Decision-making After Traumatic Brain Injury

Man with Face in His Hands

Traumatic brain injury (TBI) affects approximately 1.7 million individuals annually in the United States. TBI manifests itself through multiple impaired cognitive functions-including impaired long-term and working memory, lack of inhibitory control, and decreased verbal fluency-all of which erode an individual's ability to function in the context of daily life. While civilians suffering from TBI experience these impairments from assaults, falls, and vehicle accidents; an increasing number of military personnel experience impairment from incidents that occurred while serving in Iraq or Afghanistan.

A study protocol under development seeks to more accurately diagnose TBI in both civilians and soldiers suffering from mild to moderate brain injury. The study will compare the changes in the brain's integrative frontal lobe-mediated processes by comparing two short-term intensive group training programs: Strategic Memory Advanced Research Training (SMART) and the Brain Health Workshop (BHW).

The study protocol dedicates to each program a mixed group of approximately 50 civilians and soldiers suffering from mild or moderate TBI. Each participant undergoes pre-training cognitive testing and MRI and diffusion tensor imaging (DTI) scans to develop a baseline of cognitive function to be measured against post-training testing and scans.

As of October 2012, individuals participating in the study are being enrolled after a screening process. The authors of the study estimate they will be able to meet the sample size of enrollees within three years.

Krawczyk D, Marquez de la Plata C, et al. Evaluating the effectiveness of reasoning training in military and civilian chronic traumatic brain injury patients: study protocol. Trials. (January 2013).