Retraining the Inflamed Brain: An add-on to the REFAB* study

(*REFAB = Retraining the fatigued brain: A randomized controlled trial evaluating personalized cognitive rehabilitation treatment in somatic symptom and related disorders (SSRD))

Somatic symptom and related disorders (SSRD) encompass a range of conditions characterized by distress and impairment caused by somatic symptoms, often accompanied by cognitive difficulties. The REFAB trial, funded by the HSRI, focuses on improving cognitive functioning in SSRD through cognitive rehabilitation treatment (CRT) and exploring psychophysiological mechanisms underlying treatment outcomes. This is done by integrating biological measures and cognitive assessments. 

Previous research indicates that systemic low-grade inflammation is associated with mental disorders such as depression and trauma, as well as with cognitive disfunction. However, its role in cognitive impairment in SSRD remains unclear. The proposed study aims to address this gap by examining the role of the inflammatory biomarker interleukin 6 (IL-6) in cognitive function in SSRD patients. Furthermore, the study will explore whether changes in IL-6 levels during CRT are associated with treatment response, providing insights into the effectiveness of CRT to improve cognitive function. To answer these questions, blood samples from SSRD patients will be collected before and after CRT, after which IL-6 levels will be determined using enzyme-linked immunosorbent assay (ELISA).

This interdisciplinary collaboration between the departments of Medical & Clinical Psychology and Human Resource Studies, is in partnership with GGz Breburg (mental health care) and will be extended to also include the vocational reintegration setting later on. It underscores the holistic approach to understanding and addressing SSRD-related cognitive impairments, ultimately contributing to improved treatment strategies and quality of life for patients. 

Team Composition

• Drs. Ellen Boumans (MCP) is a PhD candidate with a background in neuropsychology and clinical psychology. She previously worked as a psychologist in clinical practice, focusing on acquired brain injury, neurodegenerative diseases and medical psychology. Her goal is to combine clinical neuropsychology with fundamental (brain) research. 
• Dr. Nina Kupper (MCP)’s research focuses on the biobehavioral pathways linking emotional distress to the incidence and progression of heart disease. She is leading the behavioral physiology lab (GO-lab). 
• Dr. Lars de Vroege (Tranzo, GGz Breburg) is a clinical psychologist and neuropsychologist at the Top Clinical Center for Body, Mind, and Health (CLGG), as well as a senior researcher at CLGG/Tilburg University, Department of Tranzo. He is involved in scientific research on various topics and contributes to projects focusing on Acquired Brain Injury (NAH) and Medically Unexplained Symptoms (SOLK) in specialized mental healthcare (GGZ). 
• Prof. Dr. Marc van Veldhoven (HRS) is the Vice Dean for Research at TSB. His current research focuses on exploring factors affecting job satisfaction, work engagement, and organizational performance, aiming to develop evidence-based strategies for promoting employee health and productivity in the workplace. 
• Prof. Dr. Willem Kop (MCP)‘s research delves into the interplay of fatigue, depression, and mental stress with the immune system and cardiac function, utilizing structured clinical interviews and ambulatory monitoring techniques. As Principal Investigator on multiple NIH-funded studies, he aims to unravel the biological mechanisms underlying the impact of psychological factors on disease outcomes, including the mediation by health behaviors like physical activity.
• GGz Breburg (Clinical Center of Excellence for Body, Mind, and Health) as a collaborating organization