Research Reports - Interventions for attention problems after traumatic brain injury

PM R. 2014 Apr 19. pii: S1934-1482(14)00172-5

Backeljauw B(1), Kurowski BG(2)

OBJECTIVE: To gain an understanding of the current state of the evidence for
management of attention problems after traumatic brain injury (TBI) in children,
determine gaps in the literature, and make recommendations for future research.
TYPE: Focused Systematic review LITERATURE SURVEY: PubMed/Medline and PsychINFO
databases were searched for relevant articles published in English over the last
20 years. Keywords included "attention" "attention deficit and disruptive
behavior disorders", and "brain injuries". Studies were limited to children.
METHODOLOGY: Titles were examined first and eliminated based on lack of relevancy
to attention problems after brain injury in children. This was followed by an
abstract and full text review. Article quality was determined based on the United
States Preventative Services Task Force recommendations for evidence grading.
SYNTHESIS: Four pharmacological and ten cognitive therapy intervention studies
were identified. These studies varied in level of evidence quality but were
primarily non-randomized or cohort studies.
CONCLUSIONS: There are studies that demonstrate benefits of varying
pharmacological and cognitive therapies for the management of attention problems
after TBI. However, there is a paucity of evidence available to definitively
guide management of attention problems after pediatric TBI. Larger randomized
controlled trials and multicenter studies are needed to elucidate optimal
treatment strategies in this population.

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