Highlights
- •Memory impairment is common after traumatic brain injury.
- •The success of cognitive rehabilitation is mixed.
- •Participants with high working memory capacity showed a greater benefit from rehabilitation.
Abstract
Objective
To explore how individual differences affect rehabilitation outcomes by specifically
investigating whether working memory capacity (WMC) can be used as a cognitive marker
to identify who will and will not improve from memory rehabilitation.
Design
Post hoc analysis of a randomized controlled clinical trial designed to treat learning
and memory impairment after traumatic brain injury (TBI): 2 × 2 between-subjects quasiexperimental
design (2 [group: treatment vs control] × 2 [WMC: high vs low]).
Setting
Nonprofit medical rehabilitation research center.
Participants
Participants (N=65) with moderate to severe TBI with pre- and posttreatment data.
Interventions
The treatment group completed 10 cognitive rehabilitation sessions in which subjects
were taught a memory strategy focusing on learning to use context and imagery to remember
information. The placebo control group engaged in active therapy sessions that did
not involve learning the memory strategy.
Main Outcome Measure
Long-term memory percent retention change scores for an unorganized list of words
from the California Verbal Learning Test-II.
Results
Group and WMC interacted (P=.008, ηp2=.12). High WMC participants showed a benefit from treatment compared with low WMC
participants. Individual differences in WMC accounted for 45% of the variance in whether
participants with TBI in the treatment group benefited from applying the compensatory
treatment strategy to learn unorganized information.
Conclusions
Individuals with higher WMC showed a significantly greater rehabilitation benefit
when applying the compensatory strategy to learn unorganized information. WMC is a
useful cognitive marker for identifying participants with TBI who respond to memory
rehabilitation with the modified Story Memory Technique.
Keywords
List of abbreviations:
H-WMC (high working memory capacity individual), LTMPRΔ (long-term memory percent retained change scores), L-WMC (low working memory capacity individual), mSMT (modified Story Memory Technique), TBI (traumatic brain injury), WMC (working memory capacity)To read this article in full you will need to make a payment
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References
- An RCT to treat learning impairment in traumatic brain injury: the TBI-MEM trial.Neurorehabil Neural Repair. 2015 Sep 10; ([Epub ahead of print])
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Supplemental Appendix S1 List of References of Neuropsychological Measures Used
- California verbal learning test–2nd ed.Psychological Corporation, San Antonio2000
- Wechsler adult intelligence scale–3rd ed.Psychological Corporation, San Antonio1997
Article Info
Publication History
Published online: November 30, 2015
Footnotes
Supported by the National Institute on Disability and Rehabilitation Research (grant nos. H133A070037 , H133A120030 ). However, these contents do not necessarily represent the policy of the Department of Education, and endorsement by the Federal Government should not be assumed.
Disclosures: J.D. has served as a consultant for Biogen and Novartis Pharmaceuticals. He also is a journal club speaker for EMD Serono. The other authors have nothing to disclose.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
