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By On June 1st, 2018

Cognitive training is linked to reduced depression and better brain health after TBI

Cognitive training is able to not only reduce depression levels after a traumatic brain injury (TBI), but can even improve overall brain health according to new findings published in the journal Human Brain Mapping.

The new findings found that after undergoing cognitive training, patients with TBI reported significant reductions in the severity of depressive symptoms, increased ability to manage emotions, improvements in cortical thickness, and recovery from abnormal neural network connectivity.

“To our knowledge, this is the first study to report brain change associated with reduced depression symptoms after cognitive training,” said lead author Dr. Kihwan Han, a research scientist at the Center for BrainHealth at the University of Texas at Dallas. Han works in the lab of Dr. Daniel Krawczyk.

“Overall, these findings suggest that cognitive training can reduce depressive symptoms in patients with traumatic brain injury even when the training does not directly target psychiatric symptoms.”

Past studies using cognitive training have found similar changes in cortical thickness and neural network connectivity.

For the study, the researchers recruited 79 participants with chronic TBI who were at least six months post-injury. These participants were randomly assigned into one of two groups. The first received strategy-based training, which used the Strategic Memory Advanced Reasoning Training (SMART) program. The second received information-based training, which used the Brain Health Workshop program.

The researchers also used the Beck Depressive Inventory to evaluate the participants, which helped diagnose 53 of them with depression.

The participants’ depressive-symptom severity, psychological functioning scores, and data from magnetic resonance imaging (MRI) brain scans were collected at three points in the study – before training, after training, and three months post-training. The scans allowed the researchers to observe changes in both the brain structure and neural network connectivity.

Both treatment strategies involved 12 90-minute sessions over eight weeks. These sessions included quizzes, homework assignments, and small group projects involving social interaction.

All 53 of the individuals diagnosed with depression showed significantly lower depressive symptoms associated with improvements in cognitive and daily life functioning.

According to Han, the social interaction, cognitive stimulation from new learning opportunities, and the hope of improvement provided by these programs may all contribute to the improved depression symptoms.

Based on the brain changes found in the scans, Han says improvements in emotional regulation may also be linked to the reduced depressive symptoms. He also noted that, over time, the improvements in depression were shown to correlate with greater cortical thickness in the prefrontal cortex – a region of the brain associated with emotional control – as well as reductions in abnormally high neural connectivity within this region of the brain.

“Identifying what changes are happening in the brain when interventions successfully reduce depressive symptoms could allow us to create more effective, pharmaceutical-free approaches to help alleviate depression in people who experience chronic traumatic brain injury symptoms,” said study author Dr. Sandra Bond Chapman, founder and chief director of the Center for BrainHealth, and Dee Wyly Distinguished University Professor.

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