The psychology of neurovisual neurorehabilitation

Abstract

Visual disorders following a stroke or traumatic brain injury are complex perceptual deficits that have a significant impact on the patient's quality of life and far-reaching consequences for rehabilitation. In addition to the neurological and neuropsychological dimension, psychological factors in particular play a decisive role in the recovery process. The placebo effect in particular illustrates the complex relationship between mind and body. Our clinical studies investigated the effectiveness of restorative therapy on training-induced neuroplasticity in patients with visual field loss. The results show that no significant perimetrically measurable improvement of the visual field can be found after training with strict, eye-tracking supported visual field measurement. However, subjective evaluations by the patients indicate improvements and thus a placebo effect. In addition, the results of our studies show that restorative training could possibly have a positive influence on the perimetrically measurable perception of patients with visual neglect. These discrepancies illustrate the need for a strict distinction between neurophysiological changes and psychological effects. Future research should use methodologically rigorous approaches to set realistic expectations for both patients and practitioners, critically evaluate existing methods and further develop effective treatment strategies. In particular, the role of the placebo effect should be further explored and considered in the evaluation of neuropsychological interventions in the rehabilitation process.