Neuropsychological Rehabilitation from a Theoretical Point of View

Pöppel, Ernst; Steinbüchel, Nicole von

doi:10.1007/978-3-642-77067-8_1

Cited by 3 publications

(1 citation statement)

References 33 publications

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“…First, cognitive rehabilitation ultimately must be based on a scientific understanding of the normal brain mechanisms underlying higher cerebral functions as well as the nature of the dysfunction itself. This has been observed by many researchers and clinicians including Luria (19480 1963) and more recently, Pöppel and von Steinbüchel (1992) and Christensen et al (1991). Second, once the underlying mechanisms are understood, devising methods to retrain patients or to teach them to compensate for their deficits based on that knowledge will most likely prove quite helpful.…”

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Learning from our successes and failures: Reflections and comments on “Cognitive Rehabilitation: How it is and how it might be”

Prigatano

1997

J Int Neuropsychol Soc

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Barbara A. Wilson's article in this issue is a thoughtful and scholarly commentary on the present state of cognitive rehabilitation. Her review of the meaning of the term “rehabilitation,” and her reminder that we are better at treating disabilities than impairments after brain damage, set the background for her four major points. First, there are currently four basic approaches to cognitive rehabilitation. Second, two of these approaches are of little help to patients. Third, combining learning theory, cognitive psychology, and neuropsychology is helpful in dealing with the “everyday problems of brain-injured people.” Finally, this latter approach combined with the holistic approach is promising, especially given that patients' personality disturbances must be considered if neuropsychological rehabilitation is to be effective.

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Learning from our successes and failures: Reflections and comments on “Cognitive Rehabilitation: How it is and how it might be”

Prigatano

1997

J Int Neuropsychol Soc

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Einführung: Prinzipien und historischer Rückblick

Prigatano

2004

Neuropsychologische Rehabilitation

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Functional Plasticity After Left Anterior Temporal Lobectomy: Reconstitution and Compensation of Verbal Memory Functions

Helmstaedter

Elger

1998

Epilepsia

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Summary:Purpose: This study investigated the functional plasticity of the brain to reconstitute and compensate for verbal memory functions after epilepsy surgery of left temporocortical and temporomesial structures. We hypothesized that memory outcome would be best when surgery is performed within the period of cerebral plasticity, and that the outcome should be worst when fluid intelligence starts to decrease with physiologic aging. We also raised the question of different plasticity and compensation mechanisms for temporomesial and temporocortical memory functions.Methods: We evaluated preoperative and l-year-postoperative memory data and other verbal functions in 104 patients with epilepsy, who underwent a standard left anterior temporal lobe. resection. We used memory measures that had been previously shown to be most selective for mesial and lateral functions, respectively. Determinants of postoperative memory outcome were evaluated by multiple regression analysis. Group statistics were calculated on the basis of the periods that are usually assumed to be significant for plasticity and behavioral compensation. Individual postoperative changes in memory functions were evaluated on the basis of test-retest data obtained in a group of 100 nonsurgical patients with localization-related epilepsies (mean retest interval >12 months).Results: Only changes in cortically represented learning and data acquisition were related to age, plasticity, and capacities for behavioral compensation. No patient in the youngest group (younger than 15 years), 33% of patients who had surgery between the ages of 15 and 30 years, and 61% of the patients undergoing surgery older than age 30 years had significant deterioration in verbal learning. In contrast, postoperative changes in temporomesial consolidatiodretrieval processes were independent of age at the time of surgery, plasticity, and capacities for behavioral compensation.Conclusions: Our data indicate different time windows for the reconstitution and compensation of mesial and cortical aspects of memory. Whereas the reconstitution of and compensation for cortical functions appear restricted by decreasing plasticity and physiological aging, mesial functions seem to be reconstituted by contralateral mesial structures over a much longer period. Concerning drug-resistant localization-related epilepsies, our results justify early consideration of surgery, especially when cortical structures are affected. Key Words: Left temporal lobe epilepsy-Memory-Cortical functions.The left temporal lobe is significantly involved in verbal declarative memory processing. Based on current neurobiologic models of memory, it is possible to differentiate between cortical and mesialhippocampal aspects of declarative memory performance, the first being involved in functions of working memory, data acquisition, and permanent repository of knowledge, the latter being involved in long-term consolidation and retrieval of memory contents (1,2). Recently we provided evidence that this model can also be appli...

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Neuropsychological Rehabilitation from a Theoretical Point of View

Cited by 3 publications

References 33 publications

Learning from our successes and failures: Reflections and comments on “Cognitive Rehabilitation: How it is and how it might be”

Learning from our successes and failures: Reflections and comments on “Cognitive Rehabilitation: How it is and how it might be”

Einführung: Prinzipien und historischer Rückblick

Functional Plasticity After Left Anterior Temporal Lobectomy: Reconstitution and Compensation of Verbal Memory Functions

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