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New Kessler Foundation study shows brain activity changes after cognitive rehabilitation for TBI

WEST ORANGE, NJ July 8, 2015. Kessler Foundation researchers published results of their TBI-MEM trial, the first study to demonstrate significant changes in cerebral activation after memory retraining in individuals with traumatic brain injury (TBI). The article, “Examining the efficacy of the modified Story Memory Technique (mSMT) in persons with TBI using functional magnetic resonance imaging (fMRI): The TBI-MEM Trial” was published on July 8 by the Journal of Head Trauma Rehabilitation. The authors are Nancy Chiaravalloti, PhD, Ekaterina Dobryakova, PhD, Glenn Wylie, DPhil, and John DeLuca, PhD, of Kessler Foundation.  

Eighteen participants with moderate to severe TBI were assigned to either the treatment (n=9) or placebo group (n=9).  All underwent neuropsychological assessment, cognitive ability assessment and functional magnetic resonance imaging (fMRI) during a learning task before and after treatment. The treatment group was administered the modified Story Memory Technique (mSMT), a 10-session memory retraining protocol based on visualization and context; the placebo group underwent memory exercises without visualization or context training. fMRI findings showed a pattern of changes in cerebral activation in the mSMT treatment group. This is consistent with the researchers’ findings in a prior study of mSMT in patients with MS, which provided the first Class I evidence for the efficacy of cognitive rehabilitation in MS. (Chiaravalloti N, et al: An RCT to treat learning impairment in MS. Neurology 2013(81) doi: 10.1212/01.wnl.0000437295.97946.a8S.)

"This is the second study we have conducted that shows significant changes in activation patterns on neuroimaging after behavioral memory intervention,” said Nancy Chiaravalloti, PhD, director of Neuroscience & Neuropsychology and Traumatic Brain Injury (TBI) Research at Kessler Foundation. “These changes likely reflect increased brain efficiency and decreased task difficulty after training with mSMT. Memory deficits are a major cause of disability after TBI. Identifying effective cognitive interventions is critical to improving quality of life in this population.”

The mSMT protocol has been translated into Spanish and is being used in the U.S., Mexico, and Argentina. A Chinese translation has also been completed for use in upcoming studies.

The study was funded by the National Institute on Disability, Independent Living & Rehabilitation Research (H133A070037 and H133G090078), and Kessler Foundation.

About MS Research at Kessler Foundation

Kessler Foundation's cognitive rehabilitation research in MS is funded by grants from the National Institutes of Health, National MS Society, NJ Commission of Brain Injury Research, Consortium of MS Centers, the Patterson Trust, Biogen Idec, Hearst Foundations, International Progressive MS Alliance, the ARSEP Foundation, and Kessler Foundation. Under the leadership of John DeLuca, PhD, senior VP of Research & Training, and Nancy Chiaravalloti, PhD, director of Neuropsychology & Neuroscience and TBI Research, scientists have made important contributions to the knowledge of cognitive decline in MS. Clinical studies span new learning, memory, executive function, attention and processing speed, emotional processing and cognitive fatigue. Research tools include innovative applications of neuroimaging, handheld devices, and virtual reality. Among recent findings are the benefits of cognitive reserve and aerobic exercise; correlation between cognitive performance and outdoor temperatures; efficacy of short-term cognitive rehabilitation using modified story technique; and the correlation between memory improvement and cerebral activation on fMRI. Foundation research scientists have faculty appointments at Rutgers New Jersey Medical School.

About Kessler Foundation

Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. For more information, visit

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