Executive functioning, attention and frontal lesions in patients with chronic CHI

To study the presence and nature of dysexecutive problems after CHI, a seri es of unstructured tasks tapping executive functioning were selected. These were administered to a group of 51 participants with CHI in the chronic st age (i.e. several years post-injury) and to 45 healthy controls. In additio n, well-known structured tests of attention and planning were administered. Of the executive tasks, only the Executive Route Finding task showed a sig nificant difference between both groups. A multivariate analysis on the att ention tests showed a significant difference between groups, indicating tha t patients in the chronic stage still process information slower than contr ols. Within the patient group, patients with and without frontal focal lesi ons were also compared on executive and attention tests. No differences wer e found with respect to the latter. However, patients with frontal lesions performed worse on a measure of the Executive Route Finding task. It is con cluded that patients with CHI, especially when they have frontal damage, ha ve to rely more heavily on externally provided cues, but this dysexecutive problem can only be demonstrated in tasks that resemble daily life tasks by providing very little structure.