title: Examining the Efficacy of the Modified Story Memory Technique (mSMT) in Persons With TBI Using Functional Magnetic Resonance Imaging (fMRI): The TBI-MEM Trial.
abstract: BACKGROUND
  New learning and memory deficits are common following traumatic brain injury (TBI). Yet few studies have examined the efficacy of memory retraining in TBI through the most methodologically vigorous randomized clinical trial. Our previous research has demonstrated that the modified Story Memory Technique (mSMT) significantly improves new learning and memory in multiple sclerosis.
  
  
  METHODS
  The present double-blind, placebo-controlled, randomized clinical trial examined changes in cerebral activation on functional magnetic resonance imaging following mSMT treatment in persons with TBI. Eighteen individuals with TBI were randomly assigned to treatment (n = 9) or placebo (n = 9) groups.
  
  
  RESULTS
  Baseline and follow-up functional magnetic resonance imaging was collected during a list-learning task. Significant differences in cerebral activation from before to after treatment were noted in regions belonging to the default mode network and executive control network in the treatment group only. Results are interpreted in light of these networks.
  
  
  CONCLUSIONS
  Activation differences between the groups likely reflect increased use of strategies taught during treatment. This study demonstrates a significant change in cerebral activation resulting from the mSMT in a TBI sample. Findings are consistent with previous work in multiple sclerosis. Behavioral interventions can show significant changes in the brain, validating clinical utility.
authors.affiliation: Kessler Foundation, Neuropsychology and Neuroscience Laboratory, West Orange, New Jersey (Drs Chiaravalloti, Dobryakova, Wylie, and DeLuca); and Department of Physical Medicine and Rehabilitation (Drs Chiaravalloti, Dobryakova, Wylie, and DeLuca) and Department of Neurology (Dr DeLuca), Rutgers, New Jersey Medical School, Newark, New Jersey.
authors.forename: Nancy D
authors.initials: ND
authors.lastname: Chiaravalloti
authors.forename: Ekaterina
authors.initials: E
authors.lastname: Dobryakova
authors.forename: Glenn R
authors.initials: GR
authors.lastname: Wylie
authors.forename: John
authors.initials: J
authors.lastname: DeLuca
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D001930:Brain Injuries / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation*; D001931:Brain Mapping; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D008875:Middle Aged; D000066530:Neurological Rehabilitation / Q000379:methods*; D017063:Outcome Assessment, Health Care; D055815:Young Adult