Cognitive and emotional/behavioural disturbances after moderate-severe acquired brain injury (ABI): state of the art and future challenge

Moderate-severe acquired brain injury (ABI) often results in a complex constellation of cognitive, communicative, emotional, and behavioural disturbances that substantially affect functional independence, interpersonal relationships, quality of life, and long-term community participation. Although considerable advances have been made in acute care and neurorehabilitation, these disturbances remain among the most disabling and challenging consequences of ABI.Traditionally, research has focused on cognitive impairments such as deficits in attention, memory, executive functions, language, and social cognition, as well as on emotional and behavioural sequelae including depression, anxiety, apathy, irritability, aggression, emotional dysregulation, and personality changes. However, growing evidence suggests that these domains are deeply interconnected and cannot be fully understood when examined in isolation. Cognitive dysfunction may influence emotional regulation and behavioural control, while emotional and behavioural disturbances may in turn affect cognitive performance, rehabilitation engagement, social participation, and overall outcome. Moreover, although language is commonly classified as a cognitive function, communication impairments represent a particularly relevant consequence of ABI. Their impact extends beyond the cognitive domain, affecting social interaction, emotional well-being, participation, and the delivery of assessment and rehabilitation interventions.Furthermore, several factors contribute to the heterogeneity of post-injury manifestations, including lesion characteristics, injury severity, premorbid personality traits, self-awareness deficits, psychosocial variables, family dynamics, environmental factors, and access to rehabilitation services. Despite significant progress, important challenges remain concerning diagnostic classification, ecological assessment, the identification of underlying neurobiological and psychological mechanisms, and the development of effective and personalized interventions.Recent advances in cognitive neuroscience, affective neuroscience, social neuroscience, neuroimaging, neuromodulation, digital health technologies, and neurorehabilitation have opened new avenues for understanding the complex interactions among cognitive, emotional, and behavioural processes following ABI. At the same time, emerging perspectives emphasize the importance of person-centred care, family involvement, psychological adjustment, and long-term participation outcomes.The main aims of this Research Topic are to: (a) advance current knowledge on the mechanisms underlying cognitive, communicative, emotional, and behavioural disturbances after moderate-severe ABI; (b) improve their assessment through innovative and ecologically valid approaches; (c) investigate the interactions among cognitive, communicative, emotional, behavioural, and psychosocial factors; and (d) identify and evaluate effective pharmacological, neurorehabilitative, psychotherapeutic, and technology-assisted interventions. This Research Topic welcomes all article types (Original Research, Reviews, Systematic Reviews, Meta-Analyses, Methods, Protocols, Clinical Perspectives, and Case Reports) addressing, but not limited to, the following topics in moderate-severe ABI:· Cognitive impairments, including attention, memory, executive functions, and social cognition· Communicative disturbance related with language impairments· Emotional and behavioural disturbances, including depression, anxiety, apathy, irritability, aggression, emotional dysregulation, and personality changes· Self-awareness, metacognition, anosognosia, and their impact on rehabilitation outcomes· Interactions between cognitive, emotional, behavioural, and psychosocial functioning· Neurobiological and neuroimaging correlates of cognitive and emotional/behavioural disturbances· Ecological and technology-assisted assessment methods· Predictors of long-term outcome, participation, and quality of life· Family functioning, caregiver burden, and psychosocial adjustment· Pharmacological interventions· Neuropsychological, psychotherapeutic, behavioural, and multidisciplinary rehabilitation approaches· Neuromodulation and technology-based interventions, including virtual reality, tele-rehabilitation, and artificial intelligence applications· Emerging theoretical models and future challenges in ABI rehabilitation Topic editors: Umberto Bivona, Dolores Villalobos, Giuseppa Renata Mangano Source: https://www.frontiersin.org/research-topics/81144/cognitive-and-emotionalbehavioural-disturbances-after-moderate-severe-acquired-brain-injury-abi-state-of-the-art-and-future-challenge