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Persistent memory symptoms after concussion are common, and likely perpetuated by unhelpful illness beliefs and coping behaviors. Results from a pilot study suggested that traditional cognitive rehabilitation and a novel cognitive-behavioral therapy (CBT) protocol were both associated with improvements in subjective memory functioning. The present study will more definitively compare the effectiveness of these interventions for improving subjective memory functioning after concussion.
The primary research aims of this study are to determine whether cognitive behavioral therapy (CBT) and cognitive compensatory strategy training (CCST) improves subjective memory functioning compared to usual care, and to compare the effectiveness of CBT and CCST. This study is a multisite three-armed randomized control trial (RCT) that will randomize adults with persistent memory symptoms following concussion to CBT, CCST, or a covert waitlist condition (2:2:1). Participants will be blinded to the other arms of the study and the study hypotheses.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cognitive behavioral therapy | Experimental |
| |
| Cognitive rehabilitation | Active Comparator |
| |
| Waitlist - Usual care | No Intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cognitive behavioral therapy | Behavioral | Cognitive behavioral therapy (CBT) is delivered by a psychologist over 10 individual (1:1) manualized videoconference sessions. The goal of this therapy is for participants to use their memory more normally (i.e., reduce avoidance and safety behaviors) and view memory lapses as less threatening. |
| Measure | Description | Time Frame |
|---|---|---|
| Multifactorial Memory Questionnaire-Satisfaction scale | Measures participants' concern, satisfaction, and overall appraisal of their memory ability. Participants rate their agreement with 18 statements. Total scores range from 0 to 72, with lower total scores indicating worse subjective memory functioning. | Week 20 |
| Measure | Description | Time Frame |
|---|---|---|
| Fear-Avoidance of Memory Loss Scale | Assesses fears and avoidance behaviors associated with memory decline. Participants rate 24 items on a 5-point scale, where the higher scores indicate greater memory concern and maladaptive coping. | Week 1 and week 20 |
| Patient Global Impression of Change scale |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Noah D Silverberg, PhD | Contact | 6047341313 | 2316 | noah.silverberg@ubc.ca |
| Tasha L Klotz, BA | Contact | 6047341313 | 2316 | tasha.klotz@ubc.ca |
| Name | Affiliation | Role |
|---|---|---|
| Noah D Silverberg, PhD | University of British Columbia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Calgary Brain Injury Program | Recruiting | Calgary | Alberta | T2N 2T9 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39410977 | Background | Rioux M, Mamman R, Byworth MT, Panenka WJ, Howard AK, Perez DL, Schmidt J, Courchesne C, LeMoult J, Heran MK, Silverberg ND. Pilot feasibility randomised controlled trial of cognitive-behavioural therapy for functional cognitive disorder after concussion. BMJ Neurol Open. 2024 Oct 11;6(2):e000666. doi: 10.1136/bmjno-2024-000666. eCollection 2024. |
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| ID | Term |
|---|---|
| D001924 | Brain Concussion |
| ID | Term |
|---|---|
| D000070642 | Brain Injuries, Traumatic |
| D001930 | Brain Injuries |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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| ID | Term |
|---|---|
| D015928 | Cognitive Behavioral Therapy |
| D000091942 | Cognitive Training |
| ID | Term |
|---|---|
| D001521 | Behavior Therapy |
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
| D000066530 | Neurological Rehabilitation |
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|
| Cognitive rehabilitation | Behavioral | Cognitive compensatory strategy training (CCST), a traditional cognitive rehabilitation intervention, is delivered by a Occupational Therapist over 10 individual (1:1) manualized videoconference sessions. Participants optimize their use of current compensatory strategies and/or learn new ones suited to their needs and lifestyle. The goal is to minimize memory lapses in daily life. |
|
Participants rate how much their memory functioning has improved or declined overall since the beginning of the study, on a single item rated on a 7-point scale where the midpoint is no change. |
| Week 20 |
| Work and Social Adjustment Scale | Participants rate how much their condition interferes with their ability to carry out occupational and social activities across 5 items, on a scale from 1-7 where higher scores indicate more difficulty. | Week 1 and week 20 |
| Fraser Health Acquired Brain Injury and Concussion Services | Recruiting | Langley | British Columbia | V1M 4A6 | Canada |
|
| G.F. Strong Adult Concussion Services | Recruiting | Vancouver | British Columbia | V5Z 2G9 | Canada |
|
| Integrated Adult Concussion Program at Hamilton Health Sciences | Active, not recruiting | Hamilton | Ontario | L8N 3Z5 | Canada |
| 360 Concussion Care Clinic | Recruiting | Ottawa | Ontario | K1H 7X7 | Canada |
|
| Sunnybrook Traumatic Brain Injury Clinic | Recruiting | Toronto | Ontario | M4N 3M5 | Canada |
|
| Hull-Ellis Concussion and Research Clinic at University Health Network | Recruiting | Toronto | Ontario | M5G 2A2 | Canada |
|
| Canadian Concussion Centre at Toronto Western Hospital | Recruiting | Toronto | Ontario | M5T 2S8 | Canada |
|
| D009422 | Nervous System Diseases |
| D006259 | Craniocerebral Trauma |
| D020196 | Trauma, Nervous System |
| D016489 | Head Injuries, Closed |
| D014947 | Wounds and Injuries |
| D014949 | Wounds, Nonpenetrating |
| D012046 | Rehabilitation |
| D000359 | Aftercare |
| D003266 | Continuity of Patient Care |
| D005791 | Patient Care |
| D013812 | Therapeutics |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |