Positive Technology Journal

Developing prosthetics to treat cognitive disabilities resulting from acquired brain injuries

Neurol Res. 2002 Mar;24(2):116-24

Authors: Schiff ND, Plum F, Rezai AR

Persistent cognitive disabilities represent the most troublesome consequences of acquired brain injury. Although these problems are widely recognized, few neuroprosthetic efforts have focused on developing therapeutic strategies aimed at improving general cognitive functions such as sustained attention, intention, working memory or awareness. If possible, effective modulation of these neuropsychologic components might improve recovery of interactive behaviors. The emerging field of neuromodulation holds promise that technologies developed to treat other neurological disorders may be adapted to address the cognitive problems of patients suffering from acquired brain injuries. We here discuss initial efforts at neuromodulation in patients in the persistent vegetative state and aspects of recent studies of the underlying neurobiology of PVS and other severe brain injuries. Innovative strategies for open-loop and closed-loop neuromodulation of impaired cognitive function are outlined. We discuss the possibilities of linking neuromodulation techniques to underlying neuronal mechanisms underpinning cognitive rehabilitation maneuvers. Ethical considerations surrounding the development of these strategies are reviewed.

Neuropsychological technologies in rehabilitation.

J Head Trauma Rehabil. 2002 Oct;17(5):369-77

Authors: Chute DL

OBJECTIVE: To provide an introduction and a conceptual context for the articles presented in this special edition of the Journal of Head Trauma Rehabilitation on neuropsychological technologies. SUMMARY: Many clinical assessments in neuropsychology are metamorphosing from a psychometric search for a lesion to a functional image of the working brain. Behavioral probes increasingly employ technology to provide more ecologically valid stimuli to elicit diagnostically relevant responses. Intervention strategies include an expanding range of assistive devices and technologically based treatments. The advent of the microprocessor and discipline specific programming have allowed certain aspects of rehabilitation practice to incorporate these new assessment and intervention strategies. For example, the development of neuropsychological technologies has already lead to computer based prosthetics and orthotics, cognitive probes with millisecond accurate links to functional imaging, virtual reality managed ecological assessments, cognitive retraining, assistive devices, and online, and "real-time" database-driven evaluations. Emerging technologies offer the potential for personal, portable, everyday brain imaging and rehabilitation systems. Few psychologists, physiatrists, or allied health professionals are formally trained in technological development. What has emerged thus far is a collection of individual efforts that remain to be integrated into more comprehensive tools for the rehabilitation professions. The selective history of neuropsychological technologies presented here is meant to illustrate past difficulties in the emergence of this sub-specialty and point to new applications and technological integration that may prove fruitful. The convergence of neuroengineering, adaptive assessments, everyday neuroimaging, neuroinformatics, and educational neuroimaging, presage such future developments in neuropsychological technologies.