Training in Goal-directed Attention Regulation for Individuals With Brain Injury
18. oktober 2017 oppdatert av: VA Office of Research and Development
Plasticity in Brain Network to Enhance Cognitive Rehabilitation
Brain injuries affect the lives of numerous Veterans.
This study examines how the brain is affected by injury and how rehabilitation training for attention dysfunction may change brain functioning.
Studieoversikt
Status
Fullført
Forhold
Detaljert beskrivelse
Traumatic brain injuries (TBI) are a leading cause of long-term disability among combat Veterans.
The most common and persistent sequelae after TBI are cognitive-behavioral deficits in 'executive control' and 'attention' functions.
Such abnormalities may directly contribute to poor long-term outcomes as well as impede rehabilitation of dysfunction in other cognitive and motor domains.
Effective treatments would potentially make a major impact in improving functional outcomes, but consistently effective treatments are not available.
The overall goal of this research is to improve the investigators' understanding of plasticity in brain function after TBI and to develop improved cognitive neurorehabilitation treatments.
The intervention involves individual and group-based training in cognitive skills.
Studietype
Intervensjonell
Registrering (Faktiske)
49
Fase
- Ikke aktuelt
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiesteder
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California
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Sacramento, California, Forente stater, 95655
- VA Northern California Health Care System, Mather, CA
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Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
18 år til 75 år (Voksen, Eldre voksen)
Tar imot friske frivillige
Nei
Kjønn som er kvalifisert for studier
Alle
Beskrivelse
Inclusion Criteria:
- history of traumatic brain injury
- greater than 1 week from injury
- residual dysfunction related to attention and executive control
Exclusion Criteria:
- aphasia
- active illicit drug use
- severe depression
- contraindications to MRI scanning
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Eksperimentell: Goal-oriented Attention Regulation Training
training in goal-directed attention regulation
|
training in goal-directed attention regulation
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Aktiv komparator: Education
brain health education
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brain health education workshops
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Eksperimentell: Technology-assisted Goal-directed Self-Regulation Training
computer-assisted training in goal-directed attention regulation
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computer-assisted training in goal-directed attention regulation, with trainer guidance and cognitive games to practice skills
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Self-report
Tidsramme: 5 Weeks (After completion of active trainings in Arm 1 and Arm 3)
|
Responses to goal processing questionnaire relating to areas of personal goal-based functioning.
This scale measured participants self-perceived changes to their cognitive and emotional functioning.
Participants indicated the degree to which they perceived changes to 11 questions after receiving trainings in Arm 1 and Arm 3 on a 10-point scale (1=domain became worse, 5 = no change, 10 = domain improved).
Participants did not complete this measure after Arm 2.
|
5 Weeks (After completion of active trainings in Arm 1 and Arm 3)
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Change From Baseline to Post-training for Task Errors on a Functional Performance Measure
Tidsramme: 5 weeks (After completion of Arm 1 and Arm 2)
|
Participants completed a functional assessment task, the modified Multiple Errands Task (MET).
The MET is an unstructured functional task that permits assessment of participants' abilities to follow outlined rules and complete multiple 'real-world' tasks in a limited time period.
Participants were provided written instructions and a map of the hospital where the assessment took place, and were instructed to complete 12 subtasks in 40 minutes while following 9 specified rules.
Participants completed this at task at baseline and following Training (Arms 1 & 2, but not 3).
Outcome measure was computed as post-training - baseline (negative value reflects less errors made post-training).
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5 weeks (After completion of Arm 1 and Arm 2)
|
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Change to Attention and Executive Functioning Composite Scores
Tidsramme: 5 weeks (After completion of Arm 1 and Arm 2)
|
Participants completed the following neuropsychological measures of attention and executive functions before and after Arms 1 and 2, but not Arm 3. Letter Number Sequencing from WIAT-III; Auditory Consonant Trigram: 9,18, 36 seconds; Digit Vigilance Test (Time and Errors); DKEFS subtests: Design Fluency, Verbal Fluency Switching, Inhibition (Time and Errors); and Inhibition/Switching (Time and Errors); and Trails B. Performance on these measures were scored based upon age, and when available, educational and repeated administration norms. Resultant scores were transformed into z-scores and aggregated to form a composite measure. Higher z-scores reflect better functioning. The unit of analysis for this outcome was the change score from baseline to post-training. Positive change scores reflect improved performance over time[post-training - baseline], whereas negative change scores reflect worsening performance over time. |
5 weeks (After completion of Arm 1 and Arm 2)
|
Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Samarbeidspartnere
Etterforskere
- Hovedetterforsker: Mark D'Esposito, MD, VA Northern California Health Care System, Mather, CA
Publikasjoner og nyttige lenker
Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.
Generelle publikasjoner
- Chen AJ, Novakovic-Agopian T, Nycum TJ, Song S, Turner GR, Hills NK, Rome S, Abrams GM, D'Esposito M. Training of goal-directed attention regulation enhances control over neural processing for individuals with brain injury. Brain. 2011 May;134(Pt 5):1541-54. doi: 10.1093/brain/awr067. Epub 2011 Apr 22.
- Novakovic-Agopian T, Chen AJ, Rome S, Abrams G, Castelli H, Rossi A, McKim R, Hills N, D'Esposito M. Rehabilitation of executive functioning with training in attention regulation applied to individually defined goals: a pilot study bridging theory, assessment, and treatment. J Head Trauma Rehabil. 2011 Sep-Oct;26(5):325-38. doi: 10.1097/HTR.0b013e3181f1ead2.
Hjelpsomme linker
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart
1. september 2009
Primær fullføring (Faktiske)
1. desember 2015
Studiet fullført (Faktiske)
1. april 2017
Datoer for studieregistrering
Først innsendt
16. desember 2009
Først innsendt som oppfylte QC-kriteriene
16. desember 2009
Først lagt ut (Anslag)
18. desember 2009
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
20. oktober 2017
Siste oppdatering sendt inn som oppfylte QC-kriteriene
18. oktober 2017
Sist bekreftet
1. oktober 2017
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- B4605-I
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