Training of goal-directed attention regulation enhances control over neural processing for individuals with brain injury

Brain. 2011 May;134(Pt 5):1541-54. doi: 10.1093/brain/awr067. Epub 2011 Apr 22.

Abstract

Deficits in attention and executive control are some of the most common, debilitating and persistent consequences of brain injuries. Understanding neural mechanisms that support clinically significant improvements, when they do occur, may help advance treatment development. Intervening via rehabilitation provides an opportunity to probe such mechanisms. Our objective was to identify neural mechanisms that underlie improvements in attention and executive control with rehabilitation training. We tested the hypothesis that intensive training enhances modulatory control of neural processing of perceptual information in patients with acquired brain injuries. Patients (n=12) participated either in standardized training designed to target goal-directed attention regulation, or a comparison condition (brief education). Training resulted in significant improvements on behavioural measures of attention and executive control. Functional magnetic resonance imaging methods adapted for testing the effects of intervention for patients with varied injury pathology were used to index modulatory control of neural processing. Pattern classification was utilized to decode individual functional magnetic resonance imaging data acquired during a visual selective attention task. Results showed that modulation of neural processing in extrastriate cortex was significantly enhanced by attention regulation training. Neural changes in prefrontal cortex, a candidate mediator for attention regulation, appeared to depend on individual baseline state. These behavioural and neural effects did not occur with the comparison condition. These results suggest that enhanced modulatory control over visual processing and a rebalancing of prefrontal functioning may underlie improvements in attention and executive control.

Publication types

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

MeSH terms

  • Adult
  • Attention / physiology*
  • Brain Injuries / complications
  • Brain Injuries / pathology*
  • Brain Injuries / rehabilitation*
  • Cerebral Cortex / blood supply
  • Cerebral Cortex / physiopathology
  • Executive Function / physiology
  • Female
  • Goals*
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Learning Disabilities / etiology
  • Learning Disabilities / rehabilitation
  • Magnetic Resonance Imaging / methods
  • Male
  • Memory Disorders / etiology
  • Memory Disorders / rehabilitation
  • Middle Aged
  • Models, Neurological
  • Neuropsychological Tests
  • Oxygen / blood
  • Social Control, Informal / methods
  • Teaching / methods*
  • Young Adult

Substances

  • Oxygen