Rehabilitation of executive deficits in closed head injury and anterior communicating artery aneurysm patients.

This paper reports a study that was aimed to rehabilitate executive functions in closed head injury (CHI) and anterior communicating artery (ACoA) aneurysm patients. The groups tested comprised 10 CHI patients, 9 ACoA aneurysm patients and 19 controls. We employed a dual-task paradigm that is known to tap the ability to co-ordinate two actions. The treatment consisted of five experimental sessions, in which the dual-task paradigm was used. In the CHI study, the dual-task cost was measured before the treatment (assessment), immediately after the treatment (retest), and 3 months after the treatment (follow-up). In the ACoA aneurysm study, the dual-task cost was also assessed 12 months after the treatment. A significant reduction of the dual-task cost from assessment to retest was found. This reduction remained stable in the follow-up sessions. The results are discussed with reference to the absence of spontaneous recovery of this specific executive function and to the possibility that the beneficial effect of the treatment generalises to other executive functions and/or daily living activities.

Executive functioning following mild closed head injury.

This study was aimed to identify impaired attentional components in mild CHI patients. The CHI features taken into account were age (< or = 30 vs. > 30 years), loss of consciousness (yes vs. no), and time after injury (few days vs. some months). The groups tested were composed of 26 patients and 26 controls (matched for age, sex and education). Experiment 1 used a dual-task paradigm (Umiltà et al., 1992), which taps executive functions. The double task-single task difference was greater for the CHI group, but only for patients older than 30 years and/or with consciousness loss. Two years after injury, some of these patients were retested: The results showed that this deficit was still present. Experiment 2 studied visual selective attention using the Navon (1977) paradigm. In this case, there were no differences between patients and controls. The results are discussed with reference to the anterior/posterior attention systems.