Strategy-Based Brain Training Provides Lasting Mental and Physical Gains After TBI

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New research published in Neuropsychological Rehabilitation claims that veterans and civilians who have experienced traumatic brain injury show significantly improved cognitive performance and psychological and neural health after receiving strategy-based cognitive training.


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“Veterans and others who have sustained traumatic brain injuries often experience persistent cognitive and psychological difficulties, such as depression and/or post-traumatic stress disorder, which hinder day-to-day life activities,” said Dr. Sandra Bond Chapman, founder and chief director of the Center for BrainHealth and principal investigator on the study. “This study shows that strategy-based cognitive training focusing on abstract and innovative thinking not only improves cognitive areas critical to everyday life success but also improves brain blood flow to key regions of the brain and lessens depressive and stress-related symptoms.”

For the unprecedented study, an interdisciplinary team of cognitive neuroscientists, rehabilitation specialists, and neuroimaging experts from the Center of BrainHealth at The University of Texas at Dallas examined 60 individuals between the ages of 19 and 65 years old and had sustained at least one traumatic brain injury in the past. Over two-thirds of those involved in the study had sustained a TBI over 10 years ago.

The study participants were randomly assigned to receive either strategy-based brain training intended to focus on complex abstraction and innovation or an educational, information-based program about how the brain works.

Both programs offered 18 hours of training completed across 12 group sessions within an 8-week timeframe. All participants underwent extensive cognitive assessments and MRI scans, as well as being assessed for symptoms of depression and post-traumatic stress disorder.

According to the findings, the group given strategy-based cognitive training improved complex abstraction scores by over 20% and memory scores by more than 30%. The researchers also noted participants in the strategy-based cognitive training group reported 60% reduction in depressive symptoms and nearly 40% reduction in symptoms related to PTSD.

The strategy-based training was also associated with increased brain blood flow to the frontal lobe, anterior cingulate and precuneus compared to the active comparison group.

“Previously, reduction in precuneus blood flow has been linked to severity of traumatic brain injury and symptoms of PTSD,” said Dr. Daniel Krawczyk, associate professor of cognitive neuroscience and cognitive psychology at the Center for BrainHealth and principal investigator on the study.

“Our results show that following the strategy-based training, blood flow increased more than 25% to this region, implying the brain is undergoing changes suggestive of improved neural health. Enhanced neural health of the frontal region has been associated with increased abstract thinking, the anterior cingulate to superior cognitive performance, and the precuneus to emotional regulation of stress and severity of brain injury symptoms,” said Krawczyk, who holds the Debbie and Jim Francis chair at The University of Texas at Dallas.

The findings lead the researchers to believe that improved abstract thinking and executive functioning appear to help individuals down-regulate emotional reactions, causing better mood and fewer stress symptoms.

“Our research suggests that interventions that improve frontal lobe reasoning, induces positive brain changes that support higher-order thinking and down-regulation of negative emotion. The converging patterns identified biological validity for the cognitive and mental health improvement,” said Chapman, who holds the Dee Wyly Distinguished University Chair at The University of Texas at Dallas. “The cognitive, psychological and brain blood flow benefits continued to be realized three to four months following training, suggesting that participants continued to improve after the training ended.”

She continued, “The benefits of the strategy based training were experienced months and years after injury suggesting that brain injuries should be treated more like a chronic health condition rather than a single short-term event.

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