for people ages 18-55 (full criteria)
at San Diego, California and other locations
study started
estimated completion



The proposed study tests the feasibility (Phase I) of PATH neurotraining to improve working memory and attention in mTBI patients rapidly and effectively to provide clinical testing of a therapeutic training for the remediation of cognitive disorders caused by a concussion. This study will contribute to the fundamental knowledge of how to remediate concussions from a mTBI to enhance the health, lengthen the life and reduce the disabilities that result from a mTBI.


This study will provide clinical testing of therapeutic training for the remediation of cognitive disorders caused by a concussion. The investigators will extend previous results from a pilot study of 4 mTBI subjects (Lawton & Huang, 2019) to a much larger sample of mTBI subjects. The investigators will also determine whether these results are sustained over time. The proposed study tests the feasibility (Phase I) of PATH neurotraining to improve working memory, processing speed, and reading speed (primary outcome) and attention (secondary outcomes) in mTBI subjects rapidly and effectively. This study will compare PATH training, presenting dim gray patterns moving left or right to activate the dorsal stream (Ungerleider & Mishkin, 1982; Livingstone & Hubel, 1988; Kaplan & Shapley, 1986), with sham training, presenting high contrast colored stationary patterns tilted left or right to activate the parvocells in the ventral stream, with an N-Back Working Memory (WM) task to activate dorsal lateral PreFrontal Cortex (dlPFC). The investigators predict that PATH training improves working memory, processing speed and attention more than Sham or N-Back WM training after a mTBI. Since PATH training must be followed by cognitive exercises to improve cognitive function (Lawton, 2011, 2015, 2016), a complementary strategy consisting of 15 minutes of working memory practice, recalling the correct sequence of digits, each presented for 500 msec, from 5 digits up to 10 digits will be completed for 15 minutes following both PATH and Sham training. MEG recordings (Huang et al., 2014, 2016, 2018) before and after training will provide a biomarker to determine whether PATH training improves the function of the dorsal, attention, and working memory networks more than found after a sham treatment and after a N-Back WM treatment. MEG recordings will also be used to determine whether PATH training strengthens coupled theta/ gamma activity, and/or alpha/ gamma activity. To increase its commercialization ability, PATH neurotraining must be shown to improve brain function using a biomarker, as stated by neurologists and therapists in letters of support. Whether cognitive improvements are sustained over time will be evaluated by measuring whether mTBI subjects improve on brain functioning and neuropsychological tests of cognitive function 2 months after intervention neurotraining. The investigators will also: 1) Characterize individual differences in cognitive function in mTBI patients, as well as 2) Determine the role of individual differences at initial assessment and in improvements following training for different subpopulations: 1) Veteran mTBI subjects vs. civilian mTBI subjects, 2) different age groups (18-28, 29-41, 42-55), and 3) different loci and extent of the mTBI deficit.


MTBI - Mild Traumatic Brain Injury Brain Injuries Brain Injuries, Traumatic Brain Concussion Wounds and Injuries PATH neurotraining Orientation Discrimination N-Back Working Memory Training Orientation Discrimination training N-Back Working Memory Task


For people ages 18-55

A patient with a mTBI who has had a traumatically induced physiologic disruption of brain function will be referred by neurologist Dr. Ahmed who has made a diagnosis of mTBI, which includes one or more of the following (Marshall et al., 2012):

  1. any loss of consciousness from 5- 30 min (not longer than 30 min),
  2. any loss of memory for events immediately before or after the accident for as much as 24 hours,
  3. any alteration of mental state at the time of the accident (e.g. feeling dazed, disoriented, or confused),
  4. after 30 minutes, Glasgow Coma Scale of 13-15 (not lower or is considered more severe than a mild TBI),
  5. post-traumatic amnesia less than 24 hours,
  6. a score of 19-25 on the Montreal Cognitive Assessment (MoCA) screening test,
  7. focal neurologic deficits that might/might not be transient,
  8. one or multiple concussions.

For this study, the following criteria will be utilized:

Inclusion Criteria:

  1. Diagnosis of mTBI,
  2. between the ages of 18 to 55 years, when development and aging are not factors,
  3. agrees to complete the study after hearing the time commitment involved,
  4. has corrected 20/20 visual acuity, so can do PATH training (dim gray stripes),
  5. reads English fluently, so can follow instructions, and
  6. can complete the PATH neurotraining task, by pushing the left or right arrow key on the computer.

Exclusion Criteria:

  1. mTBI occurred less than 3 months earlier,
  2. post-traumatic amnesia longer than 24 hours,
  3. diagnosis of epilepsy or seizure disorder in last 12 months,
  4. diagnosis of major depressive disorder or severe anxiety,
  5. answers 'Yes' to any of the questions on the Columbia Suicide Severity Rating Scale,
  6. had a stroke or metabolic derangements causing cognitive impairments, ie. alcohol or substance abuse,
  7. has extensive metal dental hardware (e.g., braces and large metal dentures; fillings are acceptable) or other metal objects in head, neck, or face areas that cause artifacts in MEG data, and are not removable during pre-processing, and
  8. has claustrophobia since MEG scanner is in small enclosed space.


  • University of California at San Diego
    San Diego California 92121 United States
  • Perception Dynamics Institute
    Solana Beach California 92075 United States


not yet accepting patients
Start Date
Completion Date
Perception Dynamics Institute
Study Type
Expecting 90 study participants
Last Updated