Development of a remotely delivered learning and memory intervention and province-wide delivery infrastructure
Principal Investigator: Dr. Robin Green
More than 1% of the Canadian population suffers persisting disability from traumatic brain injury (TBI). Memory impairment is one the most common and debilitating causes, implicated in failed return to work and school, and in compromised personal relationships. The primary research aim is to test the effectiveness of a novel, online visuospatial learning and memory intervention for patients with moderate-severe TBI, one that can be delivered to patients in their own homes and requires minimal supervision. The computer-based protocol is designed to enhance learning and memory capacity and to improve the structure and function of the “hippocampi” (the brain’s memory structures), which has shown to be vulnerable to atrophy in the later stages of injury. Most rehabilitation is delivered in the early weeks and months of injury. This intervention was developed for patients in the chronic stages of injury, to help to fill an enormous clinical care gap at a stage when patients are particularly vulnerable.
The 16-week intervention involves navigating through different cities weekly, using Google Streetview. The protocol harnesses two lines of research associated with hippocampal benefits: “allocentric spatial navigation” (navigating from a bird’s eye view), and environmental enrichment – continuously novel, complex, engaging, intensive and challenging cognitive stimulation. To assess the treatment impact, researchers will undertake memory and neuroimaging assessments before and after treatment, comparing TBI patients in the treatment group to those in the control group.
The secondary aim of the research, in collaboration with the March of Dimes, is to begin to develop infrastructure in northern Ontario to facilitate the ongoing delivery of self-administered interventions. This arm of the study will examine the feasibility and efficacy of the intervention for patients living in areas remote from treatment centres. An estimated 140,000 Ontarians currently live with the enduring effects of TBI. Developing remotely deliverable, self-administered treatments is critical to the scaling of treatment to address these numbers, and to reach those for whom geographical barriers can preclude access to treatment.