Brain Recovery Through Cognitive Training Shows Promise

This story originally appeared on KERA Breakthroughs. 

In 2007, Mike Rials was a Marine serving his third combat tour in Afghanistan. He says he’d already suffered multiple blast injuries, but the last one was the worst.

That’s when his vehicle hit a landmine.

“When I came to there was fire all around,” he says. “I was the last one out, tried to pull [my friend Travis] out and he died on the helicopter.”

Rials was diagnosed with a traumatic brain injury, or TBI and returned to Texas. He was sensitive to loud, constant noises and bright lights. His thoughts were all over the place, disjointed, and heavy.

While studying at the University of Texas at Dallas, he signed up for a study with the Center for Brain Health. There, he learned it might be possible to train his mind like he had trained his body.

The Bad Reputation Of Brain Injuries

The conventional wisdom about brain injury, says Sandra Chapman, is that it is permanent.

“That is indeed false,” says Chapman, founder and director of the Center for Brain Health. She led a randomized trial funded in part by the Department of Defense published online in the journal Neurpsychological Rehabilitation showing the brain is capable of repair years after an injury.

One in 21 people will have a brain injury in their life, Chapman says. And many are told there’s only a small window of time to fix any damage. Insurance commonly covers just three months of rehab.

“So we’ve been stuck in this myth,” she says.

“We enrolled 60 individuals and they were either in this strategy-based cognitive training — to teach people how to abstract and innovate —  versus a very active control where people learned facts about the brain.”

After twelve sessions of an hour-and-a -half each, testing and brain imaging showed the group who received the strategic training improved in problem solving, abstraction, memory and psychological health.

“Sixty percent reduction in depressive symptoms and 40 percent stress reduction related to post traumatic stress disorder,” she says.

[Read KERA’s Battlefield Breakthroughs ‘The Brain Injury Link From Fallujah To Friday Night Lights‘]

People with a brain injury, Chapman says, can have a difficult time blocking information coming in. For Mike Rials, learning strategies to filter and process information helped him feel less overwhelmed and organize his thoughts.

“So really this idea of synthesizing, knowing what I want the audience to hear, knowing what I want them to take away so my message is clear,” Rials says.

Who Will Training Help? 

Traumatic brain injuries, whether the result of a fall or a car crash, used to be seen as a death sentence. As such, Dr. Geoffrey Manley says, they didn’t get treated.

“It’s’ really been as much of a cultural phenomenon as much as a scientific issue,” Manley, chief of neurosurgery at San Francisco General Hospital and professor of neurosurgery at the University of California-San Francisco, says.

“Now that we’re actually starting to try to treat this I think we’re all somewhat surprised at the level of recovery that some of these patients can achieve.”

Even if insurance did cover more than a few months of therapy, brain training isn’t going to work for everyone.

Manley says right now, we’re developing broad treatment approaches for what are really many different diseases. Like creating a single cancer pill and administering it to people with leukemia, melanoma and brain tumors.

“We’re not very precise right now when we call traumatic brain injury mild, moderate or severe concussion,” Manley says. “We believe there are subsets of patients that do indeed benefit from the sort of treatment that has been highlighted in this article and I think what we have to do is embrace the complexity that and realize there’s going to be subsets of patients that will benefit from this and there’s probably patients that won’t benefit from this.”

Since it’s too soon to know exactly who brain rehab will help, the Center for Brain Health in Dallas is aiming to bring its training program to everyone. Next year the Center will break ground on a new building called the Brain Performance Institute. And veteran Mike Rials will be there, sharing what he’s learned as Head of Training.