Cognitive rehabilitation: what it is and how it helps patients

There are many causes that can lead to cognitive impairment in a person. This is why researchers are looking for new solutions.

Some of the best known techniques in this regard are cognitive rehabilitation. Then we can find out what are its main types and practical applications, what characterizes this methodology, and what are the advantages that contribute to it over other systems.

    What is cognitive rehabilitation?

    When we talk about cognitive rehabilitation we mean a series of techniques created to repair different brain functions related to cognition, Such as attention, memory or use of language, which has been previously damaged due to some type of injury or the impairment inherent in degenerative disease.

    In this sense, injuries can be caused by traumatic injuries that cause damage to the brain, either external, like an impact, or internal, like a thrombus that causes a heart attack in one of the veins of the brain. In the case of illnesses, it is usually dementia, with Alzheimer’s disease being the most serious type.

    Other psychological illnesses, such as major depressive disorder, attention deficit hyperactivity disorder, and even schizophrenia, may also cause impairment of some of the cognitive functions of the subject who suffers from it. means of these techniques.

    The function of cognitive rehabilitation will be to slow down, slow down and even reverse, depending on the clinical possibilities, the deficits in brain function. caused to the person by the mentioned circumstances. Of course, the program to be applied will depend on the characteristics of the subject as well as the pathology from which he suffers.

    Therefore, cognitive rehabilitation programs must be individualized. It will be the health professional concerned who will decide on the scheme of techniques to be applied according to the criteria that he deems appropriate to obtain the greatest possible effect on the improvement of the cognitive functions of the patient.

    Cognitive rehabilitation versus cognitive training

    It is important to note that cognitive rehabilitation is a different concept from cognitive training. While the two are related and can even be applied in complementary ways, the truth is that their definitions are not exactly the same, as they contain important nuances that we need to be aware of.

    In the case of cognitive rehabilitation, we have already seen that it refers to any methodology intended to improve previously weakened mental functions. due to injury or illness suffered by the person.

    Conversely, when we talk about cognitive training, which refers to the stimulation of certain cognitive functions of a person who has not been injured, in order to obtain an improvement in his performance, higher on which l ‘individual had a base.

    Therefore, we could say that the fundamental difference between cognitive rehabilitation and cognitive training is that the former is used to try to repair the mental sequelae of a neurological disease from which the subject has suffered, while the latter is aimed at improving abilities that have not been damaged, but simply want to improve, for whatever reason.

      Fundamentals of cognitive rehabilitation

      We must ask ourselves how it is possible that cognitive rehabilitation is capable of restore, even partially, functions impaired by causes as serious as brain damage from subject. The reason why this is possible is precisely because of the plasticity of this organ.

      Brain plasticity is a quality by which these viscera are able to restructure its functions after events such as injury, so that other neural regions take on the tasks of these structures which have been compromised due to disease or d ‘trauma, as we have already seen. .

      Therefore, the key to successful cognitive rehabilitation is that through these techniques, different areas of the brain are stimulated to “learn” to perform functions that were once developed by neural circuits that have now been destroyed. changed it.

      In all cases, it is also important to know that not all brain damage necessarily involves impaired cognitive functions. This organ has the so-called cerebral reserve or cognitive reserve, another extraordinary capacity, by which the brain is able to take certain changes in its structure, either by disease or by aging itself, without this generating clinical symptoms. .

      This would be a case in which cognitive rehabilitation would not be necessary, because the subject, even if he had suffered a brain deficiency, would not have seen his cognitive capacities diminished and it would therefore not make sense to initiate a process to retrieve them.

      The main types of cognitive rehabilitation

      Cognitive rehabilitation, as we saw at the beginning, it is not limited to a single technique, but constitutes a set intended for a common objective. We had already indicated that it would be the doctor and / or the psychologist, who would decide which of these tools are the most appropriate to be able to help the patient in question to experience an improvement, according to the characteristics.

      These techniques can be very diverse in nature, As we will see below. Some are limited to simple exercises while others require a medical infrastructure that is not accessible to all patients. Let’s look at some examples in more detail.

      1. Activity and game books

      One of the most remarkable means of cognitive rehabilitation for its simplicity and effectiveness is the use of exercises through activity books and interactive games. As for the notebooks, different types can be found depending on the cognitive function we want to repair, Such as memory, attention or the use of language.

      It is important to choose a notebook that includes exercises at the appropriate level for the person who is going to undergo cognitive rehabilitation, because a level lower than its current capacity will have no effectWhile one who exceeds the margin that he can achieve can trigger a sense of frustration which is counterproductive.

      In the case of games and video games, one can find from physical puzzles which also vary according to the difficulty, to complete programs available for different gaming platforms, computers or even smartphones, which offer a series of challenges to the entertainment user.

      These tools are particularly useful for cognitive rehabilitation, as they attract the patient to the playful side and have very positive effects for improving mental faculties which are meant to be recovered. Of course also these games must be chosen which offer challenges according to the abilities of each individual.

      2. Electrical stimulation

      By making a qualitative leap towards a visibly more invasive technique, we find electrical stimulation for cognitive rehabilitation. More specifically, this technique is known as transcranial DC stimulation, or TDC.

      As indicated by his name, the procedure involves applying an electric current to certain areas of the brain (Those that have been damaged).

      The aim is to stimulate these regions to reverse the deterioration suffered. However, this is a relatively new technique and there are still contradictions in the results obtained, so more research is needed to reach a conclusion that will allow us to know the scope of this method.

      3. Neurotechnology

      Finally, further increasing the complexity of the selected tool, we find what is called neurotechnology. It is devices by which a computer can establish a connection to a person’s brain, Measure certain parameters and even succeed in modifying them, using pulses electric.

      It is the most complex form of cognitive rehabilitation. It allows you to develop specific programs to work on the specific damage that you have suffered an individual, which is a great advantage over other methodologies, which can be more general. Of course, it also has a certain number of drawbacks, starting with the technological devices necessary for its application.

      This condition implies that neurotechnology can only be used in very specific places and therefore for people who have sufficient resources to be able to allow such an extraordinary treatment today.

      Fortunately, technology is advancing at a breakneck pace and this also means lower production costsSo it may be that in the future, all people with brain damage will have easy access to cognitive rehabilitation based on neurotechnology.

      Bibliographical references:

      • Escolano, C., Navarro-Gil, M., García-Campayo, J., Congedo, M., De Ridder, D., Mínguez, J. (2014). A controlled study on the cognitive effect of alpha neurofeedback training in patients with major depressive disorder. Frontiers of Behavioral Neuroscience.
      • Ginarte-Arias, I. (2002). Cognitive rehabilitation. Theoretical and methodological aspects. Journal of Neurology.
      • Horvath, JC, Forte, JD, Carter, O. (2015). A quantitative review finds no evidence of cognitive effects in healthy populations of single-session transcranial direct current stimulation (tDCS). Brain stimulation. Elsevier.
      • Mateer, C. Introduction to cognitive rehabilitation. Advances in Latin American clinical psychology.

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