Strategic brain training helps individuals with long-lasting TBI

  • A small study finds strategy-based reasoning training has greater benefit for those with persistent TBI difficulties than a knowledge-based training program.

A study showing that a certain type of instructor-led brain training protocol can stimulate structural changes in the brain and neural connections even years after a traumatic brain injury (TBI) challenges the widely held belief that recovery from a TBI is limited to two years after an injury.

The study included 60 adults with TBI symptoms lasting an average of eight years. Participants were randomly placed into one of two cognitive training groups:

  • strategy-based reasoning training called Strategic Memory Advanced Reasoning Training (SMART), focused on selective attention, abstract reasoning, and other thinking strategies
  • knowledge-based training called Brain Health Workshop (BHW), focused on education regarding brain structure and function and the effects of sleep and exercise on the brain performance

Both programs comprised 12 1.5-hour sessions over 8 weeks conducted in small group settings (4–5 participants), and instruction was given using a series of slides.

More specifically, the SMART group was trained to

  • block distractions and irrelevant information and avoid multitasking
  • understand main ideas and take‐home messages
  • examine information from different perspectives.

The BHW group learned about

  • brain anatomy
  • brain function
  • the effects of a TBI on cognitive function
  • the principles of neuroplasticity
  • the impact of diet, physical exercise, sleep, and social activities on brain health.

Those in the strategy-based reasoning training showed a greater change in cortical thickness and connectivity compared to individuals who received the knowledge-based training. Changes in cortical thickness and functional connectivity also correlated to an individual's ability to switch between tasks quickly and consistently to achieve a specific goal.

Moreover, those who showed the greatest change in cortical thickness and connectivity, showed the greatest improvements in cognitive performance.

Paper available at


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