Retraining Dorsal Visual Pathways Improves Cognitive Skills After a Mild Traumatic Brain Injury.

Background and

Objectives

Currently, there are no proven solutions to remediate cognitive deficits in people with a mild traumatic brain injury (mTBI). One common issue is visual timing deficits, which may be due to processing deficits in dorsal visual pathways.

Methods

This study investigates whether a new intervention (PATH) aimed at improving these visual timing deficits is more effective than conventional cognitive therapies that either remediate: (1) pattern discrimination deficits (ventral visual pathway): Orientation Discrimination (OD), or (2) working memory deficits using ReCollect task, for 10 subjects between the ages of 26-60 years old. This study tests the ability of three different cognitive therapies to improve the primary outcome: visual working memory (VWM), and secondary outcomes: processing speed, auditory working memory, and selective attention in mTBI subjects based on neuropsychological tests administered before and after 36 30-min training sessions Monday, Wednesday and Friday mornings.

Results

On average, the PATH group exhibited a 35% improvement in VWM, compared to 15% for ReCollect and 5% for OD. A repeated-measures ANOVA found that improving dorsal stream function improved VWM significantly more than found after the other two interventions. The results reveal the importance of strengthening dorsal pathways more than conventional cognitive therapies to improve cognitive skills after mTBI. A biomarker, MagnetoEncephaloGraphy (MEG) brain recordings, using an N-Back task for subjects in treatment groups, verified these improvements as well.

Conclusions

The data from this preliminary study are very promising for a new method improving the brain's timing, more effective than conventional therapies, to improve cognitive deficits in mTBI patients.