Online Memory Intervention for Traumatic Brain Injury

Overseen By Julia Rybkina, BSc, BA

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Toronto Rehabilitation Institute

Disqualifiers: Neurological disorder, Neurodevelopmental disorder, Systemic comorbidities, Aphasia, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: 16 weeks

84 Participants Needed

Trial Summary

What is the purpose of this trial?

This study will examine the behavioural and neurophysiological efficacy and feasibility of an online spatial navigation intervention for improving memory and brain health in individuals who have sustained moderate-severe traumatic brain injury.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Online Memory Intervention for Traumatic Brain Injury?

Research shows that virtual reality navigation training can improve memory and navigation skills in people with brain injuries by activating brain areas involved in memory processing. Additionally, virtual reality interventions have been found to enhance neurocognitive performance in individuals with traumatic brain injury. ^{1 2 3 4 5}

Is the online memory intervention for traumatic brain injury safe for humans?

Research on virtual reality and online navigation training for brain injury suggests these interventions are generally safe, with studies showing improvements in memory and navigation skills without reporting significant safety concerns. ^{1 2 3 4 5}

How does the Online Spatial Navigation Therapy differ from other treatments for traumatic brain injury?

Online Spatial Navigation Therapy is unique because it uses virtual reality to help improve memory and navigation skills by engaging the brain areas involved in spatial learning, like the hippocampus. This approach is different from traditional therapies as it provides an interactive and immersive environment that can enhance memory function in brain-damaged individuals. ^{1 2 3 5 6}

Research Team

Robin E Green, PhD; CPsych

Principal Investigator

Toronto Rehabilitation Institute

Asaf Gilboa, PhD

Principal Investigator

Baycrest Health Sciences

Eligibility Criteria

This trial is for individuals aged 18-55 who have had a moderate to severe traumatic brain injury, confirmed by CT or MRI. Participants should be fluent in English, able to give consent (or have someone who can), and must live near Toronto for MRI access. They need basic computer skills and the ability to use at least one arm.

Inclusion Criteria

I have been diagnosed with a moderate to severe traumatic brain injury recently.

Fluency in English

I am able to understand and agree to the study, or I have someone who can legally decide for me.

Exclusion Criteria

I have been diagnosed with a neurodevelopmental disorder.

I have other health conditions like lupus or diabetes.

I had a traumatic brain injury before turning 18.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in an online spatial navigation intervention or watch educational videos for 1 hour/day, 5 days a week for 16 weeks

16 weeks

Remote sessions

Follow-up

Participants are monitored for changes in memory and brain health through cognitive tests and MRI scans

1 week

1 visit (in-person)

Treatment Details

Interventions

• Educational Videos
• Spatial Navigation Intervention

Trial Overview The study tests an online program designed to improve memory through spatial navigation exercises versus educational videos. It aims to see if this method is effective and practical for those with traumatic brain injuries.

Participant Groups

Group I: Spatial navigation intervention Experimental Treatment 1 Intervention

Group II: Educational Videos Active Control 1 Intervention

Who Is Running the Clinical Trial?

Toronto Rehabilitation Institute

Lead Sponsor

Trials

55

Recruited

6,000+

Ontario Neurotrauma Foundation

Collaborator

Trials

24

Recruited

1,100+

Centre for Aging and Brain Health Innovation

Collaborator

Trials

16

Recruited

5,200+

Findings from Research

A study involving 11 neurologic patients with spatial disorientation and 11 healthy controls showed that a VR-based passive navigation training program significantly improved route finding abilities over five training sessions.

Both neurologic patients and healthy controls demonstrated enhanced general spatial cognition after the VR training, suggesting that this method could be effective for rehabilitating spatial deficits caused by brain damage.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality in neurologic rehabilitation of spatial disorientation. Kober, SE., Wood, G., Hofer, D., et al.[2021]

A 24-year-old man with traumatic brain injury showed memory improvements after participating in a virtual navigation training program, indicating potential benefits of 3D video games in memory rehabilitation.

fMRI results revealed increased activation in the hippocampal and parahippocampal regions of the brain, suggesting that this type of training may enhance memory function by engaging key areas involved in memory processing.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual navigation for memory rehabilitation in a traumatic brain injured patient. Caglio, M., Latini-Corazzini, L., D'Agata, F., et al.[2012]

A systematic review of 13 studies involving 132 patients with traumatic brain injury (TBI) found that virtual reality (VR) interventions can significantly improve various aspects of neurocognitive performance, such as learning, memory, and attention.

While some studies showed that improvements in cognitive performance could translate to real-life activities, more research is needed to validate these findings and ensure consistent real-world application.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effectiveness of Virtual Reality Interventions for Improvement of Neurocognitive Performance After Traumatic Brain Injury: A Systematic Review. Manivannan, S., Al-Amri, M., Postans, M., et al.[2022]

A novel 16-week remotely delivered intervention targeting allocentric spatial navigation is being tested on 84 participants with moderate-severe traumatic brain injury (m-sTBI) to potentially offset hippocampal atrophy and improve cognitive functions like navigation and memory.

Participants will engage in structured exploration of cities using Google Street View, with outcomes measured through cognitive assessments and MRI scans to evaluate both behavioral and neural efficacy before and after the intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Remotely delivered environmental enrichment intervention for traumatic brain injury: Study protocol for a randomised controlled trial. Belchev, Z., Boulos, ME., Rybkina, J., et al.[2021]

A virtual reality navigation training program was found to be highly feasible for six middle-aged stroke patients, indicating that this approach can be effectively used to improve navigation skills after brain injury.

Five out of six patients were able to learn and partially apply an alternative navigation strategy, demonstrating that navigation abilities can be modified through targeted training, which opens up new possibilities for rehabilitation methods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Navigation strategy training using virtual reality in six chronic stroke patients: A novel and explorative approach to the rehabilitation of navigation impairment. Claessen, MH., van der Ham, IJ., Jagersma, E., et al.[2017]

In a study involving 24 participants (12 with traumatic brain injury and 12 matched controls), those with moderate to severe TBI exhibited significant deficits in spatial learning and memory when tested in a virtual maze environment.

The performance of TBI participants in the virtual maze correlated with their self-reported wayfinding difficulties and episodic memory scores, indicating that this virtual assessment could be a valuable tool for evaluating spatial learning deficits after TBI.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Humans with traumatic brain injuries show place-learning deficits in computer-generated virtual space. Skelton, RW., Bukach, CM., Laurance, HE., et al.[2008]

References

1. England pubmed.ncbi.nlm.nih.gov

Virtual reality in neurologic rehabilitation of spatial disorientation. [2021]

2. England pubmed.ncbi.nlm.nih.gov

Virtual navigation for memory rehabilitation in a traumatic brain injured patient. [2012]

3. United States pubmed.ncbi.nlm.nih.gov

The Effectiveness of Virtual Reality Interventions for Improvement of Neurocognitive Performance After Traumatic Brain Injury: A Systematic Review. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Remotely delivered environmental enrichment intervention for traumatic brain injury: Study protocol for a randomised controlled trial. [2021]

5. England pubmed.ncbi.nlm.nih.gov

Navigation strategy training using virtual reality in six chronic stroke patients: A novel and explorative approach to the rehabilitation of navigation impairment. [2017]

6. England pubmed.ncbi.nlm.nih.gov

Humans with traumatic brain injuries show place-learning deficits in computer-generated virtual space. [2008]