Spanish researchers have shown a correlation between a greater awareness of their own deficits in patients with acquired brain damage and improved functionality when developing the tasks of daily life. The new work establishes a training program to achieve it.
The level of self-awareness or deficit awareness —understood as the person’s ability to recognize that they have suffered brain damage and the disability that results from it— is one of the most complex aspects those affected, family and clinical staff face when it comes to addressing the recovery and treatment of these types of pathologies.
Due to the importance that patients develop an adjusted perception of their brain damage to facilitate their recovery and readjustment to their daily lives, researchers from the Polytechnic University of Madrid (UPM), the State Reference Center for Brain Damage Care (CEADAC) and the Complutense University of Madrid (UCM) participated in a research that develops a system of rehabilitation of self-consciousness and analyzes the way in which patients operate in their daily lives.
Acquired brain damage implies, in many cases, a greater difficulty for patients to perceive the disability derived from these injuries, explains Javier Pacios, a researcher at the Laboratory of Cognitive and Computational Neuroscience at the Center for Biomedical Technology of the UPM.
“This means that patients do not have a realistic perception of the damage they suffer or the benefits that can be derived from rehabilitation. Their level of motivation towards treatment is low and their expectations about their abilities too high. As a result of all these factors, in many cases they have problems adapting to their new life, so that their quality of life is even more damaged,” adds the researcher.
The authors developed a deficit awareness rehabilitation program that they already tested in previous works, focusing in this case on analyzing to what extent this improvement in their level of consciousness can help them improve their independence in their daily lives. For this, the team in which Javier Pacios participates took a sample of 56 patients from CEADAC.
The researchers divided the patients’ level of self-awareness into three broad categories: 1. awareness of the injury, understood as their ability to understand that they have suffered brain damage; 2. awareness of the deficit, which refers to the patient’s ability to recognize physical, sensory or cognitive difficulties arising from brain damage; 3. and finally awareness of the disability, which measures whether the patient is aware of having difficulties when carrying out daily activities such as cooking, doing household chores, taking care of a child or a pet or even studying.
The first step towards recovery
To rehabilitate deficit awareness problems in each of these three areas, the experts used a protocol developed by clinicians in the Neuropsychology area of CEADAC and whose efficacy had already been evaluated. “Our previous studies allowed us to observe that this type of intervention produces an improvement in the different levels of consciousness, which led us to study if this also resulted in greater functionality in their daily lives.”
The patients in the control group, who had not been subjected to the specific protocol for the improvement of deficit awareness, showed a slight improvement in their functionality. On the other hand, those patients who had undergone the specific protocol designed by the researchers, showed a more pronounced improvement in their level of consciousness that resulted in a much greater functional independence when performing their daily tasks.
“The results are promising and highlight the importance of developing specific programs for training deficit awareness in patients with acquired brain damage. And more importantly, our work shows a correlation between the level of improvement achieved in the field of consciousness and the degree of independence acquired by patients in daily activities,” adds Pacios.
The work, published in the journal Brain Impairment, provides the clinical evidence necessary for specialists to consider levels of self-awareness as a fundamental element when it comes to intervening in acquired brain damage. “It is a new way of approaching the treatment of the disease and opens a new field of study for health professionals,” concludes Pacios.