Rehabilitation of sensory and
cognitive function
Cognitive skills, also called cognitive functions, cognitive abilities or cognitive capacities, are brain-based skills which are needed in acquisition of knowledge, manipulation of information and reasoning. They have more to do with the mechanisms ...
typically involves methods for retraining
neural pathway
In neuroanatomy, a neural pathway is the connection formed by axons that project from neurons to make synapses onto neurons in another location, to enable neurotransmission (the sending of a signal from one region of the nervous system to an ...
s or training new neural pathways to regain or improve neurocognitive functioning that have been diminished by disease or
trauma
Trauma most often refers to:
* Major trauma, in physical medicine, severe physical injury caused by an external source
* Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event
*Traumatic i ...
. The main objective outcome for rehabilitation is to assist in regaining physical abilities and improving performance.
Three common neuropsychological problems treatable with rehabilitation are
attention deficit/hyperactivity disorder
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inappr ...
(ADHD),
concussion, and
spinal cord injury
A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cor ...
.
Rehabilitation research and practices are a fertile area for
clinical neuropsychologists,
rehabilitation psychologists, and others.
Methods
Physical therapy,
Speech therapy,
occupational therapy, hot and
cold therapy, and other methods that "exercise" specific brain functions are used. For example,
eye–hand coordination
Eye–hand coordination (also known as hand–eye coordination) is the coordinated control of eye movement with hand movement and the processing of visual input to guide reaching and grasping along with the use of proprioception of the hands to ...
exercises may rehabilitate certain motor deficits, or well structured planning and organizing exercises might help rehabilitate
executive function
In cognitive science and neuropsychology, executive functions (collectively referred to as executive function and cognitive control) are a set of cognitive processes that are necessary for the cognitive control of behavior: selecting and succ ...
s, following a traumatic blow to the head.
Brain functions that are impaired because of
traumatic brain injuries are often the most challenging and difficult to rehabilitate. Much work is being done in nerve regeneration for the most severely damaged neural pathways.
Neurocognitive
Neurocognitive functions are cognitive functions closely linked to the function of particular areas, neural pathways, or cortical networks in the brain, ultimately served by the substrate of the brain's neurological matrix (i.e. at the cellular ...
techniques, such as
cognitive rehabilitation therapy, provide assessment and treatment of cognitive impairments from a variety of brain diseases and insults that cause persistent disability for many individuals. Such disabilities result in a loss of independence, a disruption in normal childhood activities and social relationships, loss in school attendance, and educational and employment opportunities. Injuries or insults that may benefit from neurocognitive rehabilitation include traumatic and
acquired brain injuries (such as stroke, concussion, neurosurgery, etc.), cranial radiation, intrathecal chemotherapy and neurological disorders, such as
ADHD. The rehabilitation targets cognitive functions such as attention, memory, and executive function (organization, planning, time management, etc.). Specific programs are tailored to develop and address an individual's challenges after a baseline assessment of abilities and challenges.
Concussion
Much research and focus has been given to
concussion suffered frequently by athletes. While the severity of
brain trauma
A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. TBI can be classified based on severity (ranging from mild traumatic brain injury TBI/concussionto severe traumatic br ...
has been standardized for immediate "sideline" assessment, much work needs to be done to understand how to rehabilitate or accelerate the rehabilitation of athletes'
brain function
A brain is an organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It is located in the head, usually close to the sensory organs for senses such as vision. It is the most complex organ in a ver ...
following serious concussion—whether
consciousness is lost or a dazed/confused feeling is experienced or not. Currently, rehabilitation of concussive brain injury is based on rest and gradual return to normal activities with as much involvement as can be tolerated.
Methods & Tools
; Standardized
neuropsychological test
Neuropsychological tests are specifically designed tasks that are used to measure a psychological function known to be linked to a particular brain structure or pathway. Tests are used for research into brain function and in a clinical setting f ...
s
: These tasks have been designed so the performance on the task can be linked to specific
neurocognitive
Neurocognitive functions are cognitive functions closely linked to the function of particular areas, neural pathways, or cortical networks in the brain, ultimately served by the substrate of the brain's neurological matrix (i.e. at the cellular ...
processes. These tests are typically
standardized
Standardization or standardisation is the process of implementing and developing technical standards based on the consensus of different parties that include firms, users, interest groups, standards organizations and governments. Standardization ...
, meaning that they have been administered to a specific group (or groups) of individuals before being used in individual clinical cases. The data resulting from standardization are known as normative data. After these data have been collected and analyzed, they are used as the comparative standard against which individual performances can be compared. Examples of neuropsychological tests include: the Wechsler Memory Scale (WMS), the
Wechsler Adult Intelligence Scale
The Wechsler Adult Intelligence Scale (WAIS) is an IQ test designed to measure intelligence and cognitive ability in adults and older adolescents. The original WAIS (Form I) was published in February 1955 by David Wechsler, as a revision of the ...
(WAIS), Boston Naming Test, the
Wisconsin Card Sorting Test
The Wisconsin Card Sorting Test (WCST) is a neuropsychological test of set-shifting, which is the capability to show flexibility when exposed to changes in reinforcement.E. A. Berg. (1948). A simple objective technique for measuring flexibility in ...
, the
Benton Visual Retention Test
The Benton Visual Retention Test (or simply Benton test or BVRT) is an individually administered test for people aged from eight years to adulthood that measures visual perception and visual memory. It can also be used to help identify possible le ...
, and the Controlled Oral Word Association.
; Brain scans
: The use of
brain scan
Neuroimaging is the use of quantitative (computational) techniques to study the structure and function of the central nervous system, developed as an objective way of scientifically studying the healthy human brain in a non-invasive manner. Incr ...
s to investigate the structure or function of the brain is common, either as simply a way of better assessing brain injury with high resolution pictures, or by examining the relative activations of different brain areas. Such technologies may include
fMRI
Functional magnetic resonance imaging or functional MRI (fMRI) measures brain activity by detecting changes associated with blood flow. This technique relies on the fact that cerebral blood flow and neuronal activation are coupled. When an area ...
(functional magnetic resonance imaging) and
positron emission tomography (PET), which yields data related to functioning, as well as
MRI
Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio waves ...
(magnetic resonance imaging) and
computed axial tomography (CAT or CT), which yields structural data.
; Global Brain Project
: Brain models based on mouse and monkey have been developed based on theoretical neuroscience involving working memory and attention, while mapping brain activity based on time constants validated by measurements of neuronal activity in various layers of the brain. These methods also map to decision states of behavior in simple tasks that involve binary outcomes.
;
: The use of electrophysiological measures designed to measure the activation of the brain by measuring the electrical or magnetic field produced by the nervous system. This may include
electroencephalography (EEG) or
magneto-encephalography (MEG).
; Experimental tasks
: The use of designed experimental tasks, often controlled by computer and typically measuring reaction time and accuracy on a particular tasks thought to be related to a specific
neurocognitive
Neurocognitive functions are cognitive functions closely linked to the function of particular areas, neural pathways, or cortical networks in the brain, ultimately served by the substrate of the brain's neurological matrix (i.e. at the cellular ...
process. An example of this is the
Cambridge Neuropsychological Test Automated Battery
The Cambridge Neuropsychological Test Automated Battery (CANTAB), originally developed at the University of Cambridge in the 1980s but now provided in a commercial capacity by Cambridge Cognition, is a computer-based cognitive assessment system co ...
(CANTAB) or CNS Vital Signs (CNSVS).
See also
*
Clinical neuropsychology
Clinical neuropsychology is a sub-field of psychology concerned with the applied science of brain-behaviour relationships. Clinical neuropsychologists use this knowledge in the assessment, diagnosis, treatment, and or rehabilitation of patients ...
*
Cognitive neuropsychology
Cognitive neuropsychology is a branch of cognitive psychology that aims to understand how the structure and function of the brain relates to specific psychological processes. Cognitive psychology is the science that looks at how mental processes ...
*
Neuropsychology
*
Occupational therapy
*
Physical medicine and rehabilitation
Physical medicine and rehabilitation, also known as physiatry, is a branch of medicine that aims to enhance and restore functional ability and quality of life to people with physical impairments or disabilities. This can include conditions su ...
*
Physiotherapy
*
Rehabilitation psychology
Rehabilitation psychology is a specialty area of psychology aimed at maximizing the independence, functional status, health, and social participation of individuals with disabilities and chronic health conditions. Assessment and treatment may inclu ...
*
Speech therapy
References
* McKay Moore Sohlberg and Catherine A. Mateer (2001) Cognitive Rehabilitation: An Integrative Neuropsychological Approach. Andover: Taylor and Francis
* Halligan, P.W., & Wade, D.T. (Eds.) (2005). Effectiveness of Rehabilitation for Cognitive Deficits. Oxford University Press, UK.
External links
*
{{DEFAULTSORT:Rehabilitation (Neuropsychology)
Neurotrauma
Neuropsychology
Occupational therapy
Rehabilitation medicine