[WEB SITE] 7 signs of executive dysfunction after brain injury

 ‘Executive dysfunction‘ is not, perhaps, a particularly well known term, but the effects of brain injury that it covers are very common indeed. It is used to collectively describe impairment in the ‘executive functions’ – the key cognitive, emotional and behavioural skills that are used to navigate through life, especially when undertaking activities and interacting with others.

Although executive dysfunction is a common problem among many brain injury survivors, it is most commonly experienced following an injury to the frontal lobe.

The importance of executive functions is shown by the difficulties caused when they don’t work properly and someone has problems with executive dysfunction. Since the executive functions are involved in even the most routine activities, frontal injuries leading to executive dysfunction can lead to problems in many aspects of life.

Here we list the most common effects of executive dysfunction, with some examples of common issues that brain injury survivors can face:

Difficulties with motivation and organisation

• Loss of ‘get up and go’, which can be mistaken for laziness
• Problems with thinking ahead and carrying out the sequence of steps needed to complete a task

Rigid thinking

• Difficulty in evaluating the result of actions and reduced ability to change behaviour or switch between tasks if needed

Poor problem solving

• Finding it hard to anticipate consequences
• Decreased ability to make accurate judgements or find solutions if things are going wrong

Impulsivity

• Acting too quickly and impulsively without fully thinking through the consequences, for example, spending more money than can be afforded

Mood disturbances

• Difficulty in controlling emotions which may lead to outbursts of emotion such as anger or crying
• Rapid mood changes may occur, for example, switching from happiness to sadness for no apparent reason

Difficulties in social situations

• Reduced ability to engage in social interactions
• Finding it hard to initiate, participate in, or pay attention to conversations
• Poor judgement in social situations, which may lead to saying or doing inappropriate things

Memory/attention problems

• Finding it harder to concentrate
• Difficulty with learning new information
• Decreased memory for past or current events, which may lead to disorientation

Find out more

If you or someone you care for is affected by executive dysfunction, it is important to seek support. Speak to your doctor about your symptoms, and ask about referral to specialist services such as counselling, neuropsychology and rehabilitation.

You can find out more and get tips and strategies to help manage your condition on our executive dysfunction after brain injury page.

Headway groups and branches can offer support in your area, and you can contact our helpline if you would like to talk things through.

Source: 7 signs of executive dysfunction after brain injury | Headway

[WEB SITE] Studies uncover long-term effects of traumatic brain injury

Doctors are beginning to get answers to the question that every parent whose child has had a traumatic brain injury (TBI) wants to know: What will my child be like 10 years from now?

In a study to be presented Friday Feb. 10 at the annual meeting of the Association of Academic Physiatrists in Las Vegas, researchers from Cincinnati Children’s will present research on long-term effects of TBI—an average of seven years after injury. Patients with mild to moderate brain injuries are two times more likely to have developed attention problems, and those with severe injuries are five times more likely to develop secondary ADHD. These researchers are also finding that the family environment influences the development of these attention problems.

• Parenting and the home environment exert a powerful influence on recovery. Children with severe TBI in optimal environments may show few effects of their injuries while children with milder injuries from disadvantaged or chaotic homes often demonstrate persistent problems.
• Early family response may be particularly important for long-term outcomes suggesting that working to promote effective parenting may be an important early intervention.
• Certain skills that can affect social functioning, such as speed of information processing, inhibition, and reasoning, show greater long-term effects.
• Many children do very well long-term after brain injury and most do not have across the board deficits.

More than 630,000 children and teenagers in the United States are treated in emergency rooms for TBI each year. But predictors of recovery following TBI, particularly the roles of genes and environment, are unclear. These environmental factors include family functioning, parenting practices, home environment, and socioeconomic status. Researchers at Cincinnati Children’s are working to identify genes important to recovery after TBI and understand how these genes may interact with environmental factors to influence recovery.

• They will be collecting salivary DNA samples from more than 330 children participating in the Approaches and Decisions in Acute Pediatric TBI Trial.
• he primary outcome will be global functioning at 3, 6, and 12 months post injury, and secondary outcomes will include a comprehensive assessment of cognitive and behavioral functioning at 12 months post injury.
• This project will provide information to inform individualized prognosis and treatment plans.

Using neuroimaging and other technologies, scientists are also learning more about brain structure and connectivity related to persistent symptoms after TBI. In a not-yet-published Cincinnati Children’s study, for example, researchers investigated the structural connectivity of brain networks following aerobic training. The recovery of structural connectivity they discovered suggests that aerobic training may lead to improvement in symptoms.

Over the past two decades, investigators at Cincinnati Children’s have conducted a series of studies to develop and test interventions to improve cognitive and behavioral outcomes following pediatric brain injury. They developed an innovative web-based program that provides family-centered training in problem-solving, communication, and self-regulation.

• Across a series of randomized trials, online family problem-solving treatment has been shown to reduce behavior problems and executive dysfunction (management of cognitive processes) in older children with TBI, and over the longer-term improved everyday functioning in 12-17 year olds.
• Web-based parenting skills programs targeting younger children have resulted in improved parent-child interactions and reduced behavior problems. In a computerized pilot trial of attention and memory, children had improvements in sustained attention and parent-reported executive function behaviors. These intervention studies suggest several avenues for working to improve short- and long-term recovery following TBI.

Explore further: Drug shown to aid injured adult brains may exacerbate cognitive problems in children

Provided by: Cincinnati Children’s Hospital Medical Center

Source: Studies uncover long-term effects of traumatic brain injury