Related Experiment Video
Updated: Sep 4, 2025
Randomized, Triple-Blind, and Parallel-Controlled Trial of Transcranial Direct Current Stimulation for Cognitive Rehabilitation after Stroke
Published on: June 6, 2025
Research Letter: Long-Term Outcomes Following Cognitive Rehabilitation for Mild Traumatic Brain Injury: A 5-Year
Jan E Kennedy1, Douglas B Cooper, Glenn Curtiss
1Traumatic Brain Injury Center of Excellence (TBICOE), Neurology Service, Department of Medicine, Brooke Army Medical Center, Joint Base San Antonio, San Antonio, Texas (Dr Kennedy and Ms Shelton); Polytrauma Rehabilitation Center, Audie Murphy Veterans Hospital, and Departments of Psychiatry and Rehabilitation Medicine, UT Health San Antonio, San Antonio, Texas (Dr Cooper); Department of Psychology, University of South Florida, Tampa (Dr Curtiss); Brain Injury Rehabilitation Service, Department of Rehabilitation, Brooke Army Medical Center, Joint Base San Antonio, San Antonio, Texas (Dr Bowles); Department of Neurology, University of Utah School of Medicine, Salt Lake City (Dr Tate); Physical Medicine and Rehabilitation, VA Greater Los Angeles Healthcare System, Los Angeles, California (Dr Eapen); and Department of Psychiatry and Neurosciences, College of Medicine, University of South Florida, Tampa (Dr Vanderploeg).
Objective:
To examine the functioning of military service members 5 years after completing a randomized controlled trial (RCT) of cognitive rehabilitation for mild traumatic brain injury (mTBI).
Setting:
Home-based telephonic interview and internet-based self-ratings.
Participants:
Sixty-nine of the 126 (55%) active-duty service members who were enrolled in a 4-arm RCT of cognitive rehabilitation 3 to 24 months after mTBI and were successfully contacted by phone 5 years later. Original and 5-year follow-up participants in each of 4 RCT treatment arms included: psychoeducation ( n = 32 original, n = 17 follow-up), computer ( n = 30 original, n = 11 follow-up), therapist-directed ( n = 30 original, n = 23 follow-up), integrated ( n = 34 original, n = 18 follow-up).
Design:
Inception cohort evaluated 5 years after completion of an RCT of cognitive rehabilitation.
Main Measures:
Postconcussion symptoms (Neurobehavioral Symptom Inventory total score), psychological distress (Symptom Checklist-90-revised Global Severity Index score), and functional cognitive/behavioral symptoms (Key Behaviors Change Inventory total average score).
Results:
Participants' postconcussive symptoms and psychological distress improved at the 5-year follow-up. Functional cognitive/behavioral symptoms were not significantly improved, but therapeutic gains were maintained across time, to 5 years after completing the RCT.
Conclusion:
In this sample of military personnel, postconcussive symptoms and psychological distress significantly improved from posttreatment to 5 years after cognitive rehabilitation, regardless of treatment arm. Functional cognitive/behavioral symptoms significantly improved with treatment while treatment gains were maintained at the 5-year follow-up. Replication of these results with a larger sample and interim data between 18 weeks and 5 years post-treatment is needed.
