Cortical Thickness Changes in Individuals With Chronic Traumatic Brain Injury Following Strategy-based Reasoning Training

Abstract

To elucidate effects of strategy-based reasoning training on longitudinal cortical thickness changes of individuals with chronic Traumatic Brain Injury (TBI). Double-blinded, single-center, controlled intervention study. Participants were randomly assigned to either the Strategic Memory Advanced Reasoning Training (SMART) and Brain Health Workshop (BHW) group. University-based research institute. 49 participants (25 SMART), 20 to 65 years old, with mild to moderate chronic TBI (>6 months post-injury; 5-7 on GOS-E). The participants had neither contraindications to MRI nor other relevant comorbidities. The participants in both groups received interventions over 8 weeks. SMART focuses on training in the use of strategic attention, reasoning and other thinking strategies. BHW focuses on education in brain structure and function. Cortical thickness from the whole brain MRI scans of the participants was measured at the pre- and post-intervention stage. The linear mixed-effects modeling analysis with intercept as a random effect was performed on cortical thickness at each vertex of the cortical surface. Statistically significant regions for group-time interactions were identified at pvertexpcluster<0.1. Total 82 scans were included for the analysis. Relative to the BHW group, the SMART group had increased cortical thickness changes after the intervention in the left inferior frontal sulcus (IFS) (pcluster=0.002), left supramarginal gyrus (pcluster=0.08) and a region across the right IFS and inferior part of the precentral sulcus (pcluster=0.09). The SMART leads to increases in cortical thickness of chronic TBI at the post-intervention stage. Our current efforts include association of current findings with neuro-psychological measures.