehabilitation in TBI. We combine well-established word learning protocols with the novel use of actigraphy as an objective measure of sleep. Individuals in the chronic phase of moderate- severe TBI and demographically-matched non-injured healthy comparison (NC) peers will train on a group of novel words, then be assessed immediately on their encoding of those words. Next, they will participate in ongoing assessment of their consolidation of the novel words over regular time intervals that do or do not involve sleep. In Aim 1, we will test the hypothesis that word learning is impaired following TBI by contrasting group word learning performance at an immediate post-test. In Aim 2, we will determine if individuals with TBI get a similar sleep-learning benefit to NC peers by comparing performance at post-tests with and without an interim period of sleep. In exploratory Aim 3, we will examine the relationship between sleep, as measured over time via actigraphy, and word learning in the short (24 hour post-test) and long (1 week post-test) term. Exploring sleep’s role as a mediator of learning after TBI will improve basic knowledge of the causal relationships between TBI, sleep, and word learning. These findings will advance theoretical and clinical knowledge about sleep, memory, and learning in TBI and will directly contribute to our long-term goal of refining clinical management of learning deficits for improved functional outcomes after injury. Because memory and learning are critical to an individual’s ability to benefit from intervention, understanding sleep’s role in supporting learning could underlie future trials of both direct sleep interventions and targeted therapy schedules for improved learning across domains. This project represents a novel direction in TBI research, presents a unique training opportunity for the PI, and is the first step in a programmatic line of research focused on improving basic and clinical knowledge of memory and learning after TBI, with direct implications for improved therapy outcomes, community reintegration, and independence.