Article

Cognitive Rehabilitation Interventions for Executive Function: Moving from Bench to Bedside in Patients with Traumatic Brain Injury

University of Toronto, Toronto, Ontario, Canada
Journal of Cognitive Neuroscience (Impact Factor: 4.09). 08/2006; 18(7):1212-22. DOI: 10.1162/jocn.2006.18.7.1212
Source: PubMed

ABSTRACT

Executive function mediated by prefrontally driven distributed networks is frequently impaired by traumatic brain injury (TBI) as a result of diffuse axonal injury and focal lesions. In addition to executive cognitive functions such as planning and working memory, the effects of TBI impact social cognition and motivation processes. To encourage application of cognitive neuroscience methods to studying recovery from TBI, associated reorganization of function, and development of interventions, this article reviews the pathophysiology of TBI, critiques currently employed methods of assessing executive function, and evaluates promising interventions that reflect advances in cognitive neuroscience. Brain imaging to identify neural mechanisms mediating executive dysfunction and response to interventions following TBI is also discussed.

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Available from: Keith D Cicerone
    • "The Dysexecutive Questionnaire (DEX;Burgess, Alderman, Evans, Emslie, & Wilson, 1998) has been introduced as one such tool (Simblett & Bateman, 2010). A valid and reliable three-dimensional structure for the DEX has been proposed (Simblett et al., 2012;Simblett & Bateman, 2010) that is in keeping with current theoretical conceptualisations of domain-general processes associated with frontal lobe or executive functions (Cicerone et al., 2006;Stuss, 2007). However, previous research carried out bySimblett and Bateman (2010)on the psychometric properties of the DEX has highlighted some ways in which the measure could be improved. "
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    ABSTRACT: The Dysexecutive Questionnaire (DEX) is a tool for measuring everyday problems experienced with the dysexecutive syndrome. This study investigated the psychometric properties of a revised version of the measure (DEX-R), a comprehensive tool, grounded in current theoretical conceptualisations of frontal lobe function and dysexecutive problems. The aim was to improve measurement of dysexecutive problems following acquired brain injury (ABI). Responses to the DEX-R were collected from 136 men and women who had experienced an ABI (the majority of whom had experienced a stroke or subarachnoid haemorrhage) and where possible, one of their carers or family members (n = 71), who acted as an informant. Rasch analysis techniques were employed to explore the psychometric properties of four newly developed, theoretically distinct subscales based on Stuss model of frontal lobe function and to evaluate the comparative validity and reliability of self and informant ratings of these four subscales. The newly developed subscales were well targeted to the range of dysexecutive problems reported by the current sample and each displayed a good level of internal validity. Both self- and independent-ratings were found to be performing reliably as outcome measures for at least a group-level. This new version of the tool could help guide selection of interventions for different types of dysexecutive problems and provide accurate measurement in neurorehabilitation services.
    No preview · Article · Jan 2016 · Neuropsychological Rehabilitation
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    • "Remediation approaches OTs might adopt for improving EF include using metacognitive strategies, classic neuroscience research—including working memory training, improving EF using intact cognitive abilities, use of the GMT protocol, and adopting virtual reality environments to prepare for community reintegration. For more detail on deficits , assessment, and treatment, please see recent reviews specific to EF (Chung, Pollock, Campbell, Durward, & Hagen, 2013; Cicerone, Levin, Malec, Stuss, & Whyte, 2006). "
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