Prediction of Memory Rehabilitation Outcomes in Traumatic Brain Injury by Using Functional Magnetic Resonance Imaging

Gary E. Strangman, Therese M. O'Neil-Pirozzi, Richard Goldstein, Kalika Kelkar, Douglas I. Katz, David Burke, Scott L. Rauch, Cary R Savage, Mel B. Glenn

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Strangman GE, O'Neil-Pirozzi TM, Goldstein R, Kelkar K, Katz DI, Burke D, Rauch SL, Savage CR, Glenn MB. Prediction of memory rehabilitation outcomes in traumatic brain injury by using functional magnetic resonance imaging. Objective: To evaluate the ability of functional magnetic resonance imaging (fMRI) measures collected from people with traumatic brain injury (TBI) to provide predictive value for rehabilitation outcomes over and above standard predictors. Design: Prospective study. Setting: Academic medical center. Participants: Persons (N=54) with TBI greater than 1 year postinjury. Intervention: A novel 12-session group rehabilitation program focusing on internal strategies to improve memory. Main Outcome Measure: The Hopkins Verbal Learning Test-Revised (HVLT-R) delayed recall score. Results: fMRI measures were collected while participants performed a strategically directed word memorization task. Prediction models were multiple linear regressions with the following primary predictors of outcome: age, education, injury severity, preintervention HVLT-R, and task-related fMRI activation of the left dorsolateral and left ventrolateral prefrontal cortex (VLPFC). Baseline HVLT-R was a significant predictor of outcome (P=.007), as was injury severity (for severe vs mild, P=.049). We also found a significant quadratic (inverted-U) effect of fMRI in the VLPFC (P=.007). Conclusions: This study supports previous evidence that left prefrontal activity is related to strategic verbal learning, and the magnitude of this activation predicted success in response to cognitive memory rehabilitation strategies. Extreme under- or overactivation of VLPFC was associated with less successful learning after rehabilitation. Further study is necessary to clarify this relationship and to expand and optimize the possible uses of functional imaging to guide rehabilitation therapies.

Original languageEnglish (US)
Pages (from-to)974-981
Number of pages8
JournalArchives of Physical Medicine and Rehabilitation
Volume89
Issue number5
DOIs
StatePublished - May 1 2008

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Verbal Learning
Magnetic Resonance Imaging
Rehabilitation
Prefrontal Cortex
Aptitude
Wounds and Injuries
Linear Models
Outcome Assessment (Health Care)
Traumatic Brain Injury
Learning
Prospective Studies
Education
Therapeutics

Keywords

  • Magnetic resonance imaging
  • Rehabilitation

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

Prediction of Memory Rehabilitation Outcomes in Traumatic Brain Injury by Using Functional Magnetic Resonance Imaging. / Strangman, Gary E.; O'Neil-Pirozzi, Therese M.; Goldstein, Richard; Kelkar, Kalika; Katz, Douglas I.; Burke, David; Rauch, Scott L.; Savage, Cary R; Glenn, Mel B.

In: Archives of Physical Medicine and Rehabilitation, Vol. 89, No. 5, 01.05.2008, p. 974-981.

Research output: Contribution to journalArticle

Strangman, Gary E. ; O'Neil-Pirozzi, Therese M. ; Goldstein, Richard ; Kelkar, Kalika ; Katz, Douglas I. ; Burke, David ; Rauch, Scott L. ; Savage, Cary R ; Glenn, Mel B. / Prediction of Memory Rehabilitation Outcomes in Traumatic Brain Injury by Using Functional Magnetic Resonance Imaging. In: Archives of Physical Medicine and Rehabilitation. 2008 ; Vol. 89, No. 5. pp. 974-981.
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