Executive dysfunction in chronic brain-injured patients: Assessment in outpatient rehabilitation

Abstract

In this study 81 chronic brain-injured patients referred for outpatient rehabilitation, who complained of executive impairments in daily life situations and were observed by proxies and therapists to have such problems, were assessed using various tests and questionnaires of executive functioning, such as the BADS and the DEX Questionnaire. The main purpose was to examine the sensitivity of these instruments in this particular group of patients. The tests and the DEX were also administered to healthy controls to investigate which of the instruments discriminate optimally between patients and controls. The results indicate that the tests as well as the questionnaires were sensitive to the executive problems of the patients. There were no significant differences between DEX ratings of patients, proxies and therapists. This suggests that patients who were eligible for outpatient rehabilitation showed relatively intact awareness into their executive problems. A specific combination of three “open-ended” tests and the DEX contributed significantly to the prediction of group membership.

Keywords:

• Executive Functions
• Dysexecutive Syndrome
• Chronic brain injury
• Neuropsychological assessment
• Outpatient rehabilitation

This project was supported by The Netherlands Organization of Health Research and Development (ZonMw), Rehabilitation Research Program (Grant No. 1435.0009).

The authors thank all the participants and their families, as well as the healthcare institutions that participated in this study: Revalidatiecentrum Amsterdam (Amsterdam), Revalidatie Friesland (Beetsterzwaag), Revalidatiecentrum Beatrixoord (Haren), Revalidatiecentrum Heliomare (Wijk aan Zee), Revalidatiecentrum Groot Klimmendaal (Arnhem), Sint Maartenskliniek (Nijmegen), and Universitair Medisch Centrum Groningen (Groningen).