The purpose of this study was to investigate the effects of donepezil, a cholinergic agent, on chronic cognitive impairment due to traumatic brain injury (TBI). Chronic patients underwent two standardized neuropsychological evaluations – one before and the other 3 months following treatment with donepezil. Together with global inventories that appraised behaviour, fatigue, anxiety and depression, these evaluations also assessed executive functioning, memory and attention. Of the 10 patients who followed the therapy, 8 reported subjective improvement in at least one cognitive domain following therapy and most of them reported better functioning in everyday activities. This effect was supported by a slight global improvement when considering the global score of the different affectivo-behavioural scales. At the neuropsychological level, although we could observe a slight improvement in the majority of the considered tests, significant positive changes were mainly found in tests assessing speed of processing, learning and divided attention. These findings suggest that donepezil may lead to better general functioning and improve attentional skills in patients with chronic TBI.

Although socio-emotional changes are very frequently encountered after traumatic brain injury (TBI), the psychological mechanisms underlying these disorders are still poorly understood. This study aimed to explore the relationships between dysexecutive syndrome (assessed with the Behavioural Assessment of the Dysexecutive Syndrome [BADS]) and socio-emotional changes assessed by the Iowa scales of personality change (ISPC) in patients with TBI. The BADS was thus administered to 25 patients with TBI and to 25 healthy controls. Simultaneously, a close relative of each patient was given the ISPC in order to assess socio-emotional changes. Results indicated that patients displayed significantly lower executive performances than controls and experimented significant socio-emotional changes. The Modified Six Elements Test was the only subtask of the BADS to be significantly related to behavioural changes, and more specifically to externalizing disorders. It is concluded that executive functions, and especially multitasking, encompass processes whereby one can consciously control one's emotional reactions and behaviours.