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Computerized Rehab Can Improve Attention and Executive Function in TBI Patients

For the first time, researchers have shown that computerized cognitive rehabilitation (a program to help brain-injured or otherwise cognitively impaired individuals to restore normal functioning) can improve attention and executive functioning in brain injury survivors including traumatic brain injury (TBI) and stroke.

The findings, which appear online in the Journal of Head Trauma Rehabilitation, may lead to improved treatment outcomes in patients with brain injury, especially for patients with limited mobility and means and those residing in rural areas.

Persistent cognitive problems are very common following brain injury, especially in executive functioning, attention and learning.

The research team conducted a systematic literature review of computerized treatment for attention and executive function in adults who suffered a brain injury. Studies published before or during April 2015 were evaluated for quality and methodology as no previous reviews had been completed. They found eight of 11 studies reported significant gains in cognitive function following treatment in TBI patients, with the three remaining studies reporting trends toward significance. Similarly, 10 of 12 mixed population studies observed significant improvements on measures of attention and executive function, with the remaining two studies reporting positive trends. Five studies reported significant improvements subsequent to treatment for stroke patients.

“The results of this systematic review provide encouraging evidence that computerized cognitive rehabilitation can improve attention and executive functioning in brain injury survivors,” explained corresponding author Yelena Bogdanova, PhD, assistant professor of psychiatry at Boston University School of Medicine and principal investigator at the VA Boston Healthcare System.

Image shows a computer keyboard.

According to the researchers computerized treatment delivery can significantly reduce the wait time and cost of treatment, provide immediate access to treatment in any location, improve the quality of life of patients and reduce the burden of caregivers. Image is for illustrative purposes only.

According to the researchers computerized treatment delivery can significantly reduce the wait time and cost of treatment, provide immediate access to treatment in any location, improve the quality of life of patients and reduce the burden of caregivers.

Bogdanova believes further studies are needed. “It is important to evaluate the efficacy of computerized cognitive training programs and to provide specific guidelines for computerized methods of rehabilitation in patients with brain injury, as it can reduce cost and increase accessibility of treatment to traditionally underserved populations,” she added.

About this neurology research

Funding: Funding for this study was provided by the Rehabilitation Research & Development Service of the Department of Veterans Affairs (VA) grants D6996W and I21RX001773-01 to YB, the National Institutes of Health and Boston University Clinical & Translational Science Institute grant UL1-RR025771 to YB, the VA Translation Research Center for TBI & Stress Disorders [YB], and the VA BHS Psychology Research Service [YB].

Source: Gina DiGravio – Boston University Medical Center
Image Source: Image is in the public domain
Original Research: Abstract for “Computerized Cognitive Rehabilitation of Attention and Executive Function in Acquired Brain Injury: A Systematic Review” by Bogdanova, Yelena PhD; Yee, Megan K. MA; Ho, Vivian T. BS; and Cicerone, Keith D. PhD in Journal of Head Trauma Rehabilitation. Published online December 24 2015 doi:10.1097/HTR.0000000000000203


Abstract

Computerized Cognitive Rehabilitation of Attention and Executive Function in Acquired Brain Injury: A Systematic Review

Objective: Comprehensive review of the use of computerized treatment as a rehabilitation tool for attention and executive function in adults (aged 18 years or older) who suffered an acquired brain injury.

Design: Systematic review of empirical research.

Main Measures:
Two reviewers independently assessed articles using the methodological quality criteria of Cicerone et al. Data extracted included sample size, diagnosis, intervention information, treatment schedule, assessment methods, and outcome measures.

Results: A literature review (PubMed, EMBASE, Ovid, Cochrane, PsychINFO, CINAHL) generated a total of 4931 publications. Twenty-eight studies using computerized cognitive interventions targeting attention and executive functions were included in this review. In 23 studies, significant improvements in attention and executive function subsequent to training were reported; in the remaining 5, promising trends were observed.

Conclusions: Preliminary evidence suggests improvements in cognitive function following computerized rehabilitation for acquired brain injury populations including traumatic brain injury and stroke. Further studies are needed to address methodological issues (eg, small sample size, inadequate control groups) and to inform development of guidelines and standardized protocols.

“Computerized Cognitive Rehabilitation of Attention and Executive Function in Acquired Brain Injury: A Systematic Review” by Bogdanova, Yelena PhD; Yee, Megan K. MA; Ho, Vivian T. BS; and Cicerone, Keith D. PhD in Journal of Head Trauma Rehabilitation. Published online December 24 2015 doi:10.1097/HTR.0000000000000203

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