Bridging the gap between clinical neuroscience and cognitive rehabilitation: The role of cognitive training, models of neuroplasticity and advanced neuroimaging in future brain injury rehabilitation

Abstract

BACKGROUND: Magnetic resonance imaging (MRI) has brought about advances in the fields of brain plasticity and lifespan brain change, that might be of special interest for cognitive rehabilitation research and, eventually, in clinical practice. Parallel, intensive cognitive training studies show promising results for the prospect of retraining some of the impaired functioning following acquired brain injury. OBJECTIVES: However, cognitive training research is largely performed without concurrent assessments of brain structural change and reorganization, which could have addressed possible mechanisms of training-related neuroplasticity. METHODS: Criticism of cognitive training studies is often focused on lack of ecologically valid, daily-living assessments of treatment effect, and on whether the applied cognitive measures overlap too much with the training exercises. Yet, the present paper takes another point of view, where the relevance of recent MRI research of brain plasticity to the field of cognitive rehabilitation is examined. RESULTS: Arguably, treatment ought to be measured at the same level of the International Classification of Functioning, Disability and Health model, as it is targeting. In the case of cognitive training that will be the "body structure" and "body function" levels. CONCLUSIONS: MRI has shown promise to detect macro-and microstructural activity-related changes in the brain following intensive training.

Effectiveness of a Computer-Based Training Program of Attention and Memory in Patients with Acquired Brain Damage

“…This can, by itself, improve attention and focus at a multisensory level (i.e., images combined with sounds). Computer systems also allow better control and correction of failures by a constant feed-back to the patient as our results indicate [ 11 , 25 , 32 , 33 ]. Those studies have shown that memory functions benefit after specific training to develop mnemonic abilities.…”

“…Another approach to cognitive remediation aims to restore impaired functions using repetitive exercises or massed practice of specific tasks [ 16 , 32 ]. The repetitive presentation of stimuli and the performance of a response can induce neural plasticity processes that sustain the observed improvements; for example, MRI is able to detect macro-and microstructural activity-related changes in the brain following intensive training [ 33 ].…”

Computer-Based Cognitive Training for Executive Functions after Stroke: A Systematic Review

“…Nordvik et al ( 2014 ) emphasized that most computer-based training studies do not investigate the effects on a neural level. In their overview, they summarize evidence for both gray and white matter changes after training certain skills in the healthy population (Nordvik et al, 2014 ). Within the stroke population, imaging is rarely used as an outcome measure.…”

Rehabilitation of Communicative Abilities in Patients with a History of TBI: Behavioral Improvements and Cerebral Changes in Resting-State Activity

“…Behavioral experience and brain injury interact; therefore it is reasonable that, after brain damage, targeted cognitive exercises are able to reshape the structure and function of uninjured areas of the brain, promoting recovery (for example, see Chen et al, 2010 ; Berlucchi, 2011 ). Neuroimaging methods allow the brain structures and functioning to be investigated; advanced techniques have shown promise in detecting macro- and microstructural activity-related changes in the brain (for a review, see Nordvik et al, 2014 ). Of the various functional imaging techniques, functional magnetic resonance imaging (fMRI) provides rehabilitation researchers with a non-invasive and reliable method for monitoring possible changes following therapeutic interventions.…”