Examining the efficacy of the modified story memory technique (mSMT) in persons with TBI using functional magnetic imaging (fMRI): The TBI-MEM trial

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Study examined changes in cerebral activation on functional magnetic resonance imaging (fMRI) following modified Story Memory Technique (mSMT) treatment in people with traumatic brain injury (TBI). The mSMT consists of 10 sessions during which 2 skills are taught to facilitate new learning: (1) visualization (sessions 1-4) and (2) context formation (sessions 5-8). The final 2 sessions (9 and 10) focus on applying the newly learned technique to daily life. Eighteen individuals with TBI were randomly assigned to treatment or placebo groups. Participants in the placebo group underwent memory exercises at the same frequency and duration as the treatment group but were not exposed to the critical ingredients of training in visualization and context formation. Baseline and follow-up fMRI data 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. 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 individuals with TBI. The findings are consistent with previous work in multiple sclerosis. Behavioral interventions can show significant changes in the brain, validating clinical utility.

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