Serious brain injury shows remarkable improvement with cognitive rehabilitation, a study in the January 2009 issue of Neuropsychology shows.
The presented data suggests that treatment may work best when tailored to age, injury, symptoms, and time since injury. Importantly, the findings may help establish evidence-based treatment guidelines.
The researchers worked with studies whose samples and methods were most amenable to rigorous statistical techniques and documented the extent to which various treatments improve the language, attention, memory and other cognitive problems that appear after acquired brain injury (such as from trauma, stroke or loss of oxygen - in other words, not congenital).
The authors had concluded there was enough evidence to generally support the use of a variety of rehabilitative treatments. To develop specific treatment guidelines, this new analysis documented the extent to which treatment type and timing, origin of the injury, recovery level, and participant age affected the odds of success.
Generally, it is better to start treating patients as early as possible, rather than waiting for a more complete neurological recovery. Even older patients (age 55 and up) may benefit from cognitive rehabilitation, particularly if the brain injury is due to stroke.
Clinicians should focus their efforts on direct cognitive skills training in specific cognitive domains. More holistic, non-targeted interventions appear to be less effective. Especially if they were treated soon after the event, language training helped older people after stroke. Language training was still effective, just not as much, when it started more than a year after the stroke.
