Article

Traumatic brain injury, due to its diffuse nature and high
frequency of injury to frontotemporal and midbrain reticular activating systems,
may cause disruption in many aspects of attention: arousal, selective attention,
speed of information processing, and strategic control of attention, including
sustained attention, shifting and dividing of attention, and working memory. An
international team of researchers and clinicians (known as INCOG) convened to
develop recommendations for the management of attentional problems. METHODS: The
experts selected recommendations from published guidelines and then reviewed
literature to ensure that recommendations were current. Decision algorithms
incorporating the recommendations based on inclusion and exclusion criteria of
published trials were developed. The team then prioritized recommendations for
implementation and developed audit criteria to evaluate adherence to these best
practices. RESULTS: The recommendations and discussion highlight that
metacognitive strategy training focused on functional everyday activities is
appropriate. Appropriate use of dual task training, environmental modifications,
and cognitive behavioral therapy is also discussed. There is insufficient
evidence to support mindfulness meditation and practice on de-contextualized
computer-based tasks for attention. Administration of the medication
methylphenidate should be considered to improve information-processing speed.
CONCLUSION: The INCOG recommendations for rehabilitation of attention provide
up-to-date guidance for clinicians treating people with traumatic brain injury.

Langue : ANGLAIS