Executive dysfunction following traumatic brain injury: Neural substrates and treatment strategies
Open accessAbstract
Executive dysfunction is among the most common and disabling aspects of cognitive impairment following traumatic brain injury (TBI), and may include deficits in reasoning, planning, concept formation, mental flexibility, aspects of attention and awareness, and purposeful behavior. These impairments are generally attributed to frontal systems dysfunction, due either to direct insult to the frontal lobes or to disruption of their connections to other brain regions. Evaluation of executive deficits typically includes neuropsychological assessment, though adjunctive interviews can be critical in detecting subtle dysexecutive symptoms that may not be apparent on standardized testing. Rehabilitation programs emphasizing cognitive-behavioral approaches to the retraining of planning and problem-solving skills can be effective in ameliorating identified executive deficits. In addition, pharmacological approaches may be useful in addressing aspects of executive dysfunction. This review summarizes the nature of executive deficits following TBI, their neuroanatomical substrates, selected assessment and treatment strategies, and recent research findings and trends.
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Damage to densely connected and cognitively relevant regions such as the frontal lobes contributes to reduced efficiency of functional networks relevant to cognition.
“Specifically, damage to regions that are densely anatomically connected and cognitively relevant, such as the frontal lobes (McDonald, Flashman, & Saykin, 2002), contributes to reduced efficiency of functional networks relevant to cognition (Hayes et al., 2016).”
From Investigation of neurobiological responses to theta burst stimulation during recovery from mild traumatic brain injury (mTBI) (2023) · cites this paper as McDonald, Flashman, & Saykin, 2002
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- Authors
- McDonald, B. C., Flashman, L. A., & Saykin, A. J.
- Affiliations
- Dartmouth College (US)
- Venue
- NeuroRehabilitation
- Publisher
- SAGE Publications
- Published
- 2002-12-17
- Volume
- 17
- Issue
- 4
- Pages
- 333-344
- ISSN
- 1053-8135 (ISSN-L)
- 1878-6448
- OpenAlex
- W1692107071
- Cited by
- 302
- References
- 63
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 11 · 2023: 16 · 2022: 12 · 2021: 11 · 2020: 20 · 2019: 20 · 2018: 17 · 2017: 10 · 2016: 25 · 2015: 22 · 2014: 17 · 2013: 16 · 2012: 26
- FWCI
- 1.26
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurorehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Education
- National Institute on Disability and Rehabilitation Research
- National Institute of Neurological Disorders and Stroke (R01-NS-40472-01, R01NS040472)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Keywords
- executive dysfunction, traumatic brain injury, cognitive impairment, frontal lobe dysfunction, neural correlates, neuropsychological assessment, cognitive rehabilitation, cognitive behavioral therapy, planning and problem solving, pharmacotherapy
- MeSH terms
- Brain Injuries, Cognition Disorders, Humans, Neuropsychological Tests
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