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Individual Differences in Working Memory Capacity Predicts Responsiveness to Memory Rehabilitation After Traumatic Brain Injury

  • Joshua Sandry
    Correspondence
    Corresponding author Joshua Sandry, PhD, Psychology Dept, Montclair State University, 1 Normal Ave, Montclair, NJ 07043.
    Affiliations
    Psychology Department, Montclair State University, Montclair, NJ

    Neuropsychology and Neuroscience Research, Kessler Foundation, West Orange, NJ

    Department of Physical Medicine and Rehabilitation, Rutgers–New Jersey Medical School, Newark, NJ
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  • Kathy S. Chiou
    Affiliations
    Department of Physical Medicine and Rehabilitation, Rutgers–New Jersey Medical School, Newark, NJ

    Traumatic Brain Injury Research, Kessler Foundation, West Orange, NJ
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  • John DeLuca
    Affiliations
    Neuropsychology and Neuroscience Research, Kessler Foundation, West Orange, NJ

    Department of Physical Medicine and Rehabilitation, Rutgers–New Jersey Medical School, Newark, NJ

    Department of Neurology and Neurosciences, Rutgers–New Jersey Medical School, Newark, NJ
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  • Nancy D. Chiaravalloti
    Affiliations
    Neuropsychology and Neuroscience Research, Kessler Foundation, West Orange, NJ

    Department of Physical Medicine and Rehabilitation, Rutgers–New Jersey Medical School, Newark, NJ

    Traumatic Brain Injury Research, Kessler Foundation, West Orange, NJ
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Published:November 30, 2015DOI:https://doi.org/10.1016/j.apmr.2015.10.109

      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)
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      References

        • Chiaravalloti N.
        • Sandry J.
        • Moore N.
        • DeLuca J.
        An RCT to treat learning impairment in traumatic brain injury: the TBI-MEM trial.
        Neurorehabil Neural Repair. 2015 Sep 10; ([Epub ahead of print])
        • Barrett L.F.
        • Tugade M.M.
        • Engle R.W.
        Individual differences in working memory capacity and dual-process theories of the mind.
        Psychol Bull. 2004; 130: 553
        • Sandry J.
        Working memory and memory loss in neurodegenerative disease.
        Neurodegener Dis Manag. 2015; 5: 1-4
        • Chiou K.S.
        • Sandry J.
        • Chiaravalloti N.
        Cognitive contributions to differences in learning after moderate to severe traumatic brain injury.
        J Clin Exp Neuropsychol. 2015; 37: 1074-1085
        • Sandry J.
        • DeLuca J.
        • Chiaravalloti N.
        Working memory capacity links cognitive reserve with long-term memory in moderate to severe TBI: a translational approach.
        J Neurol. 2015; 262: 59-64
        • Sandry J.
        • Sumowski J.F.
        Working memory mediates the relationship between intellectual enrichment and long-term memory in multiple sclerosis: an exploratory analysis of cognitive reserve.
        J Int Neuropsychol Soc. 2014; 20: 868-872
        • Constantinidou F.
        • Zaganas I.
        • Papastefanakis E.
        • Kasselimis D.
        • Nidos A.
        • Simos P.G.
        Age-related decline in verbal learning is moderated by demographic factors, working memory capacity, and presence of amnestic mild cognitive impairment.
        J Int Neuropsychol Soc. 2014; 20: 822-835
        • Cowan N.
        • Beschin N.
        • Della Sala S.
        Verbal recall in amnesiacs under conditions of diminished retroactive interference.
        Brain. 2004; 127: 825-834
        • Schelble J.L.
        • Therriault D.J.
        • Miller M.D.
        Classifying retrieval strategies as a function of working memory.
        Mem Cognit. 2012; 40: 218-230

      Supplemental Appendix S1 List of References of Neuropsychological Measures Used

        • Delis D.C.
        • Kramer J.H.
        • Kaplan E.
        • Ober B.A.
        California verbal learning test–2nd ed.
        Psychological Corporation, San Antonio2000
        • Wechsler D.
        Wechsler adult intelligence scale–3rd ed.
        Psychological Corporation, San Antonio1997