Attention and Arousal in Neurorehabilitation

Robertson, Ian; Levine, Brian

doi:10.1093/med/9780199837755.003.0053

Cited by 6 publications

(10 citation statements)

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“…Improving the awareness of attentional errors is crucial to GMT, rehearsed throughout the sessions by means of noticing attentional slips, stopping the autopilot, and improving present-mindedness. These tendencies are consistent with the theoretical assumptions that GMT targets executive attention (Robertson & Levine, 2013). This result can be seen as a contribution to disentangle the non-specific from the GMT-specific training-effects, resulting in fewer but theoretically more important findings, such as GMT possibly being associated with distinct improvement of inhibitory control.…”

Section: Discussionsupporting

confidence: 89%

Section: The Use Of Neuropsychological Tests As Outcome Measures Raissupporting

confidence: 89%

“…GMT attempts to address underlying deficits in sustained attention (Robertson & Levine, 2013) and could thus be conceptualized as a “bottom-up” intervention targeting the impairment-level. However, as a metacognitive strategy intervention aiming at improved “top-down” control, GMT also targets the activity- and participation-level (Bilbao et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

“…Studies of GMT for patients with ABI have reported improved sustained and executive attention (error reduction, planning and time allocation) (Levine et al, 2000, 2011; Metzler-Baddeley and Jones, 2010; Novakovic-Agopian et al, 2011; Schweitzer et al, 2008), and reduction of ED in daily life (Miotto et al, 2009; Spikman et al, 2010). Imaging studies have suggested that GMT results in functional changes in brain networks supporting sustained attention (Chen et al, 2011; Robertson & Levine, 2013), which in turn may lead to functional improvements that generalize to broader domains of goal-directed behaviors.…”

Section: Introductionmentioning

confidence: 99%

“…Still, the significance of "STOP" was different for the groups, considering "STOP" a key-concept in GMT, and non-present in BHW. As such, this cuing was not "content-free", and might have augmented treatment-effects in the GMT group specifically (Fish et al, 2007;Manly et al, 2002).GMT attempts to address underlying deficits in sustained attention (Robertson & Levine, 2013) and could thus be conceptualized as a "bottom-up" intervention targeting the Tornås-Goal Management Training in ABI 20 impairment-level. However, as a metacognitive strategy intervention aiming at improved "top-down" control, GMT also targets the activity-and participation-level (Bilbao et al, 2003).…”

mentioning

confidence: 99%

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Rehabilitation of Executive Functions in Patients with Chronic Acquired Brain Injury with Goal Management Training, External Cuing, and Emotional Regulation: A Randomized Controlled Trial

Tornås

Løvstad

Solbakk

et al. 2016

J Int Neuropsychol Soc

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Methods: Seventy patients with a verified ABI and executive dysfunction were randomly allocated to GMT (n = 33) or a psycho-educative active control condition, Brain Health Workshop (BHW) (n = 37). In addition, all participants received external cueing by text messages. Neuropsychological tests and self-reported questionnaires of executive functioning were administered pre-intervention, immediately after intervention, and at 6 months followup. Assessors were blinded to group allocation.Results: Questionnaire measures indicated significant improvement of everyday executive functioning in the GMT group, with effects lasting at least 6 months post-treatment. Both groups improved on the majority of the applied neuropsychological tests. However, improved performance on tests demanding executive attention was most prominent in the GMT group. Conclusions:The results indicate that GMT combined with external cueing is an effective metacognitive strategy training method, ameliorating executive dysfunction in daily life for patients with chronic ABI. The strongest effects were seen on self-report measures of executive functions 6 months post-treatment, suggesting that strategies learned in GMT were applied and consolidated in everyday life after the end of training. Furthermore, these findingsshow that executive dysfunction can be improved years after the ABI. INTRODUCTIONExecutive functions (EF) are required for independent, purposive, self-directed behavior and include processes of initiation, planning, purposive action, volition, inhibition, flexibility, as well as self-monitoring and self-regulation (Lezak, 1995;Stuss, 2011). A division between "cold" and "hot" components of EF has been suggested, with "cold" EF corresponding closely to cognitive and logical processes, and the "hot" aspects of EF involving regulation of emotion and motivation (Chan, Shum, Toulopoulou & Chen, 2008).Thus, EF is an umbrella term for a set of interrelated capacities resulting from activity in anatomically and functionally independent, but interconnected networks subserved by widespread brain regions, the prefrontal cortex playing a central role (Stuss & Alexander, 2007).Executive dysfunction (ED) is common following acquired brain injury (ABI) (Stuss & Levine, 2002;Novakovic-Agopian et al, 2011), and may disrupt the ability to effectively use intact functions or compensatory strategies, undermine efficient self-management (Lewis, Babbage & Leathem, 2011), hamper the rehabilitation process (Robertson & Murre, 1999), and is also associated with long-term negative psychosocial and vocational outcome (Draper & Ponsford, 2008; Ylvisaker & Feeney, 2000). Thus, techniques for reducing ED might significantly impact functional outcome (Manly & Murphy, 2012).Most theories describe EF as top-down controlled processes involved in the control and direction of self-regulatory cognition, emotion and behavior (Cicerone et al., 2006;Stuss, 2011). Current theories of cognitive EF bear close resemblance to dominant models of attention (Norman & Shalli...

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Section: Discussionsupporting

confidence: 89%

Section: The Use Of Neuropsychological Tests As Outcome Measures Raissupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Rehabilitation of Executive Functions in Patients with Chronic Acquired Brain Injury with Goal Management Training, External Cuing, and Emotional Regulation: A Randomized Controlled Trial

Tornås

Løvstad

Solbakk

et al. 2016

J Int Neuropsychol Soc

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Emotional health and coping in spina bifida after goal management training: A randomized controlled trial.

Stubberud

Langenbahn

Levine

et al. 2015

Rehabilitation Psychology

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Moderators, mediators and nonspecific predictors of outcome after cognitive rehabilitation of executive functions in a randomised controlled trial

Tornås

Stubberud

Solbakk

et al. 2017

Neuropsychological Rehabilitation

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The majority of treatment effects were nonspecific to intervention, probably underscoring the variables' general contribution to outcome of cognitive rehabilitation interventions. Interventions targeting specific cognitive domains, such as attention or working memory, need to take into account the patients' overall cognitive and emotional self-perceived functioning. Future studies should investigate the identified predictors further, and also consider other predictor candidates.

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Attention and Arousal in Neurorehabilitation

Cited by 6 publications

References 0 publications

Rehabilitation of Executive Functions in Patients with Chronic Acquired Brain Injury with Goal Management Training, External Cuing, and Emotional Regulation: A Randomized Controlled Trial

Rehabilitation of Executive Functions in Patients with Chronic Acquired Brain Injury with Goal Management Training, External Cuing, and Emotional Regulation: A Randomized Controlled Trial

Emotional health and coping in spina bifida after goal management training: A randomized controlled trial.

Moderators, mediators and nonspecific predictors of outcome after cognitive rehabilitation of executive functions in a randomised controlled trial

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