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Impact Factor
This article is part of the Research Topic Cognitive neurorehabilitation

Original Research ARTICLE

Front. Hum. Neurosci., 17 February 2011 | http://dx.doi.org/10.3389/fnhum.2011.00009

Rehabilitation of executive functioning in patients with frontal lobe brain damage with goal management training

Brian Levine1,2,3*, Tom A. Schweizer4,5, Charlene O’Connor1,2,6, Gary Turner6,7, Susan Gillingham1, Donald T. Stuss1,2,3, Tom Manly8 and Ian H. Robertson9
  • 1 Rotman Research Institute, Baycrest Centre, Toronto, ON, Canada
  • 2 Department of Psychology, University of Toronto, Toronto, ON, Canada
  • 3 Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada
  • 4 Department of Medicine (Neurosurgery), University of Toronto, Toronto, ON, Canada
  • 5 Keenan Research Centre of the Li Ka Shing Knowledge Institute at St. Michael’s Hospital, Toronto, ON, Canada
  • 6 Department of Occupational and Rehabilitation Sciences, University of Toronto, Toronto, ON, Canada
  • 7 Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
  • 8 Medical Research Council Cognition and Brain Sciences Unit, Cambridge, England
  • 9 Department of Psychology and Neurosciences, Trinity College, Dublin, Ireland

Executive functioning deficits due to brain disease affecting frontal lobe functions cause significant real-life disability, yet solid evidence in support of executive functioning interventions is lacking. Goal Management Training (GMT), an executive functioning intervention that draws upon theories concerning goal processing and sustained attention, has received empirical support in studies of patients with traumatic brain injury, normal aging, and case studies. GMT promotes a mindful approach to complex real-life tasks that pose problems for patients with executive functioning deficits, with a main goal of periodically stopping ongoing behavior to monitor and adjust goals. In this controlled trial, an expanded version of GMT was compared to an alternative intervention, Brain Health Workshop that was matched to GMT on non-specific characteristics that can affect intervention outcome. Participants included 19 individuals in the chronic phase of recovery from brain disease (predominantly stroke) affecting frontal lobe function. Outcome data indicated specific effects of GMT on the Sustained Attention to Response Task as well as the Tower Test, a visuospatial problem-solving measure that reflected far transfer of training effects. There were no significant effects on self-report questionnaires, likely owing to the complexity of these measures in this heterogeneous patient sample. Overall, these data support the efficacy of GMT in the rehabilitation of executive functioning deficits.

Keywords: rehabilitation, executive functioning, frontal lobe, stroke, traumatic brain injury mindfulness

Citation: Levine B, Schweizer TA, O’Connor C, Turner G, Gillingham S, Stuss DT, Manly T and Robertson IH (2011) Rehabilitation of executive functioning in patients with frontal lobe brain damage with goal management training. Front. Hum. Neurosci. 5:9. doi: 10.3389/fnhum.2011.00009

Received: 22 September 2010; Accepted: 11 January 2011;
Published online: 17 February 2011.

Edited by:

Donald T. Stuss, Baycrest Centre for Geriatric Care, Canada

Reviewed by:

Gail A. Eskes, Dalhousie University, Canada
James F. Malec, Rehabilitation Hospital of Indiana, USA

Copyright: © 2011 Levine, Schweizer, O’Connor, Turner, Gillingham, Stuss, Manly and Robertson. This is an open-access article subject to an exclusive license agreement between the authors and Frontiers Media SA, which permits unrestricted use, distribution, and reproduction in any medium, provided the original authors and source are credited.

*Correspondence: Brian Levine, Rotman Research Institute, Baycrest Centre, 3560 Bathurst Street, Toronto, ON, Canada M6A 2E1. e-mail: blevine@rotman-baycrest.on.ca