Integrated PRocEsses and StrategieS Training (I-PRESS Training)
Research type
Research Study
Full title
Development and evaluation of a novel treatment intervention for people with acquired brain injury
IRAS ID
261172
Contact name
Jonathan J. Evans
Contact email
Sponsor organisation
NHS Greater Glasgow & Clyde
Duration of Study in the UK
1 years, 8 months, 31 days
Research summary
Summary of Research
Injury to the brain from stroke, head injury, tumour, and other forms of acquired brain injury (ABI) frequently results in difficulties in mental (cognitive) functions such as memory, concentration, planning, and problem solving. These impairments cause difficulties managing everyday tasks, particularly when they involve multiple steps that must be coordinated over time (such as cooking a meal). People often neglect key steps in a task, failing to move from one step to another at the correct time. These problems reduce the ability of people with ABI to be independent in activities of daily living, and to return to work.There is some evidence that interventions that involve teaching people mental strategies to improve their ability to remember the steps in a task, and to stay ‘on task’, can improve performance on complex everyday tasks. One example of such a technique is Goal Management Training (GMT). Such evidence is limited, however, and the extent of improvement is relatively modest. Another approach to treating cognitive impairments is to exercise the cognitive processes involved, often using computerised training programmes. Evidence for the effectiveness of computerised cognitive training is also relatively limited, particularly in people with ABI. One of the most promising strands of research into cognitive training has focused on training programmes that adapt to the performance of the person being trained, such that the training demands become gradually greater as progress is made. Programmes like this have mainly focused on training working memory, which is the ability to hold and manipulate information in mind. Working memory is critical to functions such as planning and problem solving. We believe that combining GMT and adaptive working memory updating (WMU) training may substantially improve the benefit that could be gained from either in isolation. In this project we will develop a novel, combined GMT and WMU training programme and examine its impact on behavioural tasks and also on brain function using functional magnetic resonance imaging (fMRI). Our aim is to use findings from cognitive neuroscience to inform clinical interventions for people with ABI.
Summary of Results
The study examined the feasibility of delivering a cognitive intervention online and investigated the neural activity taking place whilst performing memory tasks using functional Magnetic Resonance Imaging methods. The intervention involved a combined goal management strategy training and a computerised working memory training targeting adults with acquired brain injury (ABI) experiencing planning, problem solving difficulties in their daily life. The aim was to investigate the feasibility of delivering the intervention remotely and to test the functional Magnetic Resonance Imaging protocol on individuals with acquired brain injury.Fourteen participants were recruited from NHS Lanarkshire and NHS Greater Glasgow and Clyde, with twelve of them entering the intervention stage of the study. Participants attended eight group sessions of the goal management training (GMT) which took place remotely on Microsoft teams and completed eight training sessions of the working memory training program on their personal device at their own time at home. Participants engaged well with the online group sessions despite the remote delivery; they attended most of the group sessions, they were keen to share their own experiences in the group, demonstrated good effort to complete the assignments both during and between sessions and everyone enjoyed the opportunity to meet others with a brain injury. Delivery of the computerised working memory training proved more challenging than anticipated; most participants however were able to complete the training successfully.
The functional Magnetic Resonance Imaging protocol involved performing three different types of memory tasks inside the scanner and was tested on seven participants. All participants were able to complete all tasks and remained in the scanner for the total session duration. Participants performed well above chance on the memory tasks whilst brain activations were in line with previous research.
Overall, the small pilot exhibited positive results evidenced by group attendance and participation as well as participants’ positive feedback together with the tolerability of the functional magnetic imaging protocol.
REC name
South East Scotland REC 01
REC reference
19/SS/0112
Date of REC Opinion
13 Nov 2019
REC opinion
Further Information Favourable Opinion