Goal-Oriented Attention Regulation Training in Veterans with Chronic TBI (P01.186)

Abstract

Objective: To present preliminary results of a study assessing the effects of training in attention and executive control in veterans with chronic TBI and executive dysfunction. Background Some of the most common and disabling consequences of brain injury are deficits in executive control processes, including selecting and maintaining goal-relevant information for organization and execution of goal-relevant activities. Goal-oriented attentional self-regulation training (GOALS) was designed to target and improve such deficits via training applied to individually-defined goals. A prior study of individuals with chronic brain injury showed improvement on measures of attention/executive function, memory and functional task performance, as well as changes in goal-directed control over neural processing on fMRI. Design/Methods: Fourteen veterans with chronic TBI (>6months) and mild-moderate executive dysfunction were randomized to start with 5 weeks of either GOALS training or active control matched in therapy time and intensity (brain health education-BHW). Participants that started with BHW switched to GOALS for the following 5 weeks. Measurements at baseline, weeks 5 and 10 included neuropsychological tests, assessments of functional performance in complex 9real-life9 settings, and self-report measures of emotional regulation and daily functioning. Results: After GOALS training, participants significantly improved on neuropsychological measures of attention/executive function and functional task performance, as well as on subjective reports of emotional regulation and daily functioning. Participants who completed BHW training did not show significant changes in these variables, though reported improved understanding of brain health. Participants found protocols engaging and incorporated some of the GOALS strategies into their daily life. Conclusions: Preliminary results suggest that GOALS training may improve cognitive functioning with ecologically significant impacts for veterans with chronic TBI and executive dysfunction. Furthermore, improving attentional self-regulation may also improve functioning in other domains such as functional performance in daily lives and emotional health. Intervening to improve cognitive functioning even during chronic stages of injury may be valuable. Supported by: Office of Research and Development Rehabilitation R&D Service Department of Veterans Affairs. Disclosure: Dr. Novakovic-Agopian has nothing to disclose. Dr. Chen has nothing to disclose. Dr. Abrams has nothing to disclose. Dr. Rossi has nothing to disclose. Dr. Binder has nothing to disclose. Dr. Muir has nothing to disclose. Dr. Murphy has nothing to disclose. Dr. Carlin has nothing to disclose. Dr. Fitzsimmons has nothing to disclose. Dr. D9Esposito has nothing to disclose.