Neuroplastic Changes Induced by Cognitive Rehabilitation in Traumatic Brain Injury: A Review

Galetto, Valentina; Sacco, Katiuscia

doi:10.1177/1545968317723748

Cited by 74 publications

(49 citation statements)

References 94 publications

(163 reference statements)

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“…In particular, cognitive dysfunction may interfere with work, relationships, leisure, and daily activities, increasing the burden of the disease [6, 7]. Growing evidence demonstrates that cognitive rehabilitation (CR), through previously learned skills or new compensatory strategies, is effective in patients with TBI as it enhances cognitive and psychosocial interaction [8–12]. In recent years, technological innovations have allowed the development of new rehabilitative strategies, such as PC-based rehabilitation or Virtual Reality Training (VRT), which have proven effective in the CR of neurological patients [13–16].…”

Section: Introductionmentioning

confidence: 99%

Improving Cognitive Function after Traumatic Brain Injury: A Clinical Trial on the Potential Use of the Semi-Immersive Virtual Reality

Luca

Maggio

Maresca

et al. 2019

Behavioural Neurology

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Traumatic brain injury (TBI) is the most common cause of long-term disability and death among young adults, and it represents an enormous socioeconomic and healthcare burden. Our purpose is to evaluate the effects of a virtual reality training with BTs-Nirvana (BTs-N) on the recovery of cognitive functions in TBI subjects, using the interactive semi-immersive program. One hundred patients with TBI were enrolled in this study and randomized into either the Traditional Cognitive Rehabilitation Group (TCRG: n=50) or the Virtual Reality Training Group (VRTG: n=50). The VRTG underwent a VRT with BTs-N, whereas the TCRG received a standard cognitive treatment. Each treatment session lasted 60 minutes and was repeated three times a week for 8 weeks. All of the patients were evaluated by a specific psychometric battery before (T0) and immediately (T1) after the end of the training. VRTG and TCRG had a significant improvement in cognitive functioning and in mood, but only VRTG presented with a significant increase in cognitive flexibility and shifting skills and in selective attention. In conclusion, our results suggest that VR may be a useful and effective approach for the rehabilitation of patients with TBI, leading to better cognitive and behavioral outcomes.

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Section: Introductionmentioning

confidence: 99%

Improving Cognitive Function after Traumatic Brain Injury: A Clinical Trial on the Potential Use of the Semi-Immersive Virtual Reality

Luca

Maggio

Maresca

et al. 2019

Behavioural Neurology

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“…Although motor and cognitive neurorehabilitation after acquired brain injury is strongly based on intensive training and task-specific learning for promoting neural reorganization and recovery ( Alia et al, 2017 ; Galetto and Sacco, 2017 ), conventional methodologies still strive to accomplish this goal ( Levin et al, 2014 ). Paper-and-pencil tasks are widely used in cognitive rehabilitation, and are assumed to be reliable and with adequate construct validity in the assessment and rehabilitation of cognitive functions after brain injury ( Wilson, 1993 ).…”

Section: Introductionmentioning

confidence: 99%

Combined Cognitive-Motor Rehabilitation in Virtual Reality Improves Motor Outcomes in Chronic Stroke – A Pilot Study

et al. 2018

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Stroke is one of the most common causes of acquired disability, leaving numerous adults with cognitive and motor impairments, and affecting patients’ capability to live independently. Virtual Reality (VR) based methods for stroke rehabilitation have mainly focused on motor rehabilitation but there is increasing interest toward the integration of cognitive training for providing more effective solutions. Here we investigate the feasibility for stroke recovery of a virtual cognitive-motor task, the Reh@Task, which combines adapted arm reaching, and attention and memory training. 24 participants in the chronic stage of stroke, with cognitive and motor deficits, were allocated to one of two groups (VR, Control). Both groups were enrolled in conventional occupational therapy, which mostly involves motor training. Additionally, the VR group underwent training with the Reh@Task and the control group performed time-matched conventional occupational therapy. Motor and cognitive competences were assessed at baseline, end of treatment (1 month) and at a 1-month follow-up through the Montreal Cognitive Assessment, Single Letter Cancelation, Digit Cancelation, Bells Test, Fugl-Meyer Assessment Test, Chedoke Arm and Hand Activity Inventory, Modified Ashworth Scale, and Barthel Index. Our results show that both groups improved in motor function over time, but the Reh@Task group displayed significantly higher between-group outcomes in the arm subpart of the Fugl-Meyer Assessment Test. Improvements in cognitive function were significant and similar in both groups. Overall, these results are supportive of the viability of VR tools that combine motor and cognitive training, such as the Reh@Task. Trial Registration: This trial was not registered because it is a small clinical study that addresses the feasibility of a prototype device.

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“…[13][14][15] Accordingly, the neurorehabilitation community seeks to identify training-induced neuroplasticity of the injured brain. 16,17 Previously, we reported the efficacy of cognitive training in TBI and its underlying neuroplasticity [18][19][20][21] as measured by changes in cortical thickness, cerebral blood flow, and resting-state functional connectivity.…”

Section: Introductionmentioning

confidence: 99%

Cognitive Training Reorganizes Network Modularity in Traumatic Brain Injury

Han

Chapman

Krawczyk

2019

Neurorehabil Neural Repair

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Background. Graph-theoretic approaches are increasingly popular for identifying the patterns of disrupted neural systems after traumatic brain injury (TBI). However, the patterns of neuroplasticity in brain organization after cognitive training in TBI are less well understood. Objective. We identified the patterns of training-induced neuroplasticity of the whole-brain network in TBI, using resting-state functional connectivity and graph theory. Methods. A total of 64 civilians and veterans with TBI were randomized into either a strategy-based cognitive training group (n = 33) or a knowledge-based training group (active control group; n = 31) for 8 weeks. The participants experienced mild to severe TBI without focal damage and persistent cognitive dysfunctions. A subset of participants complained of subclinical but residual psychiatric symptoms. We acquired their resting-state functional magnetic resonance imaging before training, immediately posttraining, and 3 months posttraining. From participants’ resting-state networks, we obtained the modularity, participation coefficient, within-module connectivity, global efficiency, and local efficiency over multiple network densities. We next performed longitudinal analyses on those measures corrected for multiple comparisons across network densities using false discovery rate (FDR). Results. Relative to the knowledge-based training group, the strategy-based cognitive training group had reduced modularity and increased participation coefficient, global efficiency, and local efficiency over time ( Pnodal < .05; qFDR < 0.05). Brain behavior analysis revealed that the participation coefficient and global efficiency within the strategy-based cognitive training group correlated with trail-making scores in the context of training ( Pnodal < .05; qFDR < 0.05). Conclusions. Cognitive training reorganized modular networks in TBI over the whole brain. Graph-theoretic approaches may be useful in identifying a potential brain-based marker of training efficacy in TBI.

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Neuroplastic Changes Induced by Cognitive Rehabilitation in Traumatic Brain Injury: A Review

Abstract: Outcomes showed that cerebral activation may be significantly modified by cognitive rehabilitation, in spite of the severity of the injury.

Cited by 74 publications

References 94 publications

Improving Cognitive Function after Traumatic Brain Injury: A Clinical Trial on the Potential Use of the Semi-Immersive Virtual Reality

Improving Cognitive Function after Traumatic Brain Injury: A Clinical Trial on the Potential Use of the Semi-Immersive Virtual Reality

Combined Cognitive-Motor Rehabilitation in Virtual Reality Improves Motor Outcomes in Chronic Stroke – A Pilot Study

Cognitive Training Reorganizes Network Modularity in Traumatic Brain Injury

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