Environmental modifications to rehabilitate social behavior deficits after acquired brain injury: What is the evidence?

Social behavior deficits are a common, debilitating consequence of traumatic brain injury and stroke, particularly when sustained during childhood. Numerous factors influence the manifestation of social problems after acquired brain injuries, raising the question of whether environmental manipulations can minimize or prevent such deficits. Here, we examine both clinical and preclinical evidence addressing this question, with a particular focus on environmental enrichment paradigms and differing housing conditions. We aimed to understand whether environmental manipulations can ameliorate injury-induced social behavior deficits. In summary, promising data from experimental models supports a beneficial role of environmental enrichment on social behavior. However, limited studies have considered social outcomes in the chronic setting, and few studies have addressed the social context specifically as an important component of the post-injury environment. Clinically, limited high-caliber evidence supports the use of specific interventions for social deficits after acquired brain injuries. An improved understanding of how the post-injury environment interacts with the injured brain, particularly during development, is needed to validate the implementation of rehabilitative interventions that involve manipulating an individuals' environment.

Automated summary

Social behavior deficits are common and debilitating after traumatic brain injury and stroke, especially when they occur in childhood. Environmental manipulations, such as environmental enrichment, can potentially ameliorate these deficits, but more research is needed, particularly in chronic settings and considering social context as an important component of post-injury environment. Current evidence for specific interventions in social deficits after acquired brain injuries is limited. A better understanding of how the post-injury environment interacts with the injured brain, especially during development, is necessary to validate rehabilitative interventions that involve manipulating an individuals' environment.