Brain injury's impact on cognition

Any type of brain injury whether due to trauma or some other brain insult has three types of effect on the injured person: physical, emotional/behavioural and cognitive. Cognitive effects are not always noticed straight away and fall into six broad categories as follows:

  • € Memory
  • € Attention and Concentration
  • € Speed of information processing
  • € Planning, organising and problem solving (executive functions)
  • € Visuo-spatial and perceptual difficulties
  • € Language skills

The most common causes of cognitive disturbance are Stroke, Traumatic Brain Injury (e.g., after an accident), a tumour, with diseases like multiple sclerosis or with dementia.  Also psychiatric diseases such as Schizophrenia or behavioural issues in childhood are of concern. 

Actually each of these terms describing cognitive effects represents a multifaceted issue that can present in very different ways from person to person.

A disturbance in our ability to pay attention mostly means that the frontal lobe of the brain is damaged.  People with attention disturbances often complain about memory problems and tiredness, but also about the fact that they can be easily distracted.  Often those people are inclined to "let themselves go" and to show little effort.  In everyday life a disturbance of attention ability might appears in the fact that it is not possible for the person concerned, for example, to read a bus timetable or to follow a conversation.

For a person with a memory disturbance, the processes involved in the performance of memory do not work. Normally, the information must be perceived, then it is processed and stored.  And when the information is needed later, the memory is "triggered" again.

Disturbances of the so-called executive functions are mostly related in the frontal lobe of the brain. Such damage mostly concerns the motor, social, emotional, linguistic and cognitive abilities.  People with disturbances of the executive functions often show little interest in their own environment and are not aware of their disease. They have problems planning an action and often forget what they are supposed to be doing in the middle of the task. They also often have difficulties to show flexibility and are in favour of neglecting communication and nutrition.

People with visual field disturbances usually have absolutely healthy eyes. The disturbance lies on both visual paths which work as the connection between the eyes and the brain.  Because those nerves are very long and stretch almost through the whole brain, the chance is very high that with brain damage, the visual field is also disturbed. That can sometimes affect only a small part of the visual field, but sometimes a complete side or more. With such damage it is impossible for most persons to read a book or a text in general.

The coordination of visual perception with the musculo-skeletal system is called "Visual motor ability". For example, eye-hand coordination is difficult for persons with disturbances of the visual motor ability, since it is part of the sensory motor functions. Visual motor ability characterizes the quality of ingesting and processing visual symbols as well as the ability of their hand-motor realization. The intact visual perception ability and adequate eye-hand coordination are the foundation. 

There has been a lot of hype about using games to help with "brain training".Some scientists doubt that sufficient evidence exists to support the use of games in cognitive retraining.  I think part of the difficulty we have is that brain injured people are not an homogenous group and of course not all games are the same. Often games have not been designed with cognitive deficits in mind and even when they have, issues such as how long to train are not really well understood. With some individuals, unsupervised training may cause more issues than solve them.

For these reasons we take a different approach to RehaCom.  If you have the chance to review you it you will see that it is exhaustive in its depth and breadth.  Designed by neuropsychologists in Germany and with many years of practical experience now, RehaCom is intended to be a professional software tool to use in helping brain injured persons recover cognitive function.  The emphasis is on the word tool - RehaCom is not the solution to cognitive rehabilitation. What RehaCom can do is enable greater efficiency and effectiveness from the therapist. The therapist should blend restitution/retraining strategies along with compensation strategies. In other words the therapist remains "in the driving seat". It is incorrect to think that any software can be the complete answer.

RehaCom is not a game although it is as engaging as one. Unlike a game, RehaCom tracks in very fine detail exactly what the user does and notes performance in a way that provides excellent detail for a therapist who can then shape their rehabilitation strategy accordingly.  Also RehaCom was designed with guidance from neuropsychologists and therapists to give precise training for specific cognitive deficits.  It automatically adapts the moment by moment therapy task to the users level of performance. 

If you want to learn more about RehaCom we have a wealth of information on this site and you can request a demo disk that will let you explore the potential of this powerful tool.