Common wisdom says that recovery from a concussion should only take a few days to a week, but recent studies have repeatedly shown that the damage from a brain injury can take months or longer to fully recover from, especially in youth. New research from the Center for BrainHealth at The University of Texas at Dallas also shows that recovery can be greatly improved with targeted brain training even years after the injury.
“The after-effects of concussions and more severe brain injuries can be very different and more detrimental to a developing child or adolescent brain than an adult brain,” said Dr. Lori Cook, study author and director of the Center for BrainHealth’s pediatric brain injury programs. “While the brain undergoes spontaneous recovery in the immediate days, weeks and months following a brain injury, cognitive deficits may continue to evolve months to years after the initial brain insult when the brain is called upon to perform higher-order reasoning and critical thinking tasks.”
The study, published in the journal Fronteirs in Neurology, evaluated 20 adolescents between the ages of 12 and 20 who experienced a traumatic brain injury at least six months before participating in the research. The participants, chosen for their demonstration of gist reasoning deficits or inability to get the essence of dense information, were randomized into two training groups. One group used strategy-based gist reasoning training, while the other used fact-based memory training.
The participants of the study completed eight, 45-minute sessions over the course of one month. The researchers then compared the effects of the two training strategies on the ability to abstract meaning and recall facts. These tests included pre- and post-training assessments, where the adolescents were tasked with reading several facts and then creating a high-level summary, drawing upon interferences to transform ideas into novel, generalized statements, and recall important facts.
After training, only the group using gist-reasoning strategies showed significant improvement in the ability to abstract meanings. Also, this group showed large generalized gains to untrained areas including executive functions of working memory and inhibition.
“These preliminary results are promising in that higher-order cognitive training that focuses on big picture thinking improves cognitive performance in ways that matter to everyday life success,” Cook said. “What we found was that training higher-order cognitive skills can have a positive impact on untrained key executive functions as well as lower-level, but also important, processes such as straightforward memory, which is used to remember details.
“While the study sample was small and a larger trial is needed, the real-life application of this training program is especially important for adolescents who are at a very challenging life stage when they face major academic and social complexities,” she said. “These cognitive challenges require reasoning, filtering, focusing, planning, self-regulation, activity management and combating information overload, which is one of the chief complaints that teens with concussions express.”
These findings could help practitioners craft better treatment and rehabilitation plans for traumatic brain injuries and ensure better long-term recoveries with less risk of disability.
“Brain injuries require routine follow-up monitoring. We need to make sure that optimized brain recovery continues to support later cognitive milestones, and that is especially true in the case of adolescents,” said Dr. Sandra Bond Chapman, study author, founder and chief director of the Center for BrainHealth and Dee Wyly Distinguished University Chair. “What’s promising is that no matter the severity of the injury or the amount of time since injury, brain performance improved when teens were taught how to strategically process incoming information in a meaningful way, instead of just focusing on rote memorization.”