The neuropsychological rehabilitation of memory and learning disorders
People
The research group is led by a MRC senior scientist, Barbara Wilson, and is linked with the Oliver Zangwill Centre for Neuropsychological Rehabilitation in Ely, which was opened in September 1996 as a result of collaboration between Lifespan NHS Trust, Anglia and Oxford Research and Development Initiative, and the MRC. Members of the group include:
- Hazel Emslie
- Jennifer Foley
- Eve Greenfield
- Eira Martin
- Agnes Shiel
Background
The World Health Organisation defines rehabilitation as "the restoration of patients to the highest level of physical, psychological and social adaptation attainable. It includes all measures aimed at reducing the impact of disabling and handicapping conditions and at enabling disabled people to achieve optimal social integration." Wilson further defines cognitive rehabilitation as 'a process whereby people with brain injury work together with professional staff and others to remediate or alleviate cognitive deficits arising from a neurological insult. Research Programme
Our current studies in neuropsychological rehabilitation are focused on the following main areas:
- Development of new assessment procedures to develop ecologically valid tests to identify and monitor cognitive deficits and predict behaviour outside the laboratory or clinic. Current projects include in particular development of tests of prospective memory, post traumatic amnesia, divided attention and dysexecutive deficits in children
Theoretically derived treatment techniques for cognitive disabilities following brain injury, such as errorless learning paradigms and computerised reminding services, such as NeuroPage and Memojog (in collaboration with the Oliver Zangwill Centre)
- Improving predicting of recovery from brain injury (e.g., during and after coma) and testing the efficacy of different rehabilitation interventions, such as the effects of posture on arousal (in collaboration with Department of Academic Neurosurgery, the Wolfson Brain Imaging Centre, and the Neurosurgical Critical Care Unit at Addenbrooke's Hospital)
Approaches
- Neuropsychology: The groups studied include: (i) people with cognitive problems resulting from non-progressive brain injury, such as traumatic head injury, encephalitis, hypoxic brain damage and stroke; (ii) people with Huntington's Disease, Multiple Sclerosis and other progressive conditions.
- Brain Imaging: PET is use to demonstrate distinct and specific physiological responses (changes in cerebral blood flow, rCBF) to controlled external stimuli in patients in the vegetative and minimally conscious states and to examine changes in and interelationships between behavioural, electrophysiological and rCBF in patients as they emerge from coma.
- Behavioural assessment: Objective assessment of residual cognitive function in patients in the VS and MCS depends on motor and other responses which may be minimal, inconsistent, difficult to document, or undetectable. Observation and analysis of behaviour in these and similar groups can be used to detect evidence of function.