Sozzi M, Balconi M, Arangio R, Pisani L, Mariani C
Department of Neuro Rehabilitative Sciences, Casa di Cura Privata del Policlinico, Milan, Italy.
Cogn Process. 2012 Aug;13 Suppl 1:S339-42. doi: 10.1007/s10339-012-0493-5.
The aim of this work is to verify the effectiveness of our treatment in patients with spatial neglect in relation to their age and to the severity of neglect. Lots of studies on rehabilitation were proposed and, in some of them, treatments based upon visual-scanning abilities were described. Our rehabilitation training is aimed to induce patients to find by themselves an adequate strategy to solve spatial problems and, after that, try to let this searching strategy as automatized as possible. In this study, forty-six patients with right brain damage and left visuo-spatial neglect underwent to this specific cognitive treatment. A neuropsychological battery was administered before and after treatment. Repeated measure MANOVA on test performances showed significant main effects of treatments, age, and severity of neglect; an interaction effect between these three variables was found as well. Our results confirm an effectiveness of treatment, in particular for elderly patients. Actually, they seem to show a better recovery of neglect after cerebral stroke, even for those of them affected by a severe neglect. These data could be explained in accordance with recent neurophysiological models that claim compensatory responses to reduce brain plasticity even in terms of reorganization of cognitive functions such as visuo-spatial attention.
这项工作的目的是验证我们的治疗方法对于存在空间忽视的患者在年龄和忽视严重程度方面的有效性。已经提出了许多关于康复的研究，其中一些描述了基于视觉扫描能力的治疗方法。我们的康复训练旨在引导患者自行找到解决空间问题的适当策略，然后尽可能使其搜索策略自动化。在这项研究中，46例右脑损伤并伴有左侧视觉空间忽视的患者接受了这种特定的认知治疗。在治疗前后进行了神经心理成套测验。对测试表现进行重复测量多变量方差分析显示治疗、年龄和忽视严重程度有显著的主效应；这三个变量之间也存在交互效应。我们的结果证实了治疗的有效性，特别是对老年患者。实际上，他们似乎显示出中风后忽视症状有更好的恢复，即使是那些受严重忽视影响的患者。这些数据可以根据最近的神经生理模型来解释，这些模型认为即使在诸如视觉空间注意力等认知功能重组方面，也存在补偿反应以降低大脑可塑性。
