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Plasticity of the Attentional Network After Brain Injury and Cognitive Rehabilitation

Department of Physical Medicine and Rehabilitation, Division for Neurorehabilitation, Stroke and Cerebrovascular Center, yunkim{at}skku.edu

Woo-Kyoung Yoo, MD, PhD

Department of Physical and Rehabilitation Medicine, Hallym University Sacred Heart Hospital, Anyang

Myoung-Hwan Ko, MD, PhD

Department of Physical Medicine and Rehabilitation, Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju

Chang-hyun Park, MS

Department of Physics, Korea Advanced Institute of Science and Technology, Daejejon Republic of Korea, Department of Physical Medicine and Rehabilitation, Division for Neurorehabilitation, Stroke and Cerebrovascular Center, Sungkyunkwan University School of Medicine, Seoul

Sung Tae Kim, MD

Department of Radiology, Center for Imaging Science, Sungkyunkwan University School of Medicine, Seoul

Duk L. Na, MD, PhD

Department of Neurology Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul

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.

Key Words: Traumatic brain injury • Cognitive training • Plasticity • Attentional network • Functional MRI

This version was published on June 1, 2009

Neurorehabilitation and Neural Repair, Vol. 23, No. 5, 468-477 (2009)
DOI: 10.1177/1545968308328728


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