Article

Although attention functions are often impaired after stroke, traumatic brain
injury or inflammatory diseases, little is known about the time course and the
long-term efficacy of training-induced improvement. The present single case study
evaluates the time course and longitudinal stability of attention improvement
after alertness training by repeatedly testing the subject between individual
training sessions as well as one and seven months after the end of the training.
The outpatient (M.P.) trained developed severe alertness deficits following
brainstem encephalitis in 2003 without signs of cortical damage, and since then
had not achieved full recovery. In 2008, M.P. participated in 15 treatment
sessions on 15 separate working days over a period of three weeks. In each
session a 45-minute alertness training task was administered, using the CogniPlus
ALERT computer training program. Attention performance was assessed by
neuropsychological tests four years, one year, and immediately before the therapy
after every third training session and three times after the termination of
therapy. Furthermore, a self-report questionnaire measured subjective experience
of attention in everyday life situations. In order to compare the performance
between training sessions, a procedure specialised for psychometric single-case
diagnosis was used to analyse the data. Surprisingly, even after three
consecutive training sessions, M.P. showed immense improvement in alertness.
Furthermore, after two weeks she felt more energetic and more able to
concentrate. Six months after the end of the training the improvement remained
stable. The unexpectedly fast time course of recovery induced by the training, as
well as the stable long-term effects, probably depend on intact cortical
structures. In M.P. it appeared that top-down control of the alertness network on
impaired brainstem arousal structures had been re-activated by the training
procedure and had remained stable across a long time period.

Langue : ANGLAIS