Neurobehavioral Changes after Acquired Brain Injury

Neurobehavioral changes are common after brain injury. These may include a broad range of disturbances in social and interpersonal behavior, such as aggression, disinhibition, lack of empathy or apathy. Often, these changes are qualified by significant others as 'personality changes'. Although these changes are known to have a serious negative impact on daily life functioning and social participation of patients, and often involve a severe burden for close others, still little is known about their exact nature, their determinants and long-term consequences. In clinical practice, there are several important issues that need answers. A major question refers to how to assess such changes reliably and validly. Previous studies have focused on neuropsychiatric classification of these changes, others on the use of neuropsychological measures such as tests for social cognition, but clear recommendations for clinical practice are still sorely needed. In addition, the role of the social environment, coping abilities or personality characteristics of brain injured patients in the emergence and maintenance of behavioral changes may be relevant. Another pending question pertains to identifying important factors underpinning these deficits, which aide in the prediction of outcome and determining treatment targets and needs. These factors may include injury characteristics, brain regions involved, and cognitive or emotional factors. In particular, imaging studies may add valuable insights about relations between neurobehavioral disturbances and structural or functional brain abnormalities. Furthermore, there is a great need for treatment studies that investigate whether behavioral, pharmacological or neurosurgical approaches, or a combination of these, might be beneficial in diminishing neurobehavioral symptoms of brain injury.

We welcome contributions addressing these issues, not only restricted to patients with Traumatic Brain Injury (TBI), but also other types of Acquired Brain Injury (ABI), adults or children. We are convinced that increasing our knowledge on neurobehavioral changes will advance the quality of clinical care for these patients.