Post-traumatic amnesia
Attention
### Attention

[Attention](/wiki/Attention "Attention") is a cognitive resource that contributes to many mental functions. The ability to engage attention requires a certain level of conscious awareness, arousal and concentration, all mechanisms that are generally impaired by traumatic brain injury. The involvement of attention in such a vast array of cognitive processes has led to the suggestion that attentional deficit may act as an underlying factor in the range of cognitive deficits observed in patients experiencing post\-traumatic amnesia (PTA).

Attention has been regarded as an important factor in the healthy functioning of encoding, verbal comprehension and new learning. Automatic attention processes (such as counting forwards) are recovered before simple memory skills (such as a recognition test of verbal material) in individuals with mild to moderate brain injury. This implies that the recovery of attentional ability precedes the progression of memory recovery after injury, helping to pave the way to regain ability for new learning. In terms of more severe brain injuries, this automatic attention task performance recovers before disorientation completely resolves.

One of the weaknesses of the method most often used in assessing PTA, the Galveston Orientation and Amnesia Test (GOAT), is that it does not include any assessment of attention, which could help give a better indication of potential for recovery. By omitting attention, the test is omitting some crucial aspects of a person's cognitive capabilities.

In addition, assessing attention during the period of PTA may help determine whether the patient is still in a state of PTA or if they are experiencing a more permanent form of memory deficit. In patients with mild TBI, the damage consists primarily of [diffuse axonal injury](/wiki/Diffuse_axonal_injury "Diffuse axonal injury") (widespread damage to white matter) without any focal damage (damage to specific areas). Sometimes, injury of the [brainstem](/wiki/Brainstem "Brainstem") was also observed. In these cases, there is likely the presence of an attentional deficit without a true amnesiac state. In more severely brain\-damaged individuals, the damage to the [temporal lobes](/wiki/Temporal_lobes "Temporal lobes") and the [frontal lobes](/wiki/Frontal_lobes "Frontal lobes") serves as good indication that amnesia will result. Patients with more chronic forms of memory impairment showed poor performance when tested with PTA scales, making differentiation between the two types of memory impairment very difficult. PTA patients exhibit poor simple [reaction time](/wiki/Reaction_time "Reaction time"), reduced information processing speed and reduced verbal fluency, which are all attentional deficits that could be used to distinguish these patients from those with more severe and permanent memory problems.


Can poor performance on PTA scales indicate chronic forms of memory impairment?