Neurocognitive Driving Rehabilitation in Virtual Environments (NeuroDRIVE) as an Adjunctive Intervention for Traumatic Brain Injury

Subjects eligible for participation must meet the following criteria:

1. Currently has a valid driver s license, or had a valid driver s license prior to injury
2. 18 years of age or older
3. Able to effectively manipulate the steering wheel and the gas/brake pedals without adaptive equipment
4. Able to read, write, and speak in English
5. History of traumatic brain injury greater than 12 weeks prior to initiation into the current study
6. Able to provide informed consent
7. NBSI score greater than or equal to 16 (Mild TBI sub-group only)

EXCLUSION CRITERIA:

Subjects are not eligible for participation if any of the following conditions exist:

1. Risk for injury from the MRI magnet, including:

   • Pacemakers or other implanted electrical devices.
   • Brain stimulators.
   • Some types of dental implants.
   • Aneurysm clips (metal clips on the wall of a large artery).
   • Metallic prostheses (including metal pins and rods, heart valves, and cochlear implants).
   • Permanent eyeliner (other non-metallic tattoos are permissible).
   • Implanted delivery pump.
   • Shrapnel fragments.
   • Welders and metal workers are also at risk for injury because of possible small metal fragments in the eye of which they may be unaware.
   • Fear of confined spaces.
   • Back problems that may result in back pain or discomfort from lying in the scanner.
   • Weight of over 350 pounds, due to the weight limit of the MRI table.
   • It is not known if MRI is completely safe for a developing fetus. Therefore, all women of childbearing potential will have a pregnancy test performed no more than 24 hours before each MRI scan. The scan will not be done if the pregnancy test is positive. Because neuroimaging is a key component of the current study, inability to participate in MRI scanning is a necessary exclusion criterion.
2. History of penetrating brain injury
3. History of serious medical condition other than TBI that could affect cognitive or motor abilities (e.g., multiple sclerosis, encephalitis, cerebrovascular disease)
4. History of severe motion sickness and/or vertigo.
5. Other medical or psychological instability that could create difficulty fulfilling the study requirements (e.g., untreated mental illness, auditory/visual hallucinations, narcolepsy)

To verify this information, study coordinators will request medical records (i.e., recent medical history, medication list, any neuroimaging, and records pertinent to the participant s recent injury) to further evaluate potential participants inclusion into the study. Medical records can be obtained in three ways:

1. Participants can bring the records when they come to NIH for testing; it will be made clear if they do not bring this information with them and we cannot verify that they meet inclusion criteria, potential participants will not be enrolled into the study that day.
2. Alternatively, the participants can also fax their medical records to a secured fax machine at the Recreational Therapy office at the NIH where access is only permitted to study staff (i.e., scheduler, physician, and nurse psychologist).
3. Participants may also fill out a medical release document and submit it to the study coordinator.

Medical history data will be reviewed, and if it is clear that the patient does not meet the inclusion criteria, we will contact them and cancel their appointment. Data obtained in this manner may be used to evaluate participant eligibility; however, it will not be used for any research purposes. Additionally, for any patients who are deemed not eligible to participate, their medical history data will be destroyed in accordance with NIH regulations.

As a condition of receiving funding from CNRM, de-identified imaging and phenotyping data (i.e., neurocognitive test results and behavioral questionnaires) from funded studies must be made available within a centralized repository (the CNRM Informatics Core) one year after the completion of the study. This is intended to facilitate use and analysis of this data for future research questions or projects. As such, potential subjects will be informed that they should not participate in this study if they do not want their data used for other projects.