Improved mTBI outcomes with a BCI Amplified CRT Training: A retrospective chart review

This study is a retrospective chart review of 200 clients who participated in a non-verbal restorative Cognitive Remediation Training (rCRT) program. The program was applied to effect proper neural functional remodeling needed to support resilient, flexible and adaptable behaviors after encountering a mild to medium closed head traumatic brain injury (mTBI). The r CRT training program focused on improving functional performance in executive cognitive control networks as defined by fMRI studies. All rCRT training activities were delivered in a semi-game-like manner, incorporating a Brain Computer Interface (BCI) that provided in-the-moment neural network performance integrity metrics (nPIMs) used to adjust the level of play required to properly engage long-term potentiation (LTP) and long term depreciation (LTD) network learning rules. This study reports on t-test and Reliable Change Index (RCI) changes found within cognitive abilities performance metrics derived from the Woodcock Johnson Cognitive Abilities III Test. We compared pre and post scores from seven cognitive abilities considered dependent on executive cognitive control networks against seven non-executive control abilities. We observed significant improvements (p values 10 to 10-22) with large Cohens d effect sizes (0.78-1.20) across thirteen cognitive ability domains with a medium effect size (.49) on the remaining. The mean percent change for pooled trained domain was double that observed for pooled untrained domain, at 17.2% versus 8.3%, respectively. To further adjust for practice effects, practice effect RCI values were computed and further supported the effectiveness of the rCRT training (RCI-trained 1.4 - 4.8; untrained RCI 0.08-0.75).