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February 1990, Vol 47, No. 2 >
Article | February 1990

The Efficacy of Cognitive Rehabilitation in Patients With Traumatic Brain Injury

Bruce T. Volpe, MD; Fletcher H. McDowell, MD
[+] Author Affiliations

Accepted for publication April 12, 1989.

Reprint requests to Cornell University Medical School, the Burke Rehabilitation Center, 785 Mamaroneck Ave, White Plains, NY 10605 (Dr Volpe).


Arch Neurol. 1990;47(2):220-222. doi:10.1001/archneur.1990.00530020128026
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Does specific therapy for patients with cognitive disorders that occur after traumatic brain injury (TBI) produce a specific and obvious improvement in quality of life? The medical literature on this question is voluminous but this review is limited to 20 relevant publications.1-19

First there are chapters, reviews, and editorials that sound a clarion call for action. There can be no disagreement that the loss of intellect and subsequent personality changes in patients with TBI are catastrophic. Unlike other neurologic disease, TBI compounds the basic neurologic infirmity with the prospect of 30 to 40 more years of disabled life. The burden for families and in many cases the eventual burden to society has received attention from medical economists and

REFERENCES

1 +
Crosson B, Buenning W.  An individual memory retraining program after closed head injury . J Clin Neuropsychol . 1984;;6:287-301.
2 +
Ryan EB, Short EJ, Weed KA.  The role of cognitive strategy training in improving academic performance of learning disabled children . J Learn Disabilities . 1986;;19:521-529.
3 +
Diller L, Gordon WA.  Interventions for cognitive deficits in brain injured adults . J Consult Clin Psychol . 1981;;49:822-834.
4 +
Glisky EL, Schacter DL, Tulving E.  Computer learning by memory-impaired patients: acquisition and retention of complex knowledge . Neuropsychologia . 1986;;24:313-328.
5 +
Glisky EL, Schacter DL, Tulving E.  Learning and retention of computer-related vocabulary in memory-impaired patients . J Clin Exp Neuropsychol . 1986;;8:282-312.
6 +
Kirn TF.  Cognitive rehabilitation aims to improve or replace memory functions in survivors of head injury . JAMA . 1987;;257:2400-2402.
7 +
Prigatano GP, Fordyce DJ, Zeiner HK, Roueche JR, Pepping M, Wood BC.  Neuropsychological rehabilitation after closed head injury in young adults . J Neurol Neurosurg Psychiatry . 1984;;47:505-513.
8 +
Ekberg K.  Cognitive approach to neuropsychological assessment . Scand J Work Environ Health Suppl . 1984;;10:36-38.
9 +
Muller R, Naumann B.  Early ambulation and psychotherapy for treatment of closed head injury . Arch Neurol . 1956;;76:597-607.
10 +
Scherzer BP.  Rehabilitation following severe head trauma . Arch Phys Med Rehabil . 1986;;67:366-374.
11 +
Corrigan JD, Arnett JA, Houck LJ, Jackson RD.  Reality orientation for brain injured patients . Arch Phys Med Rehabil . 1985;;66:626-630.
12 +
Cole JR, Cope DN, Cervelli L.  Rehabilitation of the severely brain-injured patient . Arch Phys Med Rehabil . 1985;;66:38-40.
13 +
Weinberg J, Diller L, Gordon WA, et al.  Training sensory awareness and spatial organization in people with right brain damage . Arch Phys Med Rehabil . 1979;;60:491-496.
14 +
Willis SL.  Cognitive training in everyday competence . Ann Rev Gerontol Geriatr . 1987;;7:159-188.
15 +
Abreu BC, Toglia JP.  Cognitive rehabilitation: a model for occupational therapy . Am J Occup Ther . 1987;;41:439-448.
16 +
Kirn TF.  Tapping into 'procedural' memory helps patients with amnesia to acquire new occupational skills . JAMA . 1987;;257:3187.
17 +
 Report of research aspects of rehabilitation after acute brain damage in adults . Lancet . 1982;;2:1034-1036.
18 +
Malec J, Questad K.  Rehabilitation of memory after craniocerebral trauma: case report . Arch Phys Med Rehabil . 1983;;64:436-438.
19 +
Hayden ME, Hart T.  Rehabilitation of cognitive and behavioral dysfunction in head injury . Adv Psychosom Med . 1986;;16:194-229.
20 +
Anderson DW, McLaurin RL, eds. National Head and Spinal Cord Injury Survey . Bethesda, Md: National Institute of Neurological and Communicative Disorders in Stroke; 1980;.
21 +
Becker DP, Povlishock JT, eds. Central Nervous System Trauma Status Report . Bethesda Md: National Institutes of Health; 1985;.
22 +
Jennett B, Teasdale G. Management of head injuries. Contemporary Neurology Series . Philadelphia, Pa: FA Davis Co Publishers; 1981;;20:77-84.
23 +
Hamill RW, Woolf PD, McDonald JV, Lee LA, Kelly M.  Catecholamines predict outcome in traumatic brain injury . Ann Neurol . 1987;;21:438-443.
24 +
Braakman R, Gelphe GJ, Habbema JD, Maas AI, Minderhoud JM.  Systematic selection of prognostic features in patients with severe head injury . Neurosurgery . 1980;;6:362-370.
25 +
Choi SC, Ward JD, Becker DP.  Chart for outcome predictions in severe head injury . J Neurosurg . 1983;;59:294-297.
26 +
Lobato RD, Cordobes F, Rivas JJ, et al.  Outcome from severe head injury related to the type of intracranial lesion: a computerized tomographic study . J Neurosurg . 1983;;59:762-774.
27 +
Narayan RK, Greenberg RP, Miller JN, et al.  Improved confidence of outcome predictions in severe head injury: a comparative analysis of the clinical examination, multimodality evoked potentials, CT scanning and intracranial pressure . J Neurosurg . 1981;;54:751-762.
28 +
Adams JH, Graham DL, Murray LS, Scott G.  Diffuse axonal injury due to non-missile head injury: an analysis of 45 cases . Ann Neurol . 1982;;12:557-563.
29 +
Levin HS, Amparo E, Eisenberg H, et al.  Magnetic resonance imaging and computerized tomography in relation to the neurobehavioral sequelae of mild and moderate head injuries . J Neurosurg . 1987;;66:716-723.
30 +
Marler JR, Walker MD.  Clinical research on stroke: the NINCDS strategy . In: Ginsberg MD, ed. Princeton Conference on Cerebral Vascular Diseases . New York, NY: Raven Press; 1989;:17-21.
31 +
Dikmen S, Temkin N, McLean A, Wyler A, Machamer J.  Memory and head injury severity . J Neurol Neurosurg Psychiatry . 1987;;50:1613-1618.
32 +
Caramazza A.  The logic of neuropsychological research and the problem of patient classification in aphasia . Brain Lang . 1984;;21:9-20.
33 +
Fodor JA. The Modularity of Mind . Cambridge, Mass: MIT Press; 1983;.
34 +
Ashenasy JJM, Rahmani L.  Neuropsychosocial rehabilitation of head injury . Am J Phys Med . 1987;;66:315-327.
35 +
Balliet R, Harbst KB, Kim D, Stewart RV.  Retraining of functional gait through the reduction of upper extremity weight bearing in chronic cerebellar ataxia . Int J Rehabil Med . 1987;;8:148-153.
36 +
Bach-y-Rita P.  Neural aspects of motor function as a basis of early and post acute rehabilitation . In: Delisa JA ed. Principles and Practice of Rehabilitation Medicine . Philadelphia, Pa: JB Lippincott Co; 1988;; chap 10.
37 +
Kotsoris HO, Volpe BT.  Clinical characteristics of delayed recovery from post traumatic ataxia . J Neurol Rehabil . 1987;;2:73-78.
38 +
Cotman CW, Anderson KJ.  Synaptic plasticity and functional stabilization in the hippocampal formation: possible role in Alzheimer's disease . In: Waxman SG, ed. Advances in Neurology: Functional Recovery in Neurologic Disease . New York, NY: Raven Press; 1988;;47:313-337.
39 +
Landau WM, Hartman JS.  Letter to the editor . Arch Neurol . 1988;;45:371-373.

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1 +
Crosson B, Buenning W.  An individual memory retraining program after closed head injury . J Clin Neuropsychol . 1984;;6:287-301.
2 +
Ryan EB, Short EJ, Weed KA.  The role of cognitive strategy training in improving academic performance of learning disabled children . J Learn Disabilities . 1986;;19:521-529.
3 +
Diller L, Gordon WA.  Interventions for cognitive deficits in brain injured adults . J Consult Clin Psychol . 1981;;49:822-834.
4 +
Glisky EL, Schacter DL, Tulving E.  Computer learning by memory-impaired patients: acquisition and retention of complex knowledge . Neuropsychologia . 1986;;24:313-328.
5 +
Glisky EL, Schacter DL, Tulving E.  Learning and retention of computer-related vocabulary in memory-impaired patients . J Clin Exp Neuropsychol . 1986;;8:282-312.
6 +
Kirn TF.  Cognitive rehabilitation aims to improve or replace memory functions in survivors of head injury . JAMA . 1987;;257:2400-2402.
7 +
Prigatano GP, Fordyce DJ, Zeiner HK, Roueche JR, Pepping M, Wood BC.  Neuropsychological rehabilitation after closed head injury in young adults . J Neurol Neurosurg Psychiatry . 1984;;47:505-513.
8 +
Ekberg K.  Cognitive approach to neuropsychological assessment . Scand J Work Environ Health Suppl . 1984;;10:36-38.
9 +
Muller R, Naumann B.  Early ambulation and psychotherapy for treatment of closed head injury . Arch Neurol . 1956;;76:597-607.
10 +
Scherzer BP.  Rehabilitation following severe head trauma . Arch Phys Med Rehabil . 1986;;67:366-374.
11 +
Corrigan JD, Arnett JA, Houck LJ, Jackson RD.  Reality orientation for brain injured patients . Arch Phys Med Rehabil . 1985;;66:626-630.
12 +
Cole JR, Cope DN, Cervelli L.  Rehabilitation of the severely brain-injured patient . Arch Phys Med Rehabil . 1985;;66:38-40.
13 +
Weinberg J, Diller L, Gordon WA, et al.  Training sensory awareness and spatial organization in people with right brain damage . Arch Phys Med Rehabil . 1979;;60:491-496.
14 +
Willis SL.  Cognitive training in everyday competence . Ann Rev Gerontol Geriatr . 1987;;7:159-188.
15 +
Abreu BC, Toglia JP.  Cognitive rehabilitation: a model for occupational therapy . Am J Occup Ther . 1987;;41:439-448.
16 +
Kirn TF.  Tapping into 'procedural' memory helps patients with amnesia to acquire new occupational skills . JAMA . 1987;;257:3187.
17 +
 Report of research aspects of rehabilitation after acute brain damage in adults . Lancet . 1982;;2:1034-1036.
18 +
Malec J, Questad K.  Rehabilitation of memory after craniocerebral trauma: case report . Arch Phys Med Rehabil . 1983;;64:436-438.
19 +
Hayden ME, Hart T.  Rehabilitation of cognitive and behavioral dysfunction in head injury . Adv Psychosom Med . 1986;;16:194-229.
20 +
Anderson DW, McLaurin RL, eds. National Head and Spinal Cord Injury Survey . Bethesda, Md: National Institute of Neurological and Communicative Disorders in Stroke; 1980;.
21 +
Becker DP, Povlishock JT, eds. Central Nervous System Trauma Status Report . Bethesda Md: National Institutes of Health; 1985;.
22 +
Jennett B, Teasdale G. Management of head injuries. Contemporary Neurology Series . Philadelphia, Pa: FA Davis Co Publishers; 1981;;20:77-84.
23 +
Hamill RW, Woolf PD, McDonald JV, Lee LA, Kelly M.  Catecholamines predict outcome in traumatic brain injury . Ann Neurol . 1987;;21:438-443.
24 +
Braakman R, Gelphe GJ, Habbema JD, Maas AI, Minderhoud JM.  Systematic selection of prognostic features in patients with severe head injury . Neurosurgery . 1980;;6:362-370.
25 +
Choi SC, Ward JD, Becker DP.  Chart for outcome predictions in severe head injury . J Neurosurg . 1983;;59:294-297.
26 +
Lobato RD, Cordobes F, Rivas JJ, et al.  Outcome from severe head injury related to the type of intracranial lesion: a computerized tomographic study . J Neurosurg . 1983;;59:762-774.
27 +
Narayan RK, Greenberg RP, Miller JN, et al.  Improved confidence of outcome predictions in severe head injury: a comparative analysis of the clinical examination, multimodality evoked potentials, CT scanning and intracranial pressure . J Neurosurg . 1981;;54:751-762.
28 +
Adams JH, Graham DL, Murray LS, Scott G.  Diffuse axonal injury due to non-missile head injury: an analysis of 45 cases . Ann Neurol . 1982;;12:557-563.
29 +
Levin HS, Amparo E, Eisenberg H, et al.  Magnetic resonance imaging and computerized tomography in relation to the neurobehavioral sequelae of mild and moderate head injuries . J Neurosurg . 1987;;66:716-723.
30 +
Marler JR, Walker MD.  Clinical research on stroke: the NINCDS strategy . In: Ginsberg MD, ed. Princeton Conference on Cerebral Vascular Diseases . New York, NY: Raven Press; 1989;:17-21.
31 +
Dikmen S, Temkin N, McLean A, Wyler A, Machamer J.  Memory and head injury severity . J Neurol Neurosurg Psychiatry . 1987;;50:1613-1618.
32 +
Caramazza A.  The logic of neuropsychological research and the problem of patient classification in aphasia . Brain Lang . 1984;;21:9-20.
33 +
Fodor JA. The Modularity of Mind . Cambridge, Mass: MIT Press; 1983;.
34 +
Ashenasy JJM, Rahmani L.  Neuropsychosocial rehabilitation of head injury . Am J Phys Med . 1987;;66:315-327.
35 +
Balliet R, Harbst KB, Kim D, Stewart RV.  Retraining of functional gait through the reduction of upper extremity weight bearing in chronic cerebellar ataxia . Int J Rehabil Med . 1987;;8:148-153.
36 +
Bach-y-Rita P.  Neural aspects of motor function as a basis of early and post acute rehabilitation . In: Delisa JA ed. Principles and Practice of Rehabilitation Medicine . Philadelphia, Pa: JB Lippincott Co; 1988;; chap 10.
37 +
Kotsoris HO, Volpe BT.  Clinical characteristics of delayed recovery from post traumatic ataxia . J Neurol Rehabil . 1987;;2:73-78.
38 +
Cotman CW, Anderson KJ.  Synaptic plasticity and functional stabilization in the hippocampal formation: possible role in Alzheimer's disease . In: Waxman SG, ed. Advances in Neurology: Functional Recovery in Neurologic Disease . New York, NY: Raven Press; 1988;;47:313-337.
39 +
Landau WM, Hartman JS.  Letter to the editor . Arch Neurol . 1988;;45:371-373.

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