Treatment of attention deficits in neurological disorders.
OBJECTIVE
Recent work has revealed the impact of deficits of attention on patients with neurological disorders. Here we discuss therapeutic interventions that have been used across a range of conditions, highlighting common themes both in the nature of the attention deficits and the strategies employed to treat them.


RESULTS
Cholinesterase inhibitors improve attention, as well as memory, in several conditions including cortical Lewy body disease, Parkinson's disease dementia, traumatic brain injury and Alzheimer's disease. Recent studies suggest that cholinergic stimulation may boost attention further if more specific nicotinic cholinergic agonists are used, or if cholinesterase inhibitors are combined with other agents. Monoaminergic drugs have been shown to improve attention in traumatic brain injury, attention-deficit hyperactivity disorder and hemispatial neglect following right-hemisphere stroke. New compounds targeting other neurotransmitter systems are currently being tested, while several types of behavioural intervention have shown promise, particularly in stroke patients.


CONCLUSIONS
Pharmacological and behavioural interventions can improve attention in neurological patients. In the future, optimum therapy may depend on careful delineation of the components of attention that are impaired as well as assessment of the potential for surviving brain regions to compensate for attention deficits.
Coulthard
Elizabeth
E
Institute of Cognitive Neuroscience, University College London, London, UK. l.coulthard@ion.ucl.ac.uk
Singh-Curry
Victoria
V
Husain
Masud
M
D001288:Attention / Q000187:drug effects* / Q000502:physiology; D015306:Biogenic Monoamines / Q000819:agonists / Q000378:metabolism; D001921:Brain / Q000187:drug effects* / Q000503:physiopathology; D001925:Brain Damage, Chronic / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D001927:Brain Diseases / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000494:pharmacology / Q000627:therapeutic use; D018679:Cholinergic Agonists / Q000494:pharmacology; D006801:Humans; D019965:Neurocognitive Disorders / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D009480:Neuropharmacology / Q000639:trends
D015306:Biogenic Monoamines; D000697:Central Nervous System Stimulants; D018679:Cholinergic Agonists