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Kessler TBI-MEM study provides Class 1 evidence for cognitive training efficacy in TBI

First Class I evidence for efficacy of modified Story Memory Technique in moderate to severe traumatic brain injury

Kessler Foundation


IMAGE: Nancy D. Chiaravalloti, Ph.D., is director of Neuroscience & Neuropsychology and Traumatic Brain Injury Research at Kessler Foundation. She is also project director of the Northern New Jersey TBI System,... view more

Credit: Kessler Foundation

WEST ORANGE, NJ--September 10, 2015. Kessler Foundation researchers published results of a randomized clinical trial (RCT) of a cognitive intervention to improve learning and memory in individuals with traumatic brain injury (TBI) - the TBI-MEM trial. The treatment protocol, the modified Story Memory Technique© (mSMT), was found to improve memory in adults with moderate to severe TBI, providing the first Class I evidence for the efficacy of this intervention in the TBI population. The article, "An RCT to Treat Learning Impairment in Traumatic Brain Injury: The TBI-MEM Trial," (doi: 10.1177/1545968315604395) was e-published by Neurorehabilitation & Neural Repair. The authors are Nancy D. Chiaravalloti, Ph.D., Joshua Sandry, Ph.D., Nancy B. Moore, M.A., and John DeLuca, Ph.D., of Kessler Foundation.

Cognitive deficits are a common disabling consequence of brain injury that affect emotional, social and occupational functioning. As impaired memory after TBI is a result of impaired learning, rehabilitative interventions need to address the deficit in learning. This study examined the efficacy of the mSMT, a cognitive intervention, in the TBI population. Kessler researchers previously found the mSMT intervention effective in the population with multiple sclerosis.

Of the 69 participants with moderate to severe TBI enrolled in the study, 35 were assigned to the treatment group and 34 to the placebo group. All underwent neuropsychological assessments before and after treatment and at 6-month followup. Participants in the treatment group were randomized to a booster session or non-booster session group. The treatment group received the mSMT, a 10-session memory retraining protocol. The placebo group underwent memory exercises. A significant effect was found in the treatment group; no persistent effect was seen in the treatment cohort that had booster sessions of mSMT.

"We found that memory, as assessed with standard memory tests, improved in the treatment group. Treated participants also showed an improvement in everyday functioning," said Dr. Chiaravalloti, director of Neuroscience & Neuropsychology and TBI Research at Kessler Foundation. "This extends the Class 1 evidence for efficacy of the mSMT to people with moderate to severe TBI. Further study is needed to develop strategies for extending the positive effects of this cognitive intervention in rehabilitative care."

The mSMT protocol has been translated into Spanish and is being used in the U.S., Mexico and Argentina. A Chinese translation has also been completed for use in upcoming studies.


The study was funded by the National Institute on Disability, Independent Living and Rehabilitation Research (H133A070037), and Kessler Foundation.

Related articles:

Chiaravalloti N, et al: An RCT to treat learning impairment in MS. Neurology 2013(81) doi: 10.1212/01.wnl.0000437295.97946.a8S.

Chiaravalloti N, et al. Examining the efficacy of the modified Story Memory Technique (mSMT) in persons with TBI using functional magnetic resonance imaging (fMRI): The TBI-MEM Trial. Journal of Head Trauma Rehabilitation 2015 (doi: 10.1097/HTR.0000000000000164).

About TBI Research at Kessler Foundation

Nancy Chiaravalloti, Ph.D., is director of Neuroscience & Traumatic Brain Injury (TBI) Research and project director of the Northern New Jersey TBI System (NNJTBIS), a collaborative effort of Kessler Foundation, Kessler Institute for Rehabilitation and local hospitals. John DeLuca, PhD, is co-project director. NNJTBIS is one of 16 federally funded model systems that form a national comprehensive system of care, research, education and dissemination aimed at improving quality of life for people with TBI. NNJTBIS is supported by grant #H133A120030 from the National Institute Disability, Independent Living & Disability and Rehabilitation Research (NIDILRR). In addition to NIDRR and the Department of Defense, TBI research is funded by the New Jersey Commission on Brain Injury Research, the Department of Veterans Affairs, the Department of Defense and Children's Specialized Hospital. Neuroimaging studies are conducted at the Rocco Ortenzio Neuroimaging Center at Kessler Foundation. Kessler researchers and clinicians have faculty appointments in the department of Physical Medicine and Rehabilitation at Rutgers New Jersey Medical School.

About Kessler Foundation

Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. For more information, visit


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