Table of content
Task 1 – Is It All About the Brain? (page 1)
Task 2 – The Memory Palace (page 13)
Task 3 – Slow Down (page 25)
Task 4 – Just A Young Gun With A Quick Fuse (page 38)
Task 5 – It’s All Between the Ears (page 47)
Task 6 – I Fell in Love with Someone Else (page 59)
Task 7 – Promises for the Future? (page 67)
, [ Task 1 – Is It All About the Brain? ]
(1) HAN: NEUROPLASTICITY OF COGNITIVE CONTROL NETWORKS FOLLOWING
COGNITIVE TRAINING FOR CHRONIC TRAUMATIC BRAIN INJURY
ABSTRACT
Cognitive control => the ability to coordinate thoughts and actions to achieve goals.
This study identified neural plasticity induced by cognitive control training for TBI using resting
state functional connectivity (rsFC).
INTRODUCTION
A TBI incident can be the beginning of a chronic disease process rather than an isolated event.
o Such as cognitive impairments, psychiatric disorders, reduced social functioning, etc.
A lot of people are facing challenges of TBI-related disability.
o The actual number may be greater than the estimates given the lack of public awareness
of TBI and the limited sensitivity of conventional neuropsychological measures.
o Conventional clinical imaging (CT scanning) may be insensitive to identifying brain
abnormalities especially in individuals with mild TBI.
Resting state functional connectivity (rsFC) is a technique measuring the BOLD signal from
anatomically separated brain regions acquired at rest.
o RsFC studies are increasingly popular because they do not require that subjects perform
a specific task.
o Well-positioned to identify both the patterns of injury and the associations between
injury and behavioural impairments in TBI.
o Also measures neuroplasticity within the injured brain.
Diffuse axonal injury (DAI) is one of the primary mechanisms of TBI.
o DAI induces multi-focal injuries to axons which provide the structural basis of spatially
distributed brain networks.
o Thus, DAI leads to a breakdown of brain network connectivity.
Strategy-based cognitive training for chronic TBI => integrative program to improve cognitive
control by exerting more efficient thinking strategies for selective attention and abstract
reasoning.
There are two distinct resting-state networks related to cognitive control:
o The cingulo-opercular network => support stable maintenance of task mode and
strategy during cognitive processes. Also called the salience network (=maintaining).
o Frontoparietal network => supports active, adaptive online control during cognitive
control processes. Also called the central executive network (behouden).
Specifically, TBI decreases the white matter integrity of the cingulo-opercular network and
functional connectivity between the cingulo-opercular and default networks during a cognitive
control task. Additionally, individuals with mild TBI showed increases and decreases in rsFC with
the cingulo-opercular and frontoparietal networks across brain regions, relative to healthy
individuals.
1
,MATERIALS & METHODS
This study utilized rsfMRI to identify the effects of a strategy-based cognitive training for chronic
TBI on the cognitive control networks (i.e., cingulo-opercular and fronto-parietal networks)
compared to a knowledge-based comparison condition.
o They focused on the cingulo-opercular and fronto-parietal networks as our training
protocols were aimed at improving cognitive control processes.
All participants were randomly assigned to one of the two training groups
o A strategy-based reasoning training called Strategic Memory Advanced Reasoning
Training (SMART) group.
o The knowledge-based training called Brain Health Workshop (BHW) group. The BHW
group served as an active control condition.
RESULTS
There were changes in the cingulo-opercular and fronto-parietal networks connectivity of
individuals with chronic mild TBI following strategy-based cognitive training.
The current study provided evidence for brain responses to cognitive training for chronic TBI.
Brain regions compromising of the cingulo-opercular and fronto-parietal networks in this study
were obtained from the patterns of sustained brain activity and start-cue related activity during
variety of cognitive control fMRI tasks in healthy individuals, respectively.
o RsFC revealed that these brain regions were functionally connected.
During cognitive control processes, the cingulo-opercular network is thought to be associated
with the ability to maintain relevant goals, and the fronto-parietal network is thought to be
associated with the ability to adjust goals.
o Abnormality in the cingulo-opercular and fronto-parietal networks explains deficits to
higher order cognitive functions in various clinical populations.
The findings on increased cingulo-opercular and fronto-parietal networks connectivity after
cognitive training for TBI highlight that previously impaired cognitive control networks (i.e.
cingulo-opercular and fronto-parietal) by a TBI can be influenced by training-related
neuroplasticity.
The findings demonstrate the sensitivity and specificity of rsFC in assessing neuroplasticity
following cognitive training for chronic TBI. Something that was harder to capture with
conventional neuropsychological assessment.
There were statistically significant increases in rsFC following the SMART program and these
changes occurred primarily within the SMART group relative to the comparison BHW
intervention.
From the perspective of large-scale resting-state networks, connectivity changes after SMART
primarily occurred at the level of between-network connectivity.
o Specifically, based on the Yeo atlas, changes in the cingulo-opercular network primarily
occurred between connectivity with the default mode network (Fig. 7).
o Similarly, changes in the fronto-parietal network connectivity primarily occurred in
association with the visual, somatomotor, and default mode networks (Fig. 7).
o Interactions between brain networks are critical for successful cognitive control
processes due to the diverse nature of control processes drawing from neural resources
across the brain.
o See figure 7 on the next page.
2
, Network analyses of brain imaging data demonstrated that activity in brain regions of between-
module connections increased when more cognitive components were engaged in a task.
o This indicates the importance of between network connectivity for assessing “higher-
order” cognitive function.
o Individuals with TBI often show deficits in ‘higher order’ cognitive functions that require
the integration of information across the brain.
o TBI also disrupts between-network connectivity, yielding reduced efficiency of
information processing.
Taken together, increased between-network connectivity with the cingulo-opercular and
fronto-parietal networks following SMART for TBI may indicate improved integration of
information processing for higher-level cognitive functions.
Regarding brain-behaviour relationships, associations between the trail-making test scores and
cognitive control networks occurred within the regions of the default mode network. Trail-
making involves a combination of working memory, task-switching and visuoperceptual abilities,
indicating that cognitive control is an essential construct involved in successfully coordinating
abilities to achieve better performance.
o THUS => it was not surprising to observe correlations between the trail-making scores
and fronto-parietal network connectivity within the SMART group.
Recent studies have demonstrated that interactions between the fronto-parietal and default
mode network activity support goal-directed cognition and individuals with greater cooperation
between the fronto-parietal and default mode networks showed faster reaction times during a
goal-directed re-collection task.
3
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