Article

Traumatic brain injury (TBI) commonly results in residual memory difficulties.
Such deficits are amenable to cognitive rehabilitation, but optimal selection of
rehabilitation interventions remains a challenge. We hypothesized that diffusion
tensor imaging (DTI) could be used to predict which individuals were likely to
benefit from a specific memory rehabilitation intervention. Thirty-seven
individuals with TBI, of all severities, first underwent DTI scanning, along with
18 matched controls. Participants with TBI then attended a 12-session memory
intervention emphasizing internal memory strategies (I-MEMS). Primary outcome
measures (HVLT, RBMT) were collected at the time of DTI scanning, and both
immediately and one month post-therapy. In contrast to typical neuroimaging
analysis, fractional anisotropy (FA) was used to predict long-term outcome
scores, adjusting for typical predictors (injury severity, age, education, time
since injury, pretest score). FA of the parahippocampal white matter was a
significant negative predictor of HVLT, while the anterior corpus callosum, left
anterior internal capsule, and right anterior corona radiata were negative
predictors of RBMT outcome. The importance of these predictors rivaled those of
pretest scores. Thus, FA measures may provide substantial predictive value for
other cognitive interventions as well. The reason why higher FA was associated
with less successful response to cognitive intervention remains unclear and will
require further study.

Langue : ANGLAIS