US Marines and Panamanian police carry out jungle combat drills on Panama’s Caribbean coast Copyright AFP WALTER HURTADO
March is Brain Injury Awareness Month and to mark this, a new literature review in the journal Military Medicine has found that cognitive training can not only help with brain injury rehabilitation but also improve resilience among service members and can boost cognitive function that helps prevent maladaptive behaviours (substance abuse and suicide).
The review noted that improving higher order cognitive functions reduces symptoms of psychological stress and enhances social connectedness. The research builds on the findings of the Warfighter Brain Fitness Study, published recently in the same journal.
There are two interventions examined in both journal articles: the topdown, strategybased executive function training program SMARTTM from the UT Dallas Center for Brain Health and the bottomup, adaptive, and progressively challenging BrainHQ from Posit Science.
The Warfighter Brain Fitness Study enrolled 406 healthy National Guard servicemembers, who trained in alternating sequences of BrainHQ and SMART training. That study found participants benefitted from either training across multiple key measures of cognitive resilience — a health and readiness priority of the US military — as evaluated using the BrainHealth Index. Improvements were shown across all measures (including cognitive performance and psychological wellbeing).
“Cognitive resilience is increasingly a priority health and readiness issue, not just for US warfighters, but for many whose work demands peak performance under challenging conditions,” says Dr. Henry Mahncke, CEO of Posit Science in a message sent to .
Mahncke adds: “By building cognitive resilience, we help people optimize performance, adapt, and recover from adversity. While this work began with showing we can help with recovery from injuries, increasingly it’s deployed to strengthen capabilities and resilience, and monitor cognitive readiness.”
In the literature review the reviewers noted studies of the two interventions and the factors associated with the training that help prevent brain injury by reducing the risk of maladaptive behaviours (such as substance use and suicide), including (1) improved higher order cognitive functions; (2) reduced symptoms of psychological distress; and (3) improved social connectedness.
The researchers further noted the ongoing challenge of preventing maladaptive behaviours and the wide variety of interventions:
“Based upon this literature review, there is a compelling case for cognitive training to be among these interventions. Not only does cognitive training bolster protective factors such as emotional regulation, problemsolving, and psychological wellbeing, but it reduces risk factors such as social isolation and impaired social skills. Furthermore, because cognitive training is beneficial to healthy (ie, nonclinical) populations, it can be appropriately framed as a tool to improve brain fitness, rather than as a ‘mental health’ intervention, the latter of which may be met with some resistance in military populations.”
Prior studies of BrainHQ usage in addressing traumatic brain injuries have shown its effectiveness in cognitive rehabilitation. Notably, the BRAVE Study (conducted at five VA and military hospitals) was the first randomized controlled trial of computerized brain training in veterans and servicemembers (with symptoms that had persisted for an average of 7+ years postinjury), to show significant improvement in overall cognition, with gains of 0.64 standard deviations (equivalent to moving from the 50th to the 74th percentile on a bell curve).
Furthermore, the exercises have shown benefits in more than 300 peerreviewed studies (including eight military studies). Such benefits include gains in cognition (attention, speed, memory, decisionmaking), in quality of life (depressive symptoms, confidence and control, healthrelated quality of life) and in realworld activities (health outcomes, balance, driving, workplace activities).
The technology is used by leading health plans, medical centres, clinics, and communities, and by elite athletes, the military, first responders, and other organisations focused on splitsecond peak performance and resilience.
