Plasticity of the attentional network after brain injury and cognitive rehabilitation.
BACKGROUND
This study aimed to delineate the cerebral attentional network in patients with traumatic brain injury (TBI) and assess for adaptations in this network in response to a rehabilitation intervention.


METHODS
Seventeen patients with TBI and 15 healthy subjects underwent functional magnetic resonance imaging (fMRI) using a visuospatial attention task. Ten TBI patients who successfully completed attentional training had a follow-up fMRI.


RESULTS
In the TBI patients, fMRI analysis showed more activation in the frontal and temporoparietal lobes, as well as less activation in the anterior cingulated gyrus, SMA, and temporooccipital regions compared to the healthy subjects. Following cognitive training, the TBI patients improved performance of attention tasks accompanied by changes in attentional network activation; the activity of the frontal lobe decreased, whereas activation of the anterior cingulate cortices and precuneus increased.


CONCLUSIONS
These findings demonstrate the plasticity and training induced redistribution of the visuospatial attentional network in TBI patients.
Kim
Yun-Hee
YH
Department of Physical Medicine and Rehabilitation, Division for Neurorehabilitation, Stroke and Cerebrovascular Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. yunkim@skku.edu
Yoo
Woo-Kyoung
WK
Ko
Myoung-Hwan
MH
Park
Chang-hyun
CH
Kim
Sung Tae
ST
Na
Duk L
DL
D000328:Adult; D001288:Attention / Q000502:physiology*; D001930:Brain Injuries / Q000175:diagnosis / Q000503:physiopathology* / Q000534:rehabilitation; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000033:anatomy & histology / Q000503:physiopathology*; D003072:Cognition Disorders / Q000503:physiopathology* / Q000534:rehabilitation; D015928:Cognitive Behavioral Therapy / Q000379:methods; D004185:Disability Evaluation; D005260:Female; D006179:Gyrus Cinguli / Q000033:anatomy & histology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation; D009415:Nerve Net / Q000293:injuries / Q000503:physiopathology*; D009473:Neuronal Plasticity / Q000502:physiology*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D012720:Severity of Illness Index; D013028:Space Perception / Q000502:physiology; D055815:Young Adult