Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-17T17:21:51.352Z Has data issue: false hasContentIssue false
  • English
  • Français

Effects of a multifaceted treatment program for executive dysfunction after acquired brain injury on indications of executive functioning in daily life

Published online by Cambridge University Press:  10 November 2009

JACOBA M. SPIKMAN ,
DANIELLE H.E. BOELEN ,
KIRSTEN F. LAMBERTS ,
WIEBO H. BROUWER  and
LUCIANO FASOTTI
JACOBA M. SPIKMAN*
Affiliation:
Department of Neurology, Unit Neuropsychology, University Medical Center Groningen, the Netherlands Department of Clinical Neuropsychology, University of Groningen, the Netherlands
DANIELLE H.E. BOELEN
Affiliation:
Sint Maartenskliniek, Research Development and Education, Nijmegen, the Netherlands Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, the Netherlands
KIRSTEN F. LAMBERTS
Affiliation:
Department of Neurology, Unit Neuropsychology, University Medical Center Groningen, the Netherlands
WIEBO H. BROUWER
Affiliation:
Department of Neurology, Unit Neuropsychology, University Medical Center Groningen, the Netherlands Department of Clinical Neuropsychology, University of Groningen, the Netherlands
LUCIANO FASOTTI
Affiliation:
Sint Maartenskliniek, Research Development and Education, Nijmegen, the Netherlands Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, the Netherlands
*
*Correspondence and reprint requests to: Jacoba M. Spikman, Department of Neurology, Unit Neuropsychology, University Medical Center Groningen (UMCG), PO Box 30.001, 9700 RB Groningen, The Netherlands. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

A multicenter randomized control trial (RCT) was conducted to evaluate the effects of a treatment for dysexecutive problems after acquired brain injury (ABI) on daily life functioning. Seventy-five ABI patients were randomly allocated to either the experimental treatment, multifaceted strategy training for executive dysfunction, or a control treatment, computerized cognitive function training. Assessment took place before, directly after, and 6 months post-treatment. The primary outcome measure, the Role Resumption List (RRL), and two other follow-up measures, the Treatment Goal Attainment (TGA) and the Executive Secretarial Task (EST), were indications of daily life executive functioning. The experimental group improved significantly more over time than the controls on the RRL and attained significantly higher scores on the TGA and EST. We conclude that our treatment has resulted in significant improvements of executive functioning in daily life, lasting at least 6 months post-treatment. Although control patients’ satisfaction and subjective well-being were at the same level, the experimental group had better abilities to set and accomplish realistic goals, to plan, initiate, and regulate a series of real-life tasks, and to resume previous roles with respect to work, social relations, leisure activities, and mobility. (JINS, 2010, 16, 118–129.)

Keywords

RCTDysexecutive syndromeExecutive functionsBrain damageNeuropsychological rehabilitationCognitive trainingEcological validity
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 16 , Issue 1 , January 2010 , pp. 118 - 129
Copyright
Copyright © The International Neuropsychological Society 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Alderman, N. (1991). The treatment of avoidance behaviour following severe brain injury by satiation through negative practice. Brain Injury, 5, 77–86.CrossRefGoogle ScholarPubMed
Anderson, J.R. (1993). Rules of the Mind. Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
Andres, P. (2003). Frontal cortex as the central executive of working memory: Time to revise our view. Cortex, 39, 871–895.CrossRefGoogle ScholarPubMed
Armengol, C.G. (2000). Acute oxygen deprivation: Neuropsychological profiles and implications for rehabilitation. Brain Injury, 14, 237–250.CrossRefGoogle ScholarPubMed
Bamdad, M.J., Ryan, L.M., & Warden, D.L. (2003). Functional assessment of executive abilities following traumatic brain injury. Brain Injury, 17, 1011–1020.CrossRefGoogle ScholarPubMed
Bennett, P.C., Ong, B., & Ponsford, J. (2005). Assessment of executive dysfunction following traumatic brain injury: Comparison of the BADS with other clinical neuropsychological measures. Journal of the International Neuropsychological Society, 11, 606–613.CrossRefGoogle ScholarPubMed
Boelen, D.H., Spikman, J.M., Rietveld, A.C., & Fasotti, L. (2009). Executive dysfunction in chronic brain-injured patients: Assessment in outpatient rehabilitation. Neuropsychological Rehabilitation, [Epub ahead of print].CrossRefGoogle ScholarPubMed
Burgess, P.W., Alderman, N., Evans, J., Emslie, H., & Wilson, B.A. (1998). The ecological validity of tests of executive function. Journal of the International Neuropsychological Society, 4, 547–558.CrossRefGoogle ScholarPubMed
Burgess, P.W., Alderman, N., Forbes, C., Costello, A., Coates, L.M., & Dawson, D.R. (2006). The case for the development and use of “ecologically valid” measures of executive functions in experimental and clinical neuropsychology. Journal of the International Neuropsychological Society, 12, 194–209.CrossRefGoogle ScholarPubMed
Burgess, P.W. & Simons, J.S. (2005). Theories of frontal lobe executive function: Clinical applications. In Halligan, P.W. & Wade, D.T. (Eds.), Effectiveness of Rehabilitation of Cognitive Deficits. Oxford: Oxford University Press.Google Scholar
Burgess, P.W., Wilson, B.A., Evans, J.J., & Emslie, H. (1996). The dysexecutive questionnaire. In Wilson, B.A., Alderman, N., Burgess, P.W., Emslie, H., & Evans, J.J. (Eds.), Behavioural Assessment of the Dysexecutive Syndrome. Bury St. Edmunds, UK: Thames Valley Test Company.Google Scholar
Busch, R.M., McBride, A., Curtiss, A., & Vanderploeg, R.D. (2005). The components of executive functioning in traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 27, 1022–1032.CrossRefGoogle ScholarPubMed
Cicerone, K.D. (2004). Participation as an outcome of traumatic brain injury rehabilitation. The Journal of Head Trauma Rehabilitation, 19, 494–501.CrossRefGoogle ScholarPubMed
Cicerone, K.D., & Giacino, J.T. (1992). Remediation of executive function deficits after traumatic brain injury. Neurorehabilitation, 2, 12–22.CrossRefGoogle Scholar
Cicerone, K.D., Dahlberg, C., Kalmar, K., Langenbahn, D.M., Malec, J.F., Bergquist, T.F., et al. (2000). Evidence-based cognitive rehabilitation: Recommendations for clinical practice. Archives of Physical Medicine and Rehabilitation, 81, 1596–1615.CrossRefGoogle ScholarPubMed
Cicerone, K.D., Dahlberg, C., Malec, J.F., Langenbahn, D.M., Felicetti, T., Kneipp, S., et al. (2005). Evidence-based cognitive rehabilitation: Updated review of the literature from 1998 through 2002. Archives of Physical Medicine and Rehabilitation, 86, 1681–1692.CrossRefGoogle ScholarPubMed
Deelman, B.G., Brouwer, W.H., van Zomeren, A.H., & Saan, R.J. (1980). Functiestoornissen na Trauma Capitis. In Jennekens-Schinkel, A., Diamant, J.J., Diesfelt, H.F.A., & Haaxma, R. (Eds.), Neuropsychologie in Nederland. Deventer: Van Loghum Slaterus.Google Scholar
Eslinger, P.J., & Grattan, L. (1993). Frontal lobe and frontal-striatal substrates for different forms of human cognitive flexibility. Neuropsychologia, 31, 17–28.CrossRefGoogle ScholarPubMed
Fasotti, L., & Spikman, J.M. (2002). Cognitive rehabilitation of central executive disorders. In Brouwer, W.H., van Zomeren, A.H., Berg, I.J., Bouma, J.M., & de Haan, E.H.F. (Eds.), Neuropsychological Rehabilitation: A Cognitive Approach. Amsterdam: Boom.Google Scholar
Fontaine, A., Azouvi, P., Remy, P., Bussel, B., & Samson, Y. (1999). Functional anatomy of neuropsychological deficits after severe traumatic brain injury. Neurology, 53, 1963–1968.CrossRefGoogle ScholarPubMed
Foxx, R.M., Martella, R.C., & Marchand-Martella, N.E. (1989). The acquisition, maintenance, and generalization of problem-solving skills by closed head-injury adults. Behaviour Therapy, 20, 61–76.CrossRefGoogle Scholar
Goldstein, B., Obrzut, J.E., John, C., Ledakis, G., & Armstrong, C.L. (2004). The impact of frontal and non-frontal brain tumor lesions on Wisconsin card sorting performance. Brain and Cognition, 54, 110–116.CrossRefGoogle Scholar
Hart, T., Whyte, J., Kim, J., & Vaccaro, M. (2005). Executive function and self-awareness of ‘real-world’ behavior and attention deficits following traumatic brain injury. Journal of Head Trauma Rehabilitation, 20, 333–347.CrossRefGoogle ScholarPubMed
Jelicic, M., Henquet, C.E., Derix, M.M., & Jolles, J. (2001). Test-retest reliability of the behavioural assessment of the dysexecutive syndrome in an sample of psychiatric patients. International Journal of Neuroscience, 110, 73–78.CrossRefGoogle Scholar
Lamberts, K.F., Evans, J.J., & Spikman, J.M. (2009). A real-life, ecologically valid test of executive functioning: The executive secretarial task. Journal of Clinical and Experimental Neuropsychology, [Epub ahead of print].Google Scholar
Leskela, M., Hietanen, M., Kalska, H., Yliskoski, R., Pohjasvaara, T., Mantyla, R., et al. (1999). Executive functions and speed of mental processing in elderly patients with frontal or nonfrontal ischemic stroke. European Journal of Neurology, 6, 653–661.CrossRefGoogle ScholarPubMed
Levine, B., Robertson, I.H., Clare, L., Carter, G., Hong, J., Wilson, B.A., et al. (2000). Rehabilitation of executive functioning: An experimental-clinical validation of goal management training. Journal of the International Neuropsychological Society, 6, 299–312.CrossRefGoogle ScholarPubMed
Lezak, M.D. (1982). The problem of assessing executive functions. International Journal of Psychology, 17, 281–297.CrossRefGoogle Scholar
Lichter, D.G., & Cummings, J.L. (2001). Frontal-Subcortical Circuits in Psychiatric and Neurological Disorders. New York: The Guildford Press.Google Scholar
Luteijn, F., & van der Ploeg, F.A.E. (1983). Groninger Intelligentie Test. Lisse: Swets & Zeitlinger.Google Scholar
Manly, T., Hawkins, K., Evans, J., Woldt, K., & Robertson, I.H. (2002). Rehabilitation of executive function: Facilitation of effective goal management on complex tasks using periodic auditory alerts. Neuropsychologia, 40, 271–281.CrossRefGoogle ScholarPubMed
Marker, K.R. (1987). COGPACK. The Cognitive Training Package Manual. Heidelberg & Laenburg: Marker Software.Google Scholar
Medd, J., & Tate, R.L. (2000). Evaluation of an anger management therapy programme following acquired brain injury: A preliminary study. Neuropsychological Rehabilitation, 10, 185–201.CrossRefGoogle Scholar
Mountain, M.A., & Snow, W.G. (1993). Wisconsin Card Sorting Test as a measure of frontal pathology: A review. The Clinical Neuropsychologist, 7, 108–118.CrossRefGoogle Scholar
Newell, A. (1991). Unified Theories of Cognition. Cambridge, MA: Cambridge University Press.Google Scholar
Norris, G., & Tate, R.L. (2000). The Behavioural Assessment of the Dysexecutive Syndrome (BADS): Ecological, concurrent and construct validity. Neuropsychological Rehabilitation, 10, 33–45.CrossRefGoogle Scholar
Pohjasvaraa, T., Leskela, M., Vataja, R., Kalska, H., Yliskoski, R., Hietanen, M., et al. (2002). Post-stroke depression, executive dysfunction and functional outcome. European Journal of Neurology, 9, 269–275.CrossRefGoogle Scholar
Pollens, R.D., McBratnie, B.P., & Burton, P.L. (1988). Beyond cognition: Executive functions in closed head injury. The Journal of Cognitive Rehabilitation, 6, 26–32.Google Scholar
Rath, J.F., Simon, D., Langenbahn, D.M., Sherr, R.L., & Diller, L. (2003). Group treatment of problem-solving deficits in outpatients with traumatic brain injury; a randomised outcome study. Neuropsychological Rehabilitation, 13, 461–488.CrossRefGoogle Scholar
Rockwood, K., Joyce, B., & Stolee, P. (1997). Use of goal attainment scaling in measuring clinically important change in cognitive rehabilitation patients. Journal of Clinical Epidemiology, 50, 581–588.CrossRefGoogle ScholarPubMed
Sachdev, P.S., Braodaty, H., Valenzuela, M.J., Lorentz, L., Looi, J.C., Wen, W., et al. (2004). The neuropsychological profile of vascular cognitive impairment in stroke and TIA patients. Neurology, 62, 912–919.CrossRefGoogle ScholarPubMed
Sbordone, R.J. (2000). The executive functions of the brain. In Groth-Marnat, G. (Ed.), Neuropsychological Assessment in Clinical Practice; A Guide to Test Interpretation and Integration (pp. 437–456). New York, NY: John Wiley & Sons, Inc.Google Scholar
Shallice, T. (1982). Specific impairments of planning. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, 298, 199–209.Google ScholarPubMed
Shallice, T., & Burgess, P.W. (1991). Deficits in strategy application following frontal lobe damage in man. Brain, 114, 727–741.CrossRefGoogle ScholarPubMed
Simo-Guerrero, M., Chirivella-Garrido, J., Ferri-Campos, J., Ramirez, R.M., Caballero, M.C., & Noe-Sebastian, E. (2004). Anoxic encephalopathy: Clinical description, prognosis and neuroimaging. Neurology, 38, 111–117.Google ScholarPubMed
Sirigu, A., Zalla, T., Pillon, B., Grafman, J., Agid, Y., & Dubois, B. (1996). Encoding of sequence and boundaries of scripts following prefrontal lesions. Cortex, 32, 297–310.CrossRefGoogle ScholarPubMed
Spikman, J.M., Brand, B., & Brouwer, W.H. (2003). Rolhervattingslijst [Role Resumption List]. Internal Publication of the University Medical Centre Groningen, the Netherlands. Groningen: Groningen University Medical Centre.Google Scholar
Spikman, J.M., Deelman, B.G., & van Zomeren, A.H. (2000). Executive functioning, attention and frontal lesions in patients with chronic CHI. Journal of Clinical and Experimental Neuropsychology, 22, 325–338.CrossRefGoogle ScholarPubMed
Spikman, J.M., Hol-Steegstra, A., Rietberg, H., Vos, S., Boelen, D., & Lamberts, K.F. (2007). The Executive Secretariat Task (EST); A real-life, ecologically valid measurement of executive functioning. Brain Impairment, 8, 223.Google Scholar
Spooner, D.M., & Pachana, N.A. (2006). Ecological validity in neuropsychological assessment: A case for greater consideration in research with neurologically intact populations. Archives of Clinical Neuropsychology, 21, 327–337.CrossRefGoogle ScholarPubMed
Stroop, J.R. (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology, 18, 643–662.CrossRefGoogle Scholar
Sturm, W., Fimm, B., Cantagello, A., Cremel, N., North, P., Passadori, A., et al. (2002). Computerized training of specific attention deficits in stroke and traumatic brain-injured patients; a multicentric efficacy study. In Leclerq, M. & Zimmermann, P. (Eds.), Applied Neuropsychology of Attention; Theory, Diagnosis and Rehabilitation. London: Psychology Press.Google Scholar
Sturm, W., Willmes, K., Orgass, B., & Hartje, W. (1997). Do specific deficits need specific training? Neuropsychological Rehabilitation, 7, 81–103.CrossRefGoogle Scholar
Stuss, D.T. (2006). Frontal lobes and attention: Processes and networks, fractionation and integration. Journal of the International Neuropsychological Society, 12, 261–271.CrossRefGoogle ScholarPubMed
Stuss, D.T., & Alexander, M.P. (2000). Executive functions and the frontal lobes: A conceptual view. Psychological Research, 63, 289–298.CrossRefGoogle ScholarPubMed
Suzman, K.B., Morris, R.D., Morris, M.K., & Millan, M.A. (1997). Cognitive-behavioral remediation of problem solving deficits in children with acquired brain injury. Journal of Behavioral Therapy and Experimental Psychiatry, 28, 203–212.CrossRefGoogle ScholarPubMed
Tucha, O., Smely, C., Preier, M., & Lange, K.W. (2000). Cognitive deficits before treatment among patients with brain tumors. Neurosurgery, 47, 324–333.CrossRefGoogle ScholarPubMed
van Zomeren, A.H., & van den Burg, W. (1985). Residual complaints of patients two years after severe head injury. Journal of Neurology, Neurosurgery and Psychiatry, 48, 21–28.CrossRefGoogle ScholarPubMed
von Cramon, D.Y., & Matthes-von Cramon, G. (1994). Back to work with a chronic dysexecutive syndrome? (A Case Report). Neuropsychological Rehabilitation, 4, 399–417.CrossRefGoogle Scholar
VonSteinbüchel, N., Petersen, C., & Bullinger, M. (2005). Assessment of health-related quality of life in persons after traumatic brain injury: Development of the QOLIBRI. Acta Neurochirurgica Supplementum, 93, 43–49.CrossRefGoogle Scholar
Wilson, B.A., Alderman, N., Burgess, P.W., Emslie, H., & Evans, J.J. (1996). Behavioural Assessment of the Dysexecutive Syndrome. Bury St. Edmunds: Thames Valley Test Company.Google Scholar
Wood, R.L., & Liossi, C. (2006). The ecological validity of executive tests in a severely brain injured sample. Archives of Clinical Neuropsychology, 21, 429–437.CrossRefGoogle Scholar
Worthington, A.D. (2005). The natural recovery and treatment of executive disorders. In Halligan, P.W., Kischka, U., & Marshall, J.C. (Eds.), Handbook of Clinical Neuropsychology. Oxford: Oxford University Press.Google Scholar
Ylvisaker, M. (1998). Traumatic Brain Injury Rehabilitation: Children and Adolescents. Boston: Butterworth Heinemann.Google Scholar