The Neuropsychological rehabilitation Is a form of therapy that derives from the conception of the brain as a plastic organ: factors of the environment Can alter the organization of the brain through the mechanism of plasticity 1 .
This therapy was born from the clinical and scientific observations of people who after suffering a certain deterioration of their functions Superiors (cognitive) as a result of structural damage ( Acquired Brain Damage ), Have tried and managed to recover to achieve A highly productive lifestyle 2 .
"After a stroke life changes drastically and forever, but it is not the end of existence. I emphasize the importance of taking on the damage and sequelae caused by the disease, how to deal with problems and social integration when returning home and how to adapt as best as possible to the deficits and disabilities that will remain after" (Luis Puicercús).
How was Neuropsychological Rehabilitation born?
It is a form of therapy derived from neuropsychology: a scientific discipline that studies the structure and function of the brain in relation to processes Psychological and behavioral.
For many centuries, the brain was considered as an organ devoid of function, being discarded its study. During the 27th century of the dynasty Egyptian was the Imhotep doctor Who for the first time gave importance to the brain as part of the body and as a key organ in many pathologies and traumas.
However, it was not until the beginning of the 20th century that Neuropsychologist Luria Began to apply rehabilitation techniques for those deficiencies with Clear origin in the brain. Not in vain is he considered the father of Neuropsychological Rehabilitation.
For Luria the rehabilitation is only possible by creating a new functional system based on the nervous elements that remain undamaged, this Is, the restructuring of the functional system on new bases.
The reorganization can be intrasystemic (training the patient to perform the tasks using more basic or higher levels within the same Functional system) or intersystemic (train the patient to use other functional systems).
The 13 fundamental principles of Neuropsychological Rehabilitation
- The professional must begin by working the subjective experience of the patient to reduce his frustrations and confusion, making him a participant Of the rehabilitation process.
- The patient's symptomatology is a mixture of premorbid personality / cognitive characteristics and changes Neuropsychological problems directly associated with cerebral pathology.
- Neuropsychological Rehabilitation focuses both on the recovery of brain damage and on coping in situations Interpersonal
- Neuropsychological Rehabilitation helps patients to observe their behavior and, therefore, teaches them both direct and Indirect effects of brain damage. This learning helps them to avoid destructive options and to constructively deal with their possible reactions Catastrophic
- The incorrect study of the interaction between cognition and personality leads to an erroneous understanding of many problems in the sciences Cognitive and Neuropsychological Rehabilitation.
- Because the nature of complex brain functions has not yet been fully studied, we do not yet have detailed knowledge How to train the Cognitive abilities Of a patient. However, we know the general guidelines of such training.
- Psychotherapeutic interventions are often an important part of Neuropsychological Rehabilitation because they help both Patients and their families to face personal losses.
- Working with patients with brain injuries produces emotional reactions both in the patient's family and in the team. professionals. Handling these reactions correctly is positive for the rehabilitation and adaptation processes.
- Each Neuropsychological Rehabilitation program has its own dynamic identity. Thus, throughout the process both Improvements such as partial setbacks before rehabilitation is considered satisfactory.
- Errors in identifying which patients can benefit from Neuropsychological Rehabilitation and which produce disbelief in the countryside.
- Alterations in disease awareness following brain damage are very often handled incorrectly due to Poor understanding of them.
- The planning of innovative rehabilitation programs and the competent management of patients depend directly on the understanding of the Mechanisms of recovery and deterioration of symptoms.
- The rehabilitation of patients with high-severity brain deficits requires a dual approach, both scientific and phenomenological.
" Only in some cases does brain destruction lead to irreversible effects, in most cases the activity of the nervous system can be Rehabilitated (Junque and Barroso, 1994) 4 ".
What techniques are used in Neuropsychological Rehabilitation?
Neuropsychologist Anderson believes that these can be grouped into three different therapeutic levels 5
- Restoration : Stimulation of altered cognitive functions by direct action on them.
- Compensation : Assuming that the altered function can not be restored, we try to promote the use of different alternative mechanisms or Skills preserved.
- Substitution : The central aspect of the intervention is based on teaching the patient different strategies that help to minimize the problems Resulting from cognitive dysfunctions.
Brain damage as a beginning, an inspiring story
After suffering a brain accident the life of a person can be transformed completely being, in many cases, a new beginning.
I would like to relate the highly inspiring case to one of the 30 people known in the world who have developed a specific talent or ability as Immediate consequence of a brain injury. The brain can be reorganized to create true geniuses as a consequence of the phenomenon of Plasticity, you just need to listen to what the body says.
Derek Amato - When Brain Damage Releases Hidden Genius
Derek Amato has become a genius of music after having suffered a very serious brain contusion as a result of an accident. The Direct consequences of brain damage were: hearing loss of 35% in one ear, headaches, memory loss and visual disturbances.
However the most dramatic symptom was also evident immediately: he had never played the piano before but, from the accident, his fingers They seemed to find the right notes by instinct. He became a piano virtuoso without learning or training.
How is this possible?
Darold Treffert, an expert on Savant's syndrome Gave the answer. Those who suffer from this syndrome, usually innately, share having a Intellectual deficiency and extraordinary ability.
Darold diagnosed Amato with acquired Savant's Syndrome. There is yours a unique case in the world, in fact there are 30 famous cases known to people Who, after suffering a brain trauma, suddenly develop skills classified as almost superhuman.
The neurological causes behind this phenomenon are not known in detail since this is a relatively new field of study. Researchers from All over the world begin to apply brain imaging techniques of great sophistication to find the answer in each specific case.
The existence of the internet and the communities of people who share a similar history has made it a priority issue in the Current neuropsychological research. If we know the mechanisms by which this is possible, we may be able to know what mysteries lie behind Of these capabilities.
A genie hides within each of us waiting to be released.
The explanation of the case of Amato is based on the cerebral plasticity as a result of the injury. his brain Was forced to reorganize itself in order to Deficits.
His is a story with relative parallelism to the cases of Synesthesia . Amato's visual and auditory systems were reorganized and blended Which, in Amato's words, his visual perception guides him through the piano.
He says he continually sees a moving pattern of black and white squares that, on the one hand, prevents him from reading, but on the other hand is capable Of interpreting and translating into musical notes on a piano.
The keys of the piano are white and black, as well as his visual perception acquired as a result of the injury. The Occipital lobes And lateral Are positioned in the brain forming a continuum and sharing a large number of connections and areas of association.
In this way for Amato it is instinctive to translate his random visual perceptions into sound patterns. It is a unique and unrepeatable ability of the Randomness of the characteristics of his injury and the way his brain has adapted to the changes.
Thanks to the motivation he feels for music and the feeling of privilege he feels as a consequence of his unique ability, every day when He gets up the first thing he does is play the piano.
Why? He is afraid of a day waking up and discover that his skill has disappeared. It is uncertain that its capacity will last for life but, what it is Certain is that he has discovered the his genius previously trapped.
For more similar cases related to music, I highly recommend the book" Musicofilia "Of the late deceased neurologist Oliver Sacks . Highly admired by me and many other people, Oliver has dedicated his life to spreading inspirational cases like Amato's.
Can Neuropsychological Rehabilitation contribute to discovering and enhancing cases like Amato's?
Of course yes. In fact it is through neuropsychological evaluation and rehabilitation that the response to the unpredictable consequences of A specific brain injury. Each case is unrepeatable and only professionals in the area will be able to identify the changes and explain them to patients.
It is only these types of professionals who can provide a holistic view of each particular case and design the rehabilitation treatment Necessary for each one.
During my career years I have been highly attracted to this area of study. Oliver Sacks and Luria have been two professionals and authors who have Made love to magic in every brain, that have made me see that all, though human, are different.
It is magical all that the brain can do, but more magic is still power, with a simple observation of the behavior of a person with brain damage, Know what is hidden in your brain that has made a person unique, unrepeatable and incomparable.
What is brain plasticity and what is it for?
Cerebral plasticity is a continuous process of human development that occurs both in normal and altered brains and occurs throughout all The stages of the life cycle.
It consists of the brain's ability to adapt by modifying its connections and functioning in terms of learning, practice and experience.
" Neurons adjacent to an injury can progressively"learn"the function of damaged neurons" (Rossini and Pauri, 2000) 3 .
Since learning is a lifelong process, our brain must always be plastic in order to adapt and function in Basis of new knowledge.
That of plasticity is a fundamental biological phenomenon fundamental to life as we know it: we always adapt, whether for good or for bad.
Since plasticity is universal and continuous throughout the life cycle, Neuropsychological Rehabilitation has become a highly Demanded and popular for numerous pathologies, diseases, disorders or injuries of which the brain is the main organ.
It is so popular that even exists an international scientific magazine founded in the year 1991 that takes by name" Neuropsychological Rehabilitation "and in The one that publishes the most important scientific discoveries of the area every year.
References
- Kolb, B., & Whishaw, I.Q. (2003). Fundamentals of human neuropsychology. New York: Worth Publishers.
- Principles of Neuropsychological Rehabilitation.
- Rossini, P.M. & Pauri, F. (2000). Neuromagnetic integrated methods tracking human brain mechanisms of sensorimotor areas «plastic» Reorganisation. Brain Research Reviews, 33, 2-3, 131-154.
- Junqué, C. & Barroso, J. (1994). Neuropsychology. Madrid. Synthesis.
- Anderson, R.M. (1994). Practitioner's Guide to Clinical Neuropsychology. New York: Plenum Press.