Plasticity of the attentional network after brain injury and cognitive rehabilitation

Neurorehabil Neural Repair. 2009 Jun;23(5):468-77. doi: 10.1177/1545968308328728. Epub 2008 Dec 31.

Abstract

Background: This study aimed to delineate the cerebral attentional network in patients with traumatic brain injury (TBI) and assess for adaptations in this network in response to a rehabilitation intervention.

Methods: Seventeen patients with TBI and 15 healthy subjects underwent functional magnetic resonance imaging (fMRI) using a visuospatial attention task. Ten TBI patients who successfully completed attentional training had a follow-up fMRI.

Results: In the TBI patients, fMRI analysis showed more activation in the frontal and temporoparietal lobes, as well as less activation in the anterior cingulated gyrus, SMA, and temporooccipital regions compared to the healthy subjects. Following cognitive training, the TBI patients improved performance of attention tasks accompanied by changes in attentional network activation; the activity of the frontal lobe decreased, whereas activation of the anterior cingulate cortices and precuneus increased.

Conclusions: These findings demonstrate the plasticity and training induced redistribution of the visuospatial attentional network in TBI patients.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attention / physiology*
  • Brain Injuries / diagnosis
  • Brain Injuries / physiopathology*
  • Brain Injuries / rehabilitation
  • Brain Mapping
  • Cerebral Cortex / anatomy & histology
  • Cerebral Cortex / physiopathology*
  • Cognition Disorders / physiopathology*
  • Cognition Disorders / rehabilitation
  • Cognitive Behavioral Therapy / methods
  • Disability Evaluation
  • Female
  • Gyrus Cinguli / anatomy & histology
  • Gyrus Cinguli / physiopathology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Memory Disorders / diagnosis
  • Memory Disorders / physiopathology
  • Memory Disorders / rehabilitation
  • Nerve Net / injuries
  • Nerve Net / physiopathology*
  • Neuronal Plasticity / physiology*
  • Outcome Assessment, Health Care
  • Prospective Studies
  • Severity of Illness Index
  • Space Perception / physiology
  • Young Adult