Abstract
BackgroundNeuropsychological rehabilitation is a crucial component of medical care for patients with diffuse axonal injury (DAI). However, current cognitive intervention programs directed to favor the training of specific domains individually have shown controversial results. Here, we evaluated the effectiveness of a neuropsychological rehabilitation program directed to favor training of attention, memory, visuospatial abilities, and executive functioning together in a patient with severe traumatic brain injury (TBI)-associated DAI.Case presentationA 26-year-old Hispanic woman with a recent history of a severe TBI attended our center complaining of memory problems, dysarthria, and difficulty in planning. A comprehensive cognitive assessment revealed dysfunction in sustained, selective, and divided attention, alterations in memory, planning, and organization of executive behavior, as well as impairment of visuospatial cognitive functions. The patient underwent a 24-week neuropsychological rehabilitation program directed to favor attention, memory, visuospatial abilities, and executive functioning together. After the cognitive intervention, we observed a better patient's performance in tasks requiring sustained, selective, and divided attention, improvement of encoding and retrieval memory problems, use of spatial relationships, planning, and organization of behavior skills. We also observed generalization effects on other domains, such as learning, mental flexibility, inhibition functions, and language.ConclusionsIn conclusion, our results suggest that neuropsychological rehabilitation programs favoring multiple domains together are useful in reestablishing cognitive deficits in patients with severe DAI.
Highlights
In conclusion, our results suggest that neuropsychological rehabilitation programs favoring multiple domains together are useful in reestablishing cognitive deficits in patients with severe diffuse axonal injury (DAI)
Cognitive deficits caused by diffuse axonal injury (DAI) contribute to disability observed after traumatic brain injury (TBI)
Executive functioning, and speedof-processing are the main domains affected by DAI, due to alteration of important white matter structures which disrupts brain connectivity [1]
Summary
Our study describes a novel cognitive rehabilitation program directed to train multiple cognitive domains together in patients with DAI. This program is designed to train attention, memory, visuospatial abilities, and executive functioning in a period of 24 weeks, the results obtained here demonstrated generalization effects to other domains, such as learning, mental flexibility, inhibition functions, and language. Our study adds evidence in favor of training multiple cognitive domains together, rather than individually, in young patients with cognitive sequel after TBI-associated DAI
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