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The aim of this study is to assess the brain correlates, as assessed with multimodal MRI, of working memory training in patients with severe traumatic brain injury (TBI)
This is a pilot feasibility study. Patients with subacute/chronic (> 6 months) severe TBI will be included if they suffer from a deficit in working memory. They will receive a specific hierarchical training of working memory (3 sessions per week during three months), according to a previously described methodology.
A multimodal MRI will be performed at neuroSpin center (CEA, Orsay, France) before and after cognitive training, including: structural imaging (T1, FLAIR and diffusion tensor imaging, DTI); functional connectivity at rest; and functional activation during a working memory task (n-back).
Behavioral and imaging changes after training will be analysed individually and compared to a group of healthy controls matched for age, gender and education.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| working memory training | Experimental | Patients with severe TBI will receive a hierarchical training of working memory according to a previously described methodology. They will receive 3 sessions per week during three months (each session=1 h approximately) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| working memory training | Behavioral | Hierarchical cognitive training of the different components of working memory according to Baddeley model; 15 tasks are used addressing: the phonological loop (8 tasks), the visuospatial sketchpad (4 tasks) and the central executive 3 tasks). Task are given in a hierarchical order, according to each individual patient's deficits and improvement. |
| Measure | Description | Time Frame |
|---|---|---|
| working memory questionnaire | It is a self-assessment questionnaire comprising 30 questions scored on a five-point Likert scale, ranging from 0 ("no problem at all") to 4 ("very severe problem in everyday life"). The total score will be used. | change from baseline to 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| working memory testing | neuropsychological assessment of working memory | change from baseline to 3 months |
| neuro-imaging changes | multimodal 3T MRI |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Philippe AZOUVI, MD-PhD | Contact | 0033 147107074 | philippe.azouvi@aphp.fr | |
| Erica VLACHOS, CRA | Contact | 0033 147104472 | erica.vlachos@aphp.fr |
| Name | Affiliation | Role |
|---|---|---|
| Philippe AZOUVI, MD-PhD | APHP Hôpital Raymond Poincaré | Study Chair |
| Lucie HERTZ PANNIER, MD | Neurospin- CEA | Principal Investigator |
| Eric BRUNET, MD |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| APHP Hôpital Raymond Poincaré | Recruiting | Garches | Île-de-France Region | 92380 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 16286329 | Background | Vallat C, Azouvi P, Hardisson H, Meffert R, Tessier C, Pradat-Diehl P. Rehabilitation of verbal working memory after left hemisphere stroke. Brain Inj. 2005 Dec;19(13):1157-64. doi: 10.1080/02699050500110595. | |
| 22537095 | Background | Vallat-Azouvi C, Pradat-Diehl P, Azouvi P. The Working Memory Questionnaire: a scale to assess everyday life problems related to deficits of working memory in brain injured patients. Neuropsychol Rehabil. 2012;22(4):634-49. doi: 10.1080/09602011.2012.681110. Epub 2012 Apr 27. |
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| ID | Term |
|---|---|
| D000070642 | Brain Injuries, Traumatic |
| D060825 | Cognitive Dysfunction |
| ID | Term |
|---|---|
| D001930 | Brain Injuries |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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a group of 10 patients with severe TBI will receive 3-month rehabilitation of working memory and will be compared to a group of 10 healthy controls
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|
| change from baseline to 3 months |
| Hôpital André Mignot |
| Principal Investigator |
| Claire Vallat-Azouvi, PhD | University of Paris 8 | Principal Investigator |
| 19484632 | Background | Vallat-Azouvi C, Pradat-Diehl P, Azouvi P. Rehabilitation of the central executive of working memory after severe traumatic brain injury: two single-case studies. Brain Inj. 2009 Jun;23(6):585-94. doi: 10.1080/02699050902970711. |
| 24552571 | Background | Vallat-Azouvi C, Pradat-Diehl P, Azouvi P. Modularity in rehabilitation of working memory: a single-case study. Neuropsychol Rehabil. 2014;24(2):220-37. doi: 10.1080/09602011.2014.881294. Epub 2014 Feb 19. |
| D006259 |
| Craniocerebral Trauma |
| D020196 | Trauma, Nervous System |
| D014947 | Wounds and Injuries |
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |