Computer-Assisted Cognitive Rehabilitation in Stroke and Alzheimer?s disease

Abstract

Objectives: Cognitive functions are impaired by neurodegenerative diseases of the brain and by stroke. As the most common treatment is normally used pharmacology, neurosurgery or cognitive rehabilitation, which is used as an ancillary method. The cognitive rehabilitation is efficient under the precondition of neural plasticity and under the precondition of being able to create alternative neuronal links. Method: The following hypothesis was tested: computer assisted cognitive rehabilitation is more effective with patients suffered from stroke than with patients suffered from Alzheimer disease (N = 40). We have been testing sex-matched 25 (n = 25) patients cognitively impaired by stroke with minimal interval 3 months of undergoing disease and the set of 15 patients (n = 15) with probable dgn. Alzheimer's type. The effect was monitored by form of test and retest, which are parts of neuropsychological methods-WAIS III (IQ score), TMT A/B form, Rey OST figure, Verbal fluence test. Furthermore, the possible change in the framework of anxiety and depressive components was monitored, CNS-Hospital and Depression Scale. The patients attended ambulance for 3 months-23 sessions. The therapy was performed by the help of Neurop III. All of tested patients were diagnosed with mild cognitive impairment corresponding to ICD-10 and DSM-IV criteria. Conclusion: Results in our pilot study follow the hypothesis that for the cognitive rehabilitation is crucial brain plasticity, which as we expect is higher in acute demarcated brain lesions with spared rest of the brain tissue, than in diffuse neurodegenerative disorder, where reserve for the neural plasticity and is expected to be lower, although the degree of the cognitive impairment is mild. The effect of cognitive rehabilitation at patients with Stroke was monitored in a more effective cognitive flexibility, processing speed index, perceptual organisation and attentive components. No significant impact of Cognitive rehabilitation to Global IQ and Verbal intelligence subtests were observed. Rehabilitated patients with neurodegenerative disease did not proved any significant improvement in the field of psychological tests. At the end of the cognitive training both groups of patients proved subjective significant improvement.