The effects of tablet-based home interventions on brain structure, cognitive functioning, motor performance, and daily life participation in patients with Traumatic Brain Injury

This research project investigates the effect of tablet-based rehabilitation interventions across various symptoms of patients with Traumatic Brain Injury (TBI). Patients with TBI in the chronic phase face long term deficits across multiple domains, such as cognitive functioning, motor performance, and daily life participation. TBI can lead to un-employment, homelessness, and family breakdown, resulting in a significant economic cost to the community. Recovery from TBI remains one of the most significant challenges in rehabilitation.

A critical challenge is to find ways of engaging individuals in the therapeutic process by creating meaningful, engaging and intensive forms of therapy that result in sustained change, and that are translatable to the activities of daily living. In this research program, we investigate a novel training program (CogMo) that combines cognitive and motor-based virtual-reality training. We hypothesize that the combined method may lead to larger improvements in cognition and motor skills compared to cognitive training alone, with greater impacts on daily life functioning. One of the main objectives of this research is to evaluate the feasibility and impact of this training program for people living with TBI.

We also investigate whether training effects are reflected in neuroplastic modulations of brain structure and connectivity. We are using state-of-the art diffusion and myelin mapping magnetic resonance imaging (MRI) techniques, followed by fixel-based and graph theoretical analyses to identify changes in the structure of the brain. The value of these neuroimaging methods lie in their sensitivity to axonal injury, a pathological condition that contributes to persistent cognitive and motor impairments in many people with TBI. The other major objective of this research is to use these advanced neuroimaging techniques to identify biomarkers, thus providing invaluable information on the mechanisms by which training can alleviate motor and cognitive symptoms in TBI.

Funding

ACURF

Duration

2016-20

Investigators

Associate Professor Karen Caeyenberghs, ACU
Professor Derek Jones, ACU
Professor  Mark Cook, St Vincent’s Hospital
Associate Professor Wendy D’Souza, St Vincent’s Hospital
Ms Phoebe Imms, ACU
Mr Adam Clemente, ACU
Ms Hannah Richards, ACU
Ms Alexandra Armstrong, ACU
Professor Peter Wilson, ACU
Dr Jonathon Duckworth, RMIT

Major publications

Caeyenberghs, K., Clemente, A., Imms, P., Egan, G., Hocking, D. R., Leemans, A., … & Wilson, P. H. (2018). Evidence for Training-Dependent Structural Neuroplasticity in Brain-Injured Patients: A Critical Review. Neurorehabilitation and neural repair, 32(2), 99-114.

Caeyenberghs, K., Verhelst, H., Clemente, A., & Wilson, P. H. (2017). Mapping the functional connectome in traumatic brain injury: what can graph metrics tell us? Neuroimage, 160, 113-123.

 

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