University of Athens, School of Medicine, Evangelismos Hospital, Epilepsy Surgery Unit, National and Kapodistrian 1st Department of Neurosurgery, Laboratory of Clinical Neuropsychology, Athens, Greece.
Aristotle University of Thessaloniki, School of Psychology, Faculty of Philosophy, Thessaloniki, Greece.
Arq Neuropsiquiatr. 2023 Sep;81(9):835-843. doi: 10.1055/s-0043-1770349. Epub 2023 Oct 4.
The present review attempts to discuss how some of the central concepts from the Lurian corpus of theories are relevant to the modern neuropsychology of epilepsy and epilepsy surgery. Through the lenses of the main Lurian concepts (such as the qualitative syndrome analysis), we discuss the barriers to clinical reasoning imposed by quadrant-based views of the brain, or even atheoretical, statistically-based and data-driven approaches. We further advice towards a systemic view inspired by Luria's clinical work and theorizing, given their importance towards our clinical practice, by contrasting it to the modular views when appropriate. Luria provided theory-guided methods of assessment and rehabilitation of higher cortical functions. Although his work did not specifically address epilepsy, his theory and clinical approaches actually apply to the whole neuropathology spectrum and accounting for the whole panorama of neurocognition. This holistic and systemic approach to the brain is consistent with the network approach of the neuroimaging era. As to epilepsy, the logic of cognitive functions organized into complex functional systems, contrary to modular views of the brain, heralds current knowledge of epilepsy as a network disease, as well as the concept of the functional deficit zone.
本综述试图探讨卢里亚理论体系中的一些核心概念如何与癫痫的现代神经心理学和癫痫手术相关。通过主要的卢里亚概念(如定性综合征分析)的视角,我们讨论了基于象限的大脑观点、甚至是无理论、基于统计学和数据驱动的方法对临床推理造成的障碍。我们进一步建议借鉴卢里亚临床工作和理论的系统性观点,因为它们对我们的临床实践非常重要,同时在适当的时候与模块观点进行对比。卢里亚提供了基于理论的评估和高级皮质功能康复方法。尽管他的工作并未专门针对癫痫,但他的理论和临床方法实际上适用于整个神经病理学谱,并涵盖了整个神经认知全景。这种整体和系统性的大脑方法与神经影像学时代的网络方法一致。就癫痫而言,组织成复杂功能系统的认知功能的逻辑与大脑的模块观点相反,预示着当前对癫痫作为一种网络疾病的认识,以及功能缺陷区的概念。