05-14-2002, 05:56 PM
Arciniegas DB, Held K and Wagner P (2002). Cognitive Impairment Following Traumatic Brain Injury. Curr Treat Options Neurol. 4 (1): 43-57. Summary: Cognitive impairments due to traumatic brain injury (TBI) are substantial sources of morbidity for affected individuals, their family members, and society. Disturbances of attention, memory, and executive functioning are the most common neurocognitive consequences of TBI at all levels of severity. Disturbances of attention and memory are particularly problematic, as disruption of these relatively basic cognitive functions may cause or exacerbate additional disturbances in executive function, communication, and other relatively more complex cognitive functions. Because of the high rate of other physical, neurologic, and psychiatric syndromes following TBI, a thorough neuropsychiatric assessment of the patient is a prerequisite to the prescription of any treatment for impaired cognition. Psychostimulants and other dopaminergically active agents (eg, methylphenidate, dextroamphetamine, amantadine, levodopa/carbidopa, bromocriptine) may modestly improve arousal and speed of information processing, reduce distractibility, and improve some aspects of executive function. Cautious dosing (start-low and go-slow), frequent standardized assessment of effects and side effects, and monitoring for drug-drug interactions are recommended. Cognitive rehabilitation is useful for the treatment of memory impairments following TBI. Cognitive rehabilitation may also be useful for the treatment of impaired attention, interpersonal communication skills, and executive function following TBI. This form of treatment is most useful for patients with mild to moderate cognitive impairments, and may be particularly useful for those who are still relatively functionally independent and motivated to engage in and rehearse these strategies. Psychotherapy (eg, supportive, individual, cognitive-behavioral, group, and family) is an important component of treatment. For patients with medication- and rehabilitation-refractory cognitive impairments, psychotherapy may be needed to assist both patients and families with adjustment to permanent disability. *Denver Veterans Affairs Medical Center, 1055 Clermont Street, Denver, CO 80220, USA. David.Arciniegas@UCHSC.edu
"Disturbances of attention, memory, and executive functioning"
That's an a bit weird way of thinking.
Brain stuff got damaged. Does the author just wanna keep forcing it to attention spans that are bad for damaged systems, or what.
The primary aspect is
the damages of brain systems.
Guess if the kitchen is burning down, I could call it a disturbance of cooling functions of the fridge.
But that's there not the primary aspect.
"Disturbances of attention and memory are particularly problematic,"
If for example front got damaged, it just can't.
I mean, if having broken a foot, it is just not the time to push for running.
One might regret one can't, but it would be stupid to try to force it, before systems are far enough for that again.
When they are far enough for it again, then one can.
With my brain after the concussion in the headache time, seemed not good, then when they were gone, after about over a year, came a special time. There was also not good.
Felt inside like a whole bunch of new cells were there, who are not netted in yet and chemically not adapted to the "adults", and I regarded it like with some small children, that one can't just run adult pace with them,
because they have "shorter legs".
Not sure, how long that went, maybe some months, that I counter-regulated down, because I had the impression, there were new cells still at netting in and chemically adapting, not able yet to power along like the rest,
and getting protests if I pushed too far.
After that it was O.K. again, then I could sort of power up again, no headaches, no feeling like new cells not netted in yet and not chemically adapted far enough yet.
So then was O.K. if wishing to train something out again. No systems mending disturbances to be worried about.
One good one I found listening to radio BBC.
Interesting, and seemed to help immensely to gain longer listening attention spans.
In the last year a few times I also played chess again, which trains thinking, too.
Relearning typing till most was legible again I already did early after the concussion, because that really sucked, that I could communicate like here anymore. (Took me about half a year to relearn so that most made sense again.)
Memory problems seemed to get a bit better without me doing anything about it.
Seemed more to do with front damages, and when front was healing, getting better again.
Also jokes I started to understand better again, without me doing anything in particular for that.
A bunch of stuff seemed more that it took damages to heal far and well enough.
(...) "a thorough neuropsychiatric assessment of the patient is a prerequisite to the prescription of any treatment for impaired cognition."
What, go to some psyjunkytry guy and have him add chemical attacks on brain damages, or what,
because he regards it as impaired cognition and not damaged brain stuff,
and wishes to attack damaged brain stuff.
How about I take cocain and speed to run with a broken foot instead.
"Psychostimulants" Is that what attack drugs on internal balances are called.
Gee, and I thought I had bad drug attitudes as an acidhead, but even I just took one trip within half a year after the concussion, to rapidly decide this was not the time to mess into chemical balances yet.
"and other dopaminergically active agents (eg, methylphenidate, dextroamphetamine, amantadine, levodopa/carbidopa, bromocriptine) may modestly improve arousal and speed of information processing, reduce distractibility, and improve some aspects of executive function."
See comment taking speed and cocaine to run with a broken foot.
In other words one chemically attacks brain systems to force unnatural speeds on damaged systems.
Grand, I am sure the receptor molecule balances will be delighted.
Which body organs can the stuff mess into?
Was methylphenidate the stuff that can mess into heart and circulation aspects in several ways, lower red and white blood cell numbers, might cause a whole arsenal of serious systems damages, including rare cases of cerebral occlusion, where genetic toxity and chances for cancer or damages to off-spring were not known yet, but in another mammal kind already shown that it can come to more cancer and (?)chromatic exchange in the ovaries?
... But maybe I mess that up with another drug.
Not sure if that was the one for methylphenidate, the one I think of I am used under a differing naming (ritalin), not sure if I got that right there.
Anyway, in other words one attacks crippled systems chemically to force them to do what is bad for healing, just to get capacities that are not good for them.
Why not take a hand with broken fingers, dump in drugs till not feeling the pain, and advertize it as really great for using the hand again for stuff it could else not be used for.
Gee, and I thought I have bad health attitudes.