A total of 150 adults ages 19-65 years with Traumatic Brain Injury (TBI) and/or subthreshold of full diagnosis of posttraumatic stress disorder (PTSD) will be recruited for the study (estimated 100 completers). Traumatic Brain Injury Posttraumatic Stress DisorderÄ«ehavioral: SMART Behavioral: Brain Health WorkshopÄESIGN: This is a double-blind, randomized controlled clinical trial. The purpose of the current study is to investigate the efficacy of a shortened training program (9 hours) in improving neurocognitive function in patients with mTBI and/or PTSD. SMART training has not been tested with patients with PTSD-related neuropsychological impairments. The training consisted of 15 hours of training conducted over 10 group sessions in the first 5 weeks and a final 3 hours of training at spaced intervals over the next 3 weeks. When compared to the Brain Health Workshop (BHW), an education-based active learning module, participants in the SMART group (n = 31) demonstrated improvements in gist reasoning, executive function, and memory, generalization of improvement to daily functioning activities and continuation of these gains 6 months posttraining.
The SMART program has previously been tested with patients with TBI using an 18-hour training format. This will be the first study to test its effectiveness with individuals with mild TBI (MTBI) and posttraumatic stress disorder (PTSD). The effectiveness of SMART has been extensively tested with a variety of populations, including healthy adults and adolescents, adolescents with brain injuries, healthy seniors and those at risk for Alzheimers, and veterans and civilians with lingering impairment following TBIs. In addition to improving frontal lobe capacity, SMART has also been shown to increase brain blood flow critical for complex thinking and strengthen white matter integrity. Evidence from other top-down cognitive training programs demonstrates their effectiveness in improving cognitive and daily functioning in individuals reporting a TBI. SMART emphasizes top-down processing by targeting focused attention, assimilation of information, and mental flexibility and innovation, all higher-order cognitive functions driven by the frontal lobes. New research has shown that when these very specific brain functions are targeted, such as ability to focus on a task while ignoring irrelevant information, brain changes are more significant. The focus of this study is to test a treatment program (Strategic Memory Advanced Reasoning Training SMART) that was developed to address specific brain functions found to be crucial for the recovery following traumatic brain injury (TBI). Why Should I Register and Submit Results?.