Can an external device create and trigger intention in a patient with a severe brain injury?

Goal-directed behaviour (GDB), the capacity that allows us to control our environment according to our desires and needs, requires different stages from initial intention to goal achievement. Although GDB is frequently disrupted after acquired brain injury, few studies have addressed the remediation of reduced GDB in patients with severe brain injury. The present study aimed to raise this question in RZ, a patient with severe brain injury who presented a serious reduction in GDB related to difficulties in creating an intention from internal determinants and in selecting an action plan, as well as to memory and attentional impairments. Our objective was to investigate the efficacy of an intervention programme to create and trigger a specific intention in RZ. More specifically, this programme consisted in written prompts, first accompanied by an alarm provided by his mobile phone, but gradually reduced until only the alarm remained, which was implemented in order to improve RZ's attendance at workshop sessions. Results showed that RZ's attendance rate at the workshop sessions increased, indicating that the use of an external device allowed us to create and trigger intention in a patient with severe cognitive impairments.