Successful cognitive rehabilitation for acute right frontal aslant tract injury with impaired working memory and inattention using diffusion tensor tractography.

IF 1.5 4区 医学 Q4 NEUROSCIENCES
Masaharu Sawaki, Kazuya Motomura, Hiroyasu Yamamoto, Koei Ito, Yuto Suzuki, Masahiko Yamamoto
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引用次数: 0

Abstract

Background: Language impairments caused by left frontal aslant tract (FAT) damage have a good prognosis. However, the prognosis of cognitive dysfunction after right FAT injury is unknown. The present study describes successful cognitive rehabilitation for impaired working memory and inattention together with diffusion tensor tractography (DTT).

Methods: A patient in his 40s with acute stroke underwent magnetic resonance imaging, computed tomography perfusion scans, DTT, and 11 neuropsychological tests for attention, frontal lobe, memory, visuospatial, intelligence, and cognitive functions. Three weeks of cognitive rehabilitation, including direct attention and metacognitive strategy training, and visual working memory tasks were performed. DTT and neuropsychological assessments were compared before and after rehabilitation.

Results: Neuropsychological scores in the Trail Making Test, Clinical Assessment for Attention, and Frontal Assessment Battery increased with step-by-step rehabilitation, leading to early reinstatement as a system engineer. DTT revealed that the FAT posterior segment adjacent to the lesion increased its distal branching in the inferior frontal gyrus.

Conclusion: In this case study, cognitive rehabilitation for three weeks restored impaired working memory and attention while enhancing right FAT integrity. Visualizing white matter using DTT in the acute phase provides essential insights for selecting appropriate training tasks to facilitate functional recovery from neuropsychological disturbances.

急性右额斜束损伤伴工作记忆和注意力不集中的成功认知康复。
背景:左额斜束(FAT)损伤所致的语言障碍预后良好。然而,右脂肪损伤后认知功能障碍的预后尚不清楚。本研究描述了利用弥散张量神经束造影(DTT)对工作记忆受损和注意力不集中的成功认知康复。方法:对40多岁急性脑卒中患者进行磁共振成像、ct灌注扫描、DTT和注意力、额叶、记忆、视觉空间、智力和认知功能等11项神经心理测试。进行为期三周的认知康复,包括直接注意和元认知策略训练,以及视觉工作记忆任务。比较康复前后DTT和神经心理评估。结果:随着康复的逐步进行,神经心理测试、临床注意力评估和额叶评估电池的得分增加,导致系统工程师早期恢复。DTT显示与病变相邻的FAT后段在额下回的远端分支增加。结论:在本病例研究中,三周的认知康复可以恢复受损的工作记忆和注意力,同时增强右侧FAT的完整性。在急性期使用DTT可视化白质为选择适当的训练任务以促进神经心理障碍的功能恢复提供了重要的见解。
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来源期刊
Brain injury
Brain injury 医学-康复医学
CiteScore
3.50
自引率
5.30%
发文量
148
审稿时长
12 months
期刊介绍: Brain Injury publishes critical information relating to research and clinical practice, adult and pediatric populations. The journal covers a full range of relevant topics relating to clinical, translational, and basic science research. Manuscripts address emergency and acute medical care, acute and post-acute rehabilitation, family and vocational issues, and long-term supports. Coverage includes assessment and interventions for functional, communication, neurological and psychological disorders.
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