Change in Learning and Memory Partially Mediates Effects of Compensatory Cognitive Training on Self-Reported...

Area of Science:

• Neuroscience
• Cognitive Psychology
• Rehabilitation Medicine

Background:

• Mild traumatic brain injury (mTBI) frequently results in persistent cognitive deficits.
• Compensatory cognitive training (CCT) aims to improve functioning in individuals with cognitive impairments.
• Understanding the mechanisms linking CCT to symptom improvement is crucial for optimizing treatment.

Purpose of the Study:

• To investigate the relationship between CCT, objective cognitive function, and self-reported cognitive symptoms in veterans with mTBI.
• To determine if improvements in objective cognitive functioning mediate the reduction in self-reported cognitive symptoms following CCT.

Main Methods:

• A randomized controlled trial design was employed.
• Post hoc causal mediation analysis was conducted.
• Objective cognitive functioning was assessed using neuropsychological tests, including the Hopkins Verbal Learning Test-Revised (HVLT-R).
• Self-reported cognitive symptoms were measured using the Prospective-Retrospective Memory Questionnaire and the Multiple Sclerosis Neuropsychological Screening Questionnaire.

Main Results:

• Improvements in HVLT-R Delayed Recall mediated the association between CCT participation and reduced scores on the Prospective-Retrospective Memory Questionnaire.
• Enhancements in HVLT-R Total Recall and Delayed Recall mediated the link between CCT and decreased scores on the Multiple Sclerosis Neuropsychological Screening Questionnaire.
• No other objective cognitive functioning measures significantly mediated the observed symptom changes.

Conclusions:

• Patient-reported improvements in cognitive symptoms following CCT are partly explained by gains in learning and memory.
• Subjective cognitive symptom relief can occur independently of broader objective cognitive enhancements from CCT.
• These findings suggest that targeting specific cognitive domains like memory within CCT may be effective for improving perceived cognitive function in veterans with mTBI.