PC-Based Cognitive Rehabilitation for Traumatic Brain Injury (TBI)

NCT ID: NCT00927576

Last Updated: 2015-07-31

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

265 participants

Study Classification

OBSERVATIONAL

Study Start Date

2009-07-31

Study Completion Date

2013-03-31

Brief Summary

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The investigators evaluated whether it was possible to improve the measurement of memory, attention, and executive function in patients who have suffered traumatic brain injury through the use of computer-based testing.

Note: the original design of the study was altered due to failure to recruit sufficient numbers of patients who were willing to undergo prolonged cognitive training.

Detailed Description

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Here we describe a series of computer-based tests that were used to evaluate memory, attention, and executive function in large groups of control subjects and in patients with chronic mild and moderate/severe TBI. This extensive battery of neuropsychological tests (NPTs) and subjective rating scale measures were obtained at study entry from the TBI cohort. NPT and rating scale data were compared to those obtained from control subjects to characterize the cognitive deficits following mild, moderate and severe TBI. .

Normative data were obtained by regressing the influences of age, education, and computer use on scores to create normed z-scores on different NPTs,. We hypothesized that patient with TBI would show deficits on tests of memory, attention, and executive function relative to their predicted z-scores (based on the aforementioned regression functions) and that deficits would be more pronounced in patients with severe TBI than in patients with mild TBI.

Conditions

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Traumatic Brain Injury

Study Design

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Observational Model Type

ECOLOGIC_OR_COMMUNITY

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Control subjects

Control subjects = 237. These subjects underwent extensive testing with computerized neuropsychological tests including digit span testing, spatial span testing, simple reaction time testing, choice reaction time testing, finger tapping, verbal fluency, design fluency, verbal list learning, questionnaire completion, and the trail making test.

Digit span testing

Intervention Type BEHAVIORAL

Testing of short-term verbal memory with digit span

Spatial span testing

Intervention Type BEHAVIORAL

Testing of short-term visuospatial memory with spatial span.

Finger tapping

Intervention Type BEHAVIORAL

Testing motor speed with a finger tapping test.

Simple reaction time

Intervention Type BEHAVIORAL

Testing the time to respond to the appearance of a visual stimulus.

Choice reaction time

Intervention Type BEHAVIORAL

Testing the time needed to discriminate and respond to different visual stimuli.

Verbal fluency

Intervention Type BEHAVIORAL

Evaluating how many words are produced in 90s.

Verbal list learning

Intervention Type BEHAVIORAL

Evaluating short-term memory, learning, and memory interference in the recall of 12-word lists, presented three times. Evaluating long-term memory and recognition after a 20 min interval.

Trail making test

Intervention Type BEHAVIORAL

Evaluating visuomotor speed and executive function in Trail Making Tests, A and B. In the first, subjects connect successive numbers with the mouse. In the second, they connect numbers and letters in alternation.

Design fluency

Intervention Type BEHAVIORAL

Subjects create the maximal number of 4-line patterns in 90 s.

Questionnaire completion

Intervention Type BEHAVIORAL

Question completion time is measured on each question of the Post-Traumatic Stress Disorder check list (PCL) and on the cognitive failures questionnaire.

TBI patients

TBI patients N = 28. These patients underwent extensive testing with computerized neuropsychological tests including digit span testing, spatial span testing, simple reaction time testing, choice reaction time testing, finger tapping, verbal fluency, design fluency, verbal list learning, questionnaire completion, and the trail making test.

Digit span testing

Intervention Type BEHAVIORAL

Testing of short-term verbal memory with digit span

Spatial span testing

Intervention Type BEHAVIORAL

Testing of short-term visuospatial memory with spatial span.

Finger tapping

Intervention Type BEHAVIORAL

Testing motor speed with a finger tapping test.

Simple reaction time

Intervention Type BEHAVIORAL

Testing the time to respond to the appearance of a visual stimulus.

Choice reaction time

Intervention Type BEHAVIORAL

Testing the time needed to discriminate and respond to different visual stimuli.

Verbal fluency

Intervention Type BEHAVIORAL

Evaluating how many words are produced in 90s.

Verbal list learning

Intervention Type BEHAVIORAL

Evaluating short-term memory, learning, and memory interference in the recall of 12-word lists, presented three times. Evaluating long-term memory and recognition after a 20 min interval.

Trail making test

Intervention Type BEHAVIORAL

Evaluating visuomotor speed and executive function in Trail Making Tests, A and B. In the first, subjects connect successive numbers with the mouse. In the second, they connect numbers and letters in alternation.

Design fluency

Intervention Type BEHAVIORAL

Subjects create the maximal number of 4-line patterns in 90 s.

Questionnaire completion

Intervention Type BEHAVIORAL

Question completion time is measured on each question of the Post-Traumatic Stress Disorder check list (PCL) and on the cognitive failures questionnaire.

Interventions

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Digit span testing

Testing of short-term verbal memory with digit span

Intervention Type BEHAVIORAL

Spatial span testing

Testing of short-term visuospatial memory with spatial span.

Intervention Type BEHAVIORAL

Finger tapping

Testing motor speed with a finger tapping test.

Intervention Type BEHAVIORAL

Simple reaction time

Testing the time to respond to the appearance of a visual stimulus.

Intervention Type BEHAVIORAL

Choice reaction time

Testing the time needed to discriminate and respond to different visual stimuli.

Intervention Type BEHAVIORAL

Verbal fluency

Evaluating how many words are produced in 90s.

Intervention Type BEHAVIORAL

Verbal list learning

Evaluating short-term memory, learning, and memory interference in the recall of 12-word lists, presented three times. Evaluating long-term memory and recognition after a 20 min interval.

Intervention Type BEHAVIORAL

Trail making test

Evaluating visuomotor speed and executive function in Trail Making Tests, A and B. In the first, subjects connect successive numbers with the mouse. In the second, they connect numbers and letters in alternation.

Intervention Type BEHAVIORAL

Design fluency

Subjects create the maximal number of 4-line patterns in 90 s.

Intervention Type BEHAVIORAL

Questionnaire completion

Question completion time is measured on each question of the Post-Traumatic Stress Disorder check list (PCL) and on the cognitive failures questionnaire.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* (a) fluency in the English language
* (b) no current or prior history of bipolar disorder, mania, or schizophrenia
* (c) no current substance abuse
* (d) no concurrent history of neurologic disease known to affect cognitive functioning
* (e) on a stable dosage of any required medication
* (f) auditory functioning sufficient to understanding normal conversational speech and visual acuity normal or corrected to 20/40 or better

Exclusion Criteria

* History of TBI



* current substance abuse
* current psychiatric diagnosis other than PTSD
Minimum Eligible Age

18 Years

Maximum Eligible Age

78 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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US Department of Veterans Affairs

FED

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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David L. Woods, PhD

Role: PRINCIPAL_INVESTIGATOR

VA Northern California HCS

References

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Atkins Whitmer D, Woods DL. Analysis of the cost effectiveness of a suicide barrier on the Golden Gate Bridge. Crisis. 2013;34(2):98-106. doi: 10.1027/0227-5910/a000179.

Reference Type BACKGROUND
PMID: 23261913 (View on PubMed)

Disbrow EA, Russo KA, Higginson CI, Yund EW, Ventura MI, Zhang L, Malhado-Chang N, Woods DL, Sigvardt KA. Efficacy of tailored computer-based neurorehabilitation for improvement of movement initiation in Parkinson's disease. Brain Res. 2012 May 3;1452:151-64. doi: 10.1016/j.brainres.2012.02.073. Epub 2012 Mar 9.

Reference Type BACKGROUND
PMID: 22459048 (View on PubMed)

Whitaker KJ, Kang X, Herron TJ, Woods DL, Robertson LC, Alvarez BD. White matter microstructure throughout the brain correlates with visual imagery in grapheme-color synesthesia. Neuroimage. 2014 Apr 15;90:52-9. doi: 10.1016/j.neuroimage.2013.12.054. Epub 2014 Jan 7.

Reference Type BACKGROUND
PMID: 24406309 (View on PubMed)

Woods DL, Herron TJ, Yund EW, Hink RF, Kishiyama MM, Reed B. Computerized analysis of error patterns in digit span recall. J Clin Exp Neuropsychol. 2011 Aug;33(7):721-34. doi: 10.1080/13803395.2010.550602.

Reference Type RESULT
PMID: 21957866 (View on PubMed)

Hubel KA, Reed B, Yund EW, Herron TJ, Woods DL. Computerized measures of finger tapping: effects of hand dominance, age, and sex. Percept Mot Skills. 2013 Jun;116(3):929-52. doi: 10.2466/25.29.PMS.116.3.929-952.

Reference Type RESULT
PMID: 24175464 (View on PubMed)

Hubel KA, Yund EW, Herron TJ, Woods DL. Computerized measures of finger tapping: reliability, malingering and traumatic brain injury. J Clin Exp Neuropsychol. 2013;35(7):745-58. doi: 10.1080/13803395.2013.824070. Epub 2013 Aug 15.

Reference Type RESULT
PMID: 23947782 (View on PubMed)

Woods DL, Kishiyamaa MM, Lund EW, Herron TJ, Edwards B, Poliva O, Hink RF, Reed B. Improving digit span assessment of short-term verbal memory. J Clin Exp Neuropsychol. 2011 Jan;33(1):101-11. doi: 10.1080/13803395.2010.493149.

Reference Type RESULT
PMID: 20680884 (View on PubMed)

Other Identifiers

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B6119-R

Identifier Type: -

Identifier Source: org_study_id

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