View Full Version : Stierwalt & Murray (2002). Attention impairment following traumatic brain injury.
05-04-2002, 11:25 AM
• Stierwalt JA and Murray LL (2002). Attention impairment following traumatic brain injury. Semin Speech Lang. 23 (2): 129-38. Summary: The incidence of traumatic brain injury (TBI) is approximately 2,000,000 cases annually, and approximately 5.3 million Americans are currently living with some degree of cognitive-linguistic impairment secondary to TBI. One frequent aspect of that impairment is disordered attention. Attention is a complex system comprised of several component skills, each of which may be compromised by TBI and thus must be carefully assessed to design appropriate treatment protocols. Attention treatments for patients with TBI frequently involve implementing environmental controls and designing individualized therapy tasks that vary in terms of information processing demands. This article provides a summary of those attention impairments frequently associated with TBI and outlines assessment and treatment guidelines for clinicians serving TBI patients with attention problems. Florida State University, Tallahassee, Florida.
[This message was edited by Wise Young on 06-11-03 at 10:04 AM.]
"cognitive-linguistic impairment secondary to TBI." I do regard it not as secondary, but more like parallel along. The area gets zoinked real bad, and next is damaged, and therefore can't operate just as before.
"One frequent aspect of that impairment is disordered attention."
Why should it not be ordered, as belongs,
that the damaged site is not over-taxed,
and be perfectly reduced, as "belongs" with reduced hardware.
Might be more someone does not get ordered attention reductions, and likes to call them disorders, just because not being as with undamaged brains.
(Psycho-branchers have the habit to call orders "dis"orders, too. Sometimes straight adding their branch name before that, which makes it particularily amusing.)
Also linguistic stuff, if that meant verbal, could be Broca's got damaged,
and I perceive no reason straight to stick that totally undiscerned with attentions of other systems completely undiscerned.
When the head got hit left side more frontish,
I guess frontal and Broca's could get damaged, but if it were right, I guess Broca's should fare better.
(I rather call Broca's the language structurer.
Been calling it that a long time, and never got why to call it the name of some dude.
That dude is not part of my melon.)
"Attention is a complex system"
No, there are several systems (clusters) with own atttentions.
It is not one, but several.
With brain damaged those of own I and the sequencer (where I assume a center is the thalamus) can segregate more.
There are typical signs with some of the MBD, where that is so. Also with some after brain damages later.
(But for me these are not so much verbal,
more I have them, I know them, I recognize them also easy with some others.)
I am not sure how many attentions systems there are.
Like for example there is something I call the third emotion generator (but I am not sure where it is, maybe in the hypothalamus?), that is to do with aggression and rank-fighting,
and I am not sure if it has its own attention.
I know there is a rare special stage where it seems able to go central command over the sequencer and sort of high command in the brain,
and I count it in my head among us command centrals of the brain,
but, though I guess it has own attention,
I am not entirely sure.
Like this it is also for several other systems.
Also there are systems in my head I am unfamiliar with directly, and also do not really know about more indirectly from internal observations.
So I am really not sure there how many attentions differing systems counted together have.
But for sure more than one.
Me and the sequencer for example are two.
Always been so, as long as I recall.
It seems to control main movement sequences,
and I might be off for minutes into daydreams or thinking about something internally,
while on a bicycle or walking or elsewhere
and not have a clue what's outside around in that time while heading to some place,
and leave it to the sequencer to get us where I wanted.
(Like some way often gone, with a new one here I have to be more along.)
Simplified attention of my limbic stuff
seems to be dephased with that of the sequencer often.
"comprised of several component skills,"
No, attentions are "comprised" of stuff they are off.
Apart from that my limbic stuff gets because of front more parallel processing capacities and longer concentration enabled,
and assume that for the sequencer with upper frontal cortex that is similar.
(I have the impression who wrote this text never studied some brain systems aspects in his own head. But I guess as MBD and acidhead I had some "home" advantages. ;-))
"This article provides a summary of those attention impairments frequently associated with TBI and outlines assessment and treatment guidelines for clinicians serving TBI patients with attention problems. Florida State University, Tallahassee"
I might rather make my own guidelines than trust someone to judge for my brain correctly who blatantly displays that he understood about attentions systems far less than me.
(Actually I already made sort of guidelines in another comment earlier on here.
Simplified: Don't disturb damaged systems still at healing by over-taxing them too far.)
05-14-2003, 05:52 PM
Wise, Matt's neurologist (Dr. Felllus at Kessler) just suggested a trial of Reminyl, an Alzheimer's med; he says they've been starting to use some of the meds coming on the market for Alzheimer's for people with TBI and cognitive impairment, with pretty good success. We're cautiously excited!
Tough times don't last - tough people do.
05-15-2003, 02:08 AM
Marmalady, interesting to see what happens. Wise.
"5.3 million Americans are currently living with some degree of cognitive-linguistic impairment"
Actually a prejudice about US Americans often seeming not able to talk any other language fluently,
and many seeming alike brainwashed,
might be that a few hundred millions there seem to have linguistic and cognitive impairments,
based in attitudes of the self.
(A Cairoan trader seemed to regard US tourists the second most easy to cheat.
Him also seeming to regard this to do with their degree of stupidity.
Such might also have had to do with language and Arabic numbers ignorance of many US-Americans to do with attitudes of the self,
that all are to speak their language,
and maybe overlooking that this makes them easy to be cheated targets.)
There seem to be ways to within limits train some a bit up after brain damages,
however if pains are still there and flare higher in what one is doing there, this can be regarded like a STOP! sign.
The undiscerning of this article of differing attentions systems, and brain systems in general, aside,
I thought of various,
that however for me is difficult to structure.
(And here we have effects of front damages, ironic laughter ... ;-))
After brain injuries for example headaches might still go for 1-5 years or so.
If after this there should be a time where it feels like new cells internally, the registration might be also, that their chemical balances and interlinks are not yet adapted to those of the "adult cells" longer there,
and that it takes heeding these.
After that to me it sensed one can just alike power this or that,
no longer headaches like before,
and not as some months after the headaches this feeling of new cells there.
So such no longer then had to be heeded.
So before the question might be more, how becoming is what one is doing for systems that are not up to a lot yet.
Afterwards differing methods can be considered, how to get some capacities up again,
without considering such aspects.
There seem to be two major methods (and maybe far more), that are quite differing:
One is, the self and maybe other systems try to compensate to an extent for a sector(scluster or several) disabled.
This might remain rather limited in capacities.
The other is to try to train a damaged sector up again a bit in capacities.
Depending also on the extent of damages of the region, there might remain life-long handicaps.
With methods considered, it can help to analyze what that sector(scluster) is or was to do with.
If the language output is damaged,
there seems little point in, for example, listening to radio BBC programs a lot for training, though the latter could be used if listening attention spans are damaged,
to train these up a bit again.
A neuro maybe would call it Broca's is not Wernicke's.
In other words simplified, analyzing with linguistic stuff for example, what is it, that got damaged there.
Is this to do with the input?
That Wernicke's got damaged?
That the language syllable sound inputs are not transformed well or at all at times or often into making sense?
Is it to do with front damages disabling front capacities, and for example as a limbic self central onself also getting disabled then in attention spans in effects from that?
This not just impacting in listening attention spans, but also very much else?
Are systems correlating with the self (as I assume with Alzheimer's) damaged?
Is the self damaged?
Or did the language structurer, or what neuros might call Broca's, get prezzled a real badie?
And with that language structurings
as which word goes where in a sentence, grammar endings of words, letter orders, and generally grammar getting handicapped?
So just brabbling a vague "linguistic impairment" is not particularily discerning.
However if thinking about methods how to improve some capacities after brain injuries,
some more diserning can be beneficial.
And with still rather injured systems, that their health gets not too negatively impacted upon by what one is doing.
(Alike anyone sensible ain't try jogging on a broken foot, just to be faster.)