Abstract
Traumatic Brain Injury (TBI) is defined by changes in brain function resulting from external forces acting on the brain and is typically characterized by a host of physiological and functional changes such as cognitive deficits including attention problems. In the present study, we focused on the effect of TBI on the ability to allocate attention in vision (i.e., the use of endogenous and exogenous visual cues) by systematically reviewing previous literature on the topic. We conducted quantitative synthesis of 16 selected studies of visual attention following TBI, calculating 80 effect size estimates. The combined effect size was large (g = 0.79, p < 0.0001) with medium heterogeneity (I2 = 68.39%). Subgroup analyses revealed an increase in deficit with moderate-to-severe and severe TBI as compared to mild TBI [F(2, 76) = 24.14, p < 0.0001]. Task type was another key source of variability and subgroup analyses indicated that higher order attention processes were severely affected by TBI [F(2, 77) = 5.66, p = 0.0051). Meta-regression analyses revealed significant improvement in visual attention deficit with time [p(mild) = 0.031, p(moderate-to-severe) = 0.002, p(severe) < 0.0001]. Taken together, these results demonstrate that visual attention is affected by TBI and that regular assessment of visual attention, using a systematic attention allocation task, may provide a useful clinical measure of cognitive impairment and change after TBI.
Highlights
Traumatic Brain Injury (TBI) can be defined as changes in brain function, or other brain pathology, caused by external forces acting on the brain (Menon et al, 2010)
Alterations in brain function commonly associated with TBI include loss of consciousness, loss of memory known as post-traumatic amnesia, disorientation, and other changes in mental state (Kay et al, 1993; Langlois et al, 2006; Jagnoor and Cameron, 2014; Pervez et al, 2018)
Figure is a forest plot including individual and combined effect sizes. This large, combined effect size was significantly different from zero (Z = 11.42, p < 0.0001) with medium to high heterogeneity which highlights the potential role of study design and methodology, injury severity, postinjury period and outcome measures as contributing factors. These results indicate that visuospatial attention is significantly and largely affected by TBI
Summary
Traumatic Brain Injury (TBI) can be defined as changes in brain function, or other brain pathology, caused by external forces acting on the brain (Menon et al, 2010). TBI affects all areas of the population and males, children aged zero to 4 years, and adolescents aged 15 to 19 years are more likely to sustain injury (Langlois et al, 2006; Jagnoor and Cameron, 2014; Nguyen et al, 2016) This is likely due to mobility problems in young children, risk-taking behavior in new drivers and increased activity in adult males and adolescents as falls and motor-vehicle accidents are among the leading causes of TBI (Hyder et al, 2007; Jagnoor and Cameron, 2014; Nguyen et al, 2016).
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