As brain injury often involves frontal systems, cognitive domains commonly affected include: attention, executive control, working memory, and problem solving. Our research focuses on cognitive impairment resulting from ABI. ABI may be associated not only with physical but also with cognitive, emotional and behavioural impairments.
a penetrating head injury due to an accident) or a non-traumatic injury (e.g., stroke, brain tumours, ischemia). Īcquired Brain Injury (ABI) is brain damage caused by either a traumatic (e.g. Working memory is known to decline with aging and is frequently compromised following brain injury. Impaired working memory may consequently have a significant impact on quality of life and ability to participate in social roles, with potential for negative effects on mood and emotional wellbeing. Working memory is important for everyday tasks such as problem solving, reasoning, and learning a deficit in working memory can lead to difficulties with many everyday activities that are necessary for work, study and general functioning. A network involving the dorsolateral prefrontal cortex (DLPFC) plays a fundamental role in supporting working memory, with spatial tasks primarily involving the right DLPFC and verbal task involving the left DLPFC. A core concept of Baddeley’s model of working memory is that it consists of multiple components: namely, a phonological loop governing for temporary maintenance and processing of verbal information, a visuospatial sketchpad to maintain and process visual and spatial information, an episodic buffer that bridges working memory and long-term memory, and a central executive that exercises attentional control over the above-named subsystems. Working memory operates across multiple modalities (e.g., auditory and visual), and is a system that combines attentional control with temporary storage and information manipulation. Working memory, which involves temporary maintenance and working with information in mind, is required for cognitive skills such as problem solving, planning and auditory and reading comprehension. This study was registered with : NCT04010149 on July 8, 2019.
Furthermore, we will explore whether training improvements impact on everyday life activities and how the home-based training regimen is received by participants, with the view to develop an effective home healthcare tool that could enhance working memory and daily functioning. Specifically, we will examine the impact of brain stimulation on training gains, if changes in gains would last, and whether changes in training performance transfer to other cognitive domains. The aim of the study is to assess if non-invasive tDCS stimulation has an impact on performance and benefits of a working memory training regimen. Outcome measures will be recorded at timepoints throughout the intervention, including baseline, after the 2 weeks of stimulation, at the end of the working memory training regimen and 1 month after the completion of the training. After the end of the first 2 weeks, both groups will continue the working memory training for three more weeks. Patients with a working memory deficit will be recruited and assigned to two age-matched groups receiving working memory training for 2 weeks: an active group, receiving tDCS (2 mA for 20 min), and a control group, receiving sham stimulation. We propose a combined home-based rehabilitation protocol involving the concurrent administration of a working memory training program (adaptive N-back task) with non-invasive transcranial direct current stimulation (tDCS) of the right dorsolateral prefrontal cortex to promote long-lasting modification of brain areas underlying working memory function. The above observations make working memory, and related constructs such as attention and executive functioning attractive targets for neurorehabilitation. Acquired Brain Injury (ABI) admissions have an incidence of 385 per 100,000 of the population in the UK, and as brain injury often involves the frontal networks, cognitive domains affected are likely to be executive control, working memory, and problem-solving deficits, resulting in difficulty with everyday activities.
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