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Traumatic Brain InjuryNCT01552473

Brain Training to Enhance Frontal Lobe Reasoning

A study testing Brain Training Program 1 and Brain Training Program 2 in people with Traumatic Brain Injury, run by The University of Texas at Dallas at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study is being done to improve the ability to diagnose and to achieve higher-levels of functional recovery in soldiers and civilians who have suffered either mild Traumatic Brain Injury (TBIs) or moderate-to-severe TBIs at chronic stages of brain recovery (greater than 12 months). Read more about this study

Who is it for?
Ages 19 to 65 years
Conditions the study is for
Traumatic Brain Injury
What is being tested?
Brain Training Program 1 and Brain Training Program 2
Could I receive a placebo?
No, everyone receives an active treatment
How many people
108 participants
Where
1 siteUnited States
Study dates
Mar 2012to Oct 2015
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 19 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 19-65 years of age
  • Sustained a traumatic brain injury at least 6 months previously
  • Comprehend simple instructions, perform tasks and take part in intervention
  • Read, speak and comprehend English
  • Participate in tasks involving motor abilities such as use of at least one arm or hand

Who cannot join

  • Not proficient in reading, comprehending or speaking English
  • Pre-existing Cerebral Palsy, Mental Retardation, Autism, Epilepsy, Schizophrenia, or Pervasive Developmental Disorder
  • Individuals with Psychosis, Active Behavioral Disorder, or uncontrolled epilepsy
  • Women who are pregnant

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Center for BrainHealth

    Dallas, Texas, 75235

Other trials in United States

About this study

Official title: Brain Training to Enhance Frontal Lobe Reasoning in Soldiers and Civilian Adults With TBI

This study is being done to improve the ability to diagnose and to achieve higher-levels of functional recovery in soldiers and civilians who have suffered either mild Traumatic Brain Injury (TBIs) or moderate-to-severe TBIs at chronic stages of brain recovery (greater than 12 months).

Read the detailed description

In the current randomized control trial, we study the efficacy of a functionally relevant cognitive training program applied to individuals who are experiencing the effects of chronic TBI. The top-down training program labeled SMART (Strategic Memory Advanced Reasoning Training) adopts an integrative approach to train functionally relevant complex reasoning abilities (versus specific skills). This integrative approach focused on frontal lobe functions has shown promising results in a preliminary study. SMART is compared to an equally engaging education-based program labeled BHW (Brain Health Workshop). Both SMART and BHW are short-term, intensive (18 h of training over 8 weeks) group training programs that are comparable with regard to training time, amount of information, group discussions, and homework assignments. The overall goal of this trial is to examine how training integrative frontal lobe-mediated processes might improve functioning in brain injury survivors, including military service and civilian populations. We include a range of individuals with different injury types and functional abilities. We use a broad variety of assessment tools, including cognitive, neuroimaging, and functional measures, to compare the training groups.

Our overall goal is to improve the fidelity of TBI diagnoses and to achieve higher levels of functional recovery in soldiers and civilians who have suffered mild to moderate TBIs and are at the chronic stage of brain recovery. This study is also to determine the efficacy of an empirically and theoretically driven framework to enhance frontal lobe-mediated reasoning ability in individuals with TBI, given a relatively short training duration, on trained and untrained cognitive skills, on brain changes, and on measures of real-life function. Toward these aims, this trial is enrolling both soldiers and civilians with a TBI (approximately 50 mild and 50 moderate chronic TBI patients). We use cognitive tests (assessing memory, reasoning, and comprehension abilities), functional MRI scans (performing tests of cognitive function while the subject is receiving an MRI scan), and white matter maps constructed using diffusion tensor imaging (DTI) scans. The MRI scans will be used to provide biomarkers of the contributions of different brain regions to performing cognitive tasks (e.g., memory, reasoning, etc.), as well as assessments of brain efficiency, functional brain connectivity, and brain morphology. We use these measurements to gain an understanding of each individual's cognitive skills and neural measures prior to cognitive intervention. These measures also serve as indicators of the baseline function of each soldier or civilian, to be compared with after intervention, at which point they undergo post-training cognitive, MRI, and DTI assessments, enabling us to make outcome comparisons between the two different cognitive interventions. Finally, we conduct a follow-up assessment with neuropsychological and cognitive measures and neuroimaging 3 months after the interventions to assess how individuals maintain any functional changes that may occur because of the cognitive interventions.

We are targeting this intervention toward mild and moderate TBI participants, who have relatively high functioning skills. The demands of the training can be too high for some individuals falling into the more severe range, in the frequency, duration, and type of strategies and skills emphasized. We also aim to address the high level of need placed upon studies of milder TBI cases, particularly with military populations. This priority is also emphasized by the sponsoring agency, the US Department of Defense, advocating for more studies of mild TBI under the funding mechanism supporting this work.

Being tested
Brain Training Program 1, Brain Training Program 2
Keywords
TBI, Traumatic Brain Injury, combat related injury, blast injury, concussion, sleep problems, attention problems, memory problems, headaches, dizziness, OEF, OIF, Veterans, Civilian
Medical subject headings
Brain Injuries, Traumatic, Blast Injuries, Brain Concussion, Parasomnias, Memory Disorders, Headache, Dizziness

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Brain Training Program 1Behavioural

    The training program includes 12 sessions conducted over 8 weeks. The goal of these treatment sessions is to provide information on brain injury and its recovery process. Activities involved in the sessions include discussion of study material. Participants will be encouraged to apply the information to their daily lives. The program includes additional outside practice of the activities.

  • Brain Training Program 2Behavioural

    The training program includes 12 sessions conducted over 8 weeks. The goal of these treatment sessions is to provide strategies to improve brain injury and its recovery process. Activities involved in the sessions include strategies and discussion of study material. Participants will be encouraged to apply the strategies and information to their daily lives. The program includes additional outside practice of the activities.

Study groups in NCT01552473
Study groupRoleWhat they receive
Brain Training Program 1Active comparatorTraining Program focusing on providing educational information of cognitive issues related to TBI
Receives: Behavioral: Brain Training Program 1
Brain Training Program 2ExperimentalProgram focuses on strategies to address cognitive issues following TBI
Receives: Behavioral: Brain Training Program 2

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Glasgow Outcome Scale-Extended

    Assesses disability after brain injury (1 dead to 8 good recovery). A higher score is a better outcome.

    Measured: Pre-training (Baseline) Neuropsychological Test

  2. Community Integration Questionnaire

    To examine short-term effects of treatment on cognition and real-life outcomes relating to how successful someone is able to integrate within their community (0 lowest integration (worst outcome) to 40 maximal integration (best outcome)). A higher score is a better outcome.

    Measured: Neuropsychological changes from baseline to 10 weeks post-training

  3. Functional Status Exam

    To examine short-term effects of treatment on outcomes. - (0 highest function (best outcome) to 31 lowest function (worst outcome)). A lower score is a better outcome.

    Measured: Measure at 10 weeks post-training

  4. Daneman-Carpenter Reading Span Test

    Scored as 0 words to 7 words comprehended. Higher scores indicate better comprehension and thus a better outcome. Lower scores indicates a lower degree of comprehension. A higher score is a better outcome.

    Measured: Measure at 10 weeks post-training

  5. Hayling Sentence Completion Test

    To examine short-term effects of treatment on cognition by working memory. The Hayling Sentence Completion test measures response initiation (range 0 best to 30 worst). A lower score is a better outcome.

    Measured: Measure at 10 weeks post-training

  6. Awareness Questionnaire

    To examine short-term effects of treatment on real-life outcomes. This test measures impaired self-awareness after brain injury. The scale ranges from 17 (lowest self-awareness level, worst outcome) to 85 (highest self-awareness level, best outcome). A higher score is a better outcome.

    Measured: Measure at 10 weeks post-training

Secondary outcomes (12)
  1. Network Based Statistics in Brain Connectivity

    Brain network connectivity from functional brain imaging was computed using Network-Based Statistics. Data were adjusted to form one number to characterize the significant connection changes associated with the training. This was accomplished by computing a change score. This change score combined the post-training (10 weeks), and 3-months post-training imaging data and compared that to the baseline (pre-training imaging data). This measure allows for an estimation of the number of statistically increased connections observed between different areas of the brain. A higher score indicates more significant connections and is considered to be a better outcome.

    Measured: MRI measures taken at 10 weeks and 3 months post-training are combined and compared to baseline MRI yielding one number

  2. Beck Depression Inventory (BDI)

    To examine short-term effects of treatment on measures current depressive symptoms from 0 (no depressive symptoms (best outcome)) to 63 (maximum depressive symptoms (worst outcome)). A lower score is a better outcome.

    Measured: Measure taken at 10 weeks post-training

  3. Post Traumatic Stress Disorder (PTSD) Checklist

    To examine short-term effects of treatment on self-reported measure of symptoms of posttraumatic stress disorder. The test ranges from 0 minimal stress symptoms to 80 maximum stress symptoms. A lower score is a better outcome.

    Measured: Measure taken at 10 weeks post-training

  4. Alcohol, Smoking and Substance Involvement Screening Test

    To examine short-term effects of treatment on problem substance use. The range is from 0 low levels of problem substance use to 414 (maximum level of problem substance use). A lower score is a better outcome.

    Measured: Measure taken at 10 weeks post-training

  5. Alcohol Use Disorders Identification Test

    To examine short-term effects of treatment on real-life outcomes on alcohol use disorder. The test ranges from 0 lowest use (best outcome) to 40 maximal use (worst outcome). A lower score is a better outcome.

    Measured: Measure taken at 10 weeks post-training

  6. Digit Vigilence Test

    To examine short-term effects of treatment on attention. The test is scored as time in seconds with the lowest amount of time indicating the best performance. A lower score is a better outcome.

    Measured: Measure taken at 10 weeks post-training

  7. Connor-Davidson Resilience Scale

    To examine short-term effects of treatment on resilience. the scores range from 0 (lowest reslience and worst outcome) to 100 (highest resilience and best outcome). A higher score is a better outcome.

    Measured: Measure taken at 10 weeks post-training

  8. Wechsler Memory Scale

    To examine short-term effects of treatment on memory. The scores range from 0 (lowest memory level) to 20 (higher memory level). A higher score is a better outcome.

    Measured: Measure taken at 10 weeks post-training

  9. Wechsler Abbreviated Scale of Intelligence Vocabulary Scale

    To examine short-term effects of treatment on vocabulary ability Score ranges from 20 (a lower level of vocabulary) to 80 (a higher level of vocabulary). A higher score is a better outcome.

    Measured: Measure taken at 10 weeks post-training

  10. Wechsler Abbreviated Scale of Intelligence Matrix Reasoning

    To examine short-term effects of treatment on cognition with fluid reasoning being the measure ranging from 20 (lowest performance) to 80 (highest performance). A higher score is a better outcome.

    Measured: Measure taken at 10 weeks post-training

  11. Wechsler Abbreviated Scale of Intelligence Similarities

    To examine short-term effects of treatment on cognition with a score of 20 indicating lowest similarities performance to 80 indicating the highest similarities performance. A higher score is a better outcome.

    Measured: Measure taken at 10 weeks post-training

  12. Satisfaction With Life Scale

    To examine short-term effects of treatment on real-life outcomes. This ranges from 5 lowest satisfaction with life to 35 highest satisfaction with one's life. A higher score is a better outcome.

    Measured: Measure taken at 10 weeks post-training

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Mar 2012 (estimated)
  2. Study startMar 2012
  3. Primary completionJul 2015
  4. Study completionOct 2015

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
108 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01552473
Sponsor's protocol ID
STU 032011-191
Status last verified
Feb 2025
First submitted
6 Mar 2012
Last updated
10 Mar 2025
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • Krawczyk DC, Marquez de la Plata C, Schauer GF, Vas AK, Keebler M, Tuthill S, Gardner C, Jantz T, Yu W, Chapman SB. Evaluating the effectiveness of reasoning training in military and civilian chronic traumatic brain injury patients: study protocol. Trials. 2013 Jan 30;14:29. doi: 10.1186/1745-6215-14-29.

    PubMed 23363480

Questions about this trial

What is this clinical trial studying?

A study testing Brain Training Program 1 and Brain Training Program 2 in people with Traumatic Brain Injury, run by The University of Texas at Dallas at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 10 Mar 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Glasgow Outcome Scale-Extended (time frame: Pre-training (Baseline) Neuropsychological Test). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01552473, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Mar 2025.

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Brain Training to Enhance Frontal Lobe Reasoning | AzTrials