Changes in fMRI following cognitive rehabilitation in severe traumatic brain injury: A case study

Objective: To illustrate the relationship between changes in neuropsychological testing and changes in functional magnetic resonance imaging (fMRI) before and after cognitive rehabilitation therapy (CRT). Study Design: Single case study. Setting: Outpatient treatment center. Participant: A woman with history of severe traumatic brain injury (TBI) 16 years before study. Intervention: Individualized CRT using a developmental metacognitive model. Main Outcome Measures: Neuropsychological tests and fMRI imaging performed during an eye movement task and a reading comprehension task. Results: Improvements on some neuropsychological test scores (>1 SD) and changes in the magnitude and distribution of the blood oxygen level dependent (BOLD) response as a function of task performance on both fMRI tasks. Conclusions: Individuals with severe TBI many years postinjury can demonstrate improvements in neuropsychological testing following CRT. Behavioral improvements can be related to changes in brain activity using fMRI.