Retraining Neural Pathways to Improve Cognitive Skills after a Mild Traumatic Brain Injury (mTBI)

轻度创伤性脑损伤 (mTBI) 后重新训练神经通路以提高认知技能

• 批准号: 10671337
• 负责人: TERI A LAWTON
• 金额: $ 51.59万
• 依托单位: PERCEPTION DYNAMICS INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10671337
• 关键词: Acceleration; Address; Age; Area; Athletic Injuries; Attention; Auditory; Back; Behavioral; Biological Markers; Brain; Brain Concussion; Clinical Trials; Cognition Disorders; Cognitive; Cognitive deficits; Cognitive remediation; Coupled; Data; Deceleration; Diagnosis; Discrimination; Dorsal; Educational Intervention; Event; Exhibits; Goals; Head; Health; Impaired cognition; Impairment; Individual; Individual Differences; Intervention; Knowledge; Lateral; Life; Magnetoencephalography; Marketing; Memory; Motion; Movement; Nature; Neural Pathways; Neurons; Neuropsychological Tests; Outcome; Participant; Pathway interactions; Patients; Performance; Phase; Pilot Projects; Population; Post-Concussion Syndrome; Prefrontal Cortex; Process; Quality of life; Questionnaires; Reaction Time; Reading; Rehabilitation therapy; Research; Rest; Running; Sampling; Schools; Short-Term Memory; Speed; Standardization; Stream; TBI Patients; Testing; Training; Unconscious State; Veterans; Visual; Visual Cortex; Visual Motion; Work; age group; attentional control; automobile accident; cognitive ability; cognitive function; cognitive skill; cognitive testing; commercialization; design; disability; dosage; effective therapy; executive function; falls; flexibility; functional improvement; improved; mild traumatic brain injury; neural correlate; neurotransmission; novel; personalized medicine; phase 2 designs; phase II trial; primary outcome; processing speed; reading ability; remediation; research clinical testing; response; satisfaction; screening; secondary outcome; selective attention; sustained attention; therapeutic evaluation; treatment group; trial comparing; vehicular accident

Retraining Neural Pathways Improves Cognitive Skills After A Mild Traumatic Brain Injury This study seeks to address the challenge of how to deliver targeted interventions that address individualized cognitive needs of mild traumatic brain injury (mTBI) patients. mTBIs are prevalent, with over 2.5 million concussions occurring in the U.S. each year with only 1 in 6 of these concussions being diagnosed. mTBIs represent 80% of TBIs. The bulk of mTBIs result from motor vehicle accidents, falls, and situations involving sudden acceleration and/or deceleration of the head, such as sports injuries. A mTBI can result in substantial cognitive impairments, with an inability to return to work or school, and low levels of satisfaction with one’s quality of life. Currently, there are no proven solutions to remediate cognitive deficits prevalent in those with a mTBI. Visual timing deficits are persistent in individuals with a mild TBI (mTBI), and are thought to be due to processing deficits in the dorsal pathways, and attention and executive control networks. The premise of the current proposal is rehabilitative treatments for those with a mTBI fall short because these timing issues are not being addressed. To address these limitations, we developed a movement-discrimination intervention (PATH training) that is designed to stimulate dorsal motion pathways. PATH is hypothesized to improve the precision in timing of visual events, and in turn improve cognitive functions that rely upon visual timing, such as working memory span, a function that is commonly impaired in mTBI patients. This study will provide clinical testing of therapeutic training for the treatment of cognitive disorders caused by a mTBI. We will extend previous results from a pilot study of four mTBI subjects to a much larger sample of mTBI subjects. We will determine the feasibility of an intervention that remediates visual timing deficits to improve visual and cognitive deficits in mTBI more than a Sham or a conventional working memory training task. The proposed study tests the ability of PATH neurotraining to improve visual working memory, and processing speed (primary outcomes) and auditory working memory (WM), selective attention, cognitive flexibility, sustained attention, reading speed, and reading proficiency (secondary outcomes) in mTBI subjects rapidly and effectively. We predict that PATH training is more effective than either conventional WM training or Sham training. These predictions will be evaluated by both percentile scores on neuropsychological tests of cognitive function, scores on reading speed, reading proficiency, MoCA screening test, and questionnaires, and Magnetoencephalography (MEG) brain recordings for a subset of subjects in treatment groups, providing a biomarker, as is required for commercialization. MEG brain recordings will be used to determine whether PATH neurotraining improves the function of the visual motion, attention, and working memory networks more than found after N-Back WM training. MEG recordings will also be used to determine whether PATH neurotraining strengthens coupled: 1) theta/gamma activity, and 2) alpha/ gamma activity. There is a need to provide a proven solution for a mTBI by developing, and marketing a rapid and effective treatment shown in clinical trials to improve cognitive skills.

轻度创伤性脑损伤后，再培训神经通路可提高认知能力 这项研究旨在应对如何提供针对性的干预措施的挑战 轻度创伤性脑损伤（MTBI）患者的认知需求。 MTBI很普遍，超过250万 每年在美国发生脑震荡，其中六分之一被诊断出来。 mtbis 代表TBI的80％。 MTBI的大部分是由机动车事故，跌倒和涉及的情况导致的 头部突然加速和/或减速，例如运动损伤。 MTBI可以实质性 认知障碍，无法重返工作或学校，对自己的满意程度较低 生活质量。目前，尚无可靠的解决方案来补救认知能够定义患有 mtbi。视觉时机定义在有轻度TBI（MTBI）的个体中持续存在，被认为是由于 处理在背途径以及注意力和执行控制网络中定义。前提 当前的建议是MTBI跌倒的人的康复治疗方法，因为这些时机问题是 没有被解决。为了解决这些局限性，我们开发了一种运动歧视干预措施 （路径训练）旨在刺激背运动途径。假设路径以改善 视觉事件时机的精度，进而改善了依赖视觉时机的认知功能，例如 工作记忆跨度，MTBI患者通常受损的功能。这项研究将提供临床 测试治疗由MTBI引起的认知障碍的治疗。我们将扩展 对四名MTBI受试者的试点研究的先前结果是MTBI受试者样本。我们将 确定修复视觉时序定义以改善视觉和认知的干预措施的可行性 在MTBI中定义不仅仅是假手术或常规的工作记忆训练任务。提出的研究测试 路径神经疗法改善视觉工作记忆和处理速度的能力（主要结果） 和听觉工作记忆（WM），选择性关注，认知灵活性，持续关注，阅读速度， 以及MTBI受试者的阅读能力（次要结果）迅速有效。我们预测这条路 培训比常规的WM培训或假训练更有效。这些预测将是 通过两个百分位数评分在认知功能的神经心理测试中评估，阅读评分 速度，阅读能力，MOCA筛选测试和问卷以及磁脑电图（MEG） 治疗组中一部分受试者的脑记录，提供生物标志物，如 商业化。 MEG脑记录将用于确定路径神经膜是否改善 视觉运动，注意力和工作记忆网络的功能比N-BACK WM之后发现的要多 训练。 MEG记录也将用于确定路径神经训练强度是否耦合：1） theta/伽马活性和2）α/伽马活性。有必要为MTBI提供验证的解决方案 通过开发和营销临床试验中显示的快速有效治疗，以提高认知能力。