OBJECTIVE: To evaluate the ability of functional magnetic resonance imaging (fMRI) measures collected from people with traumatic brain injury (TBI) to provide predictive value for rehabilitation outcomes over and above standard predictors. DESIGN: Prospective study. SETTING: Academic medical center. PARTICIPANTS: Persons (N=54) with TBI greater than 1 year postinjury. INTERVENTION: A novel 12-session group rehabilitation program focusing on internal strategies to improve memory. MAIN OUTCOME MEASURE: The Hopkins Verbal Learning Test-Revised (HVLT-R) delayed recall score. RESULTS: fMRI measures were collected while participants performed a strategically directed word memorization task. Prediction models were multiple linear regressions with the following primary predictors of outcome: age, education, injury severity, preintervention HVLT-R, and task-related fMRI activation of the left dorsolateral and left ventrolateral prefrontal cortex (VLPFC). Baseline HVLT-R was a significant predictor of outcome (P=.007), as was injury severity (for severe vs mild, P=.049). We also found a significant quadratic (inverted-U) effect of fMRI in the VLPFC (P=.007). CONCLUSIONS: This study supports previous evidence that left prefrontal activity is related to strategic verbal learning, and the magnitude of this activation predicted success in response to cognitive memory rehabilitation strategies. Extreme under- or overactivation of VLPFC was associated with less successful learning after rehabilitation. Further study is necessary to clarify this relationship and to expand and optimize the possible uses of functional imaging to guide rehabilitation therapies.
OBJECTIVE: To evaluate the ability of functional magnetic resonance imaging (fMRI) measures collected from people with traumatic brain injury (TBI) to provide predictive value for rehabilitation outcomes over and above standard predictors. DESIGN: Prospective study. SETTING: Academic medical center. PARTICIPANTS: Persons (N=54) with TBI greater than 1 year postinjury. INTERVENTION: A novel 12-session group rehabilitation program focusing on internal strategies to improve memory. MAIN OUTCOME MEASURE: The Hopkins Verbal Learning Test-Revised (HVLT-R) delayed recall score. RESULTS: fMRI measures were collected while participants performed a strategically directed word memorization task. Prediction models were multiple linear regressions with the following primary predictors of outcome: age, education, injury severity, preintervention HVLT-R, and task-related fMRI activation of the left dorsolateral and left ventrolateral prefrontal cortex (VLPFC). Baseline HVLT-R was a significant predictor of outcome (P=.007), as was injury severity (for severe vs mild, P=.049). We also found a significant quadratic (inverted-U) effect of fMRI in the VLPFC (P=.007). CONCLUSIONS: This study supports previous evidence that left prefrontal activity is related to strategic verbal learning, and the magnitude of this activation predicted success in response to cognitive memory rehabilitation strategies. Extreme under- or overactivation of VLPFC was associated with less successful learning after rehabilitation. Further study is necessary to clarify this relationship and to expand and optimize the possible uses of functional imaging to guide rehabilitation therapies.
Authors: Miles Berger; Jacob W Nadler; Jeffrey Browndyke; Niccolo Terrando; Vikram Ponnusamy; Harvey Jay Cohen; Heather E Whitson; Joseph P Mathew Journal: Anesthesiol Clin Date: 2015-07-16
Authors: Margaret A Naeser; Anita Saltmarche; Maxine H Krengel; Michael R Hamblin; Jeffrey A Knight Journal: Photomed Laser Surg Date: 2010-12-23 Impact factor: 2.796
Authors: Robert W Van Boven; Greg S Harrington; David B Hackney; Andreas Ebel; Grant Gauger; J Douglas Bremner; Mark D'Esposito; John A Detre; E Mark Haacke; Clifford R Jack; William J Jagust; Denis Le Bihan; Chester A Mathis; Susanne Mueller; Pratik Mukherjee; Norbert Schuff; Anthony Chen; Michael W Weiner Journal: J Rehabil Res Dev Date: 2009
Authors: Christina Weyer-Jamora; Melissa S Brie; Tracy L Luks; Ellen M Smith; Steve E Braunstein; Javier E Villanueva-Meyer; Paige M Bracci; Susan Chang; Shawn L Hervey-Jumper; Jennie W Taylor Journal: Neurooncol Pract Date: 2020-11-04