Cognitive rehabilitation: what it is and how it helps patients

There are many causes that can generate cognitive impairment in a person. Therefore, researchers are looking for new solutions.

Some of the best known techniques in this regard are cognitive rehabilitation. Below we can discover what are its main types and practical applications, what characterizes this methodology, and what are the advantages it provides compared to other systems.

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What is cognitive rehabilitation?

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

In this sense, injuries can be caused by traumatic injuries that affect the brain, since are external, such as an impact, or internal, such as a thrombus that generates a heart attack in one of the veins of the brain. In the case of diseases, they usually refer to dementias, being the

Alzheimer's the most severe type.

Other psychological illnesses, such as major depressive disorder, attention deficit hyperactivity disorder, and even schizophrenia, can also generate deterioration in some of the cognitive functions of the subject who suffers them, so that these effects, likewise, may be susceptible to be treated by means of these techniques.

The function of cognitive rehabilitation will be to slow down, stop and even reverse, depending on the clinical possibilities, the deficits in brain functions caused in the person by the mentioned circumstances. As is logical, the program to be applied will depend on the characteristics of the subject as well as the pathology suffered.

Therefore, cognitive rehabilitation programs have to be individualized. It will be the health professional in question who decides the pattern of techniques to apply based on the criteria that it determines are appropriate to achieve 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. Although both are related and can even be applied in a complementary way, the truth is that Their definitions are not exactly the same, as they contain important nuances that we must bear in mind. account.

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

On the contrary, when we speak of cognitive training, which refers to the stimulation of certain cognitive functions of a person who have not been damaged, with the aim of achieving an improvement in their performance, greater than that which the individual had from base.

Therefore, we could say that the fundamental difference between cognitive rehabilitation and cognitive training is that the The first is used to try to repair the mental sequelae derived from a neurological damage that the subject has suffered, while that the second is destined to improve capacities that have not been damaged, but simply want to improve, by the reasons whatever.

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Foundations of cognitive rehabilitation

How is it possible that cognitive rehabilitation is capable of restore, even in part, functions that have been altered by causes as serious as damage to the brain of the subject. The reason why this is possible is precisely thanks to the plasticity of this organ.

Brain plasticity is a quality by which this viscera is capable of restructuring its functions after events such as injury, so that other neuronal regions take over the tasks of those structures that have been compromised by disease or trauma, as we have already done. viewed.

Therefore, the key to the success of cognitive rehabilitation is that, through these techniques, different areas of the brain are stimulated so that they "learn" to exercise functions that were once developed by neural circuits that have now been destroyed or altered.

In any case, it is also important to know that not every injury to the brain necessarily involves damage to cognitive functions. This organ has the so-called brain reserve or cognitive reserve, another extraordinary capacity, by which the brain is capable of assume certain changes in its structure, either due to an ailment or aging itself, without causing symptoms clinic.

That would be a case in which a cognitive rehabilitation would not be necessary, since the subject, even if he had suffered an impairment brain, their cognitive abilities would not have diminished and therefore it would not make sense to start a process to get them back.

The main types of cognitive rehabilitation

Cognitive rehabilitation, as we saw at the beginning, It is not limited to a single technique, but is a set of them aimed at a common purpose. 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 ones to be able to help the patient in question to experience an improvement, according to their features.

These techniques can be of a very diverse nature, as we will see below. Some are limited to mere 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 notebooks

One of the most prominent means of cognitive rehabilitation for its simplicity and effectiveness is the use of exercises through activity books and interactive games. Regarding the notebooks, different types can be found depending on the cognitive function that we are interested in repairing, such as memory, attention or the use of language.

It is important to select a notebook that includes exercises of the appropriate level for the person who is going to undergo cognitive rehabilitation, since a level below your current capacity will have no effect whatsoeverWhile one that exceeds the margin that can be achieved can trigger a feeling of frustration that is counterproductive.

In the case of games and videogames, we can find from physical puzzles that, likewise, vary depending on the difficulty, to complete programs available for different gaming platforms, computers or even smartphones, which propose a series of challenges to the user from the entertainment point of view.

These tools are especially useful for cognitive rehabilitation, as they attract the patient from the playful side and have very positive effects for the improvement of the mental faculties that are intended recover. Of course also You should choose those games that propose challenges according to the capabilities of each individual.

2. Electrical stimulation

Taking a qualitative leap to a visibly more invasive technique, we find electrical stimulation for cognitive rehabilitation. Specifically, this technique is known as transcranial direct current stimulation, or tDCS.

As its name suggests, the procedure is to apply an electrical current to certain brain areas (those that have been damaged).

The objective is to stimulate these regions to reverse the deterioration suffered. However, it is a relatively new technique and there are still certain contradictions about the results obtained, so it is requires further research to establish conclusions that allow us to know the scope of this rehabilitation method cognitive.

3. Neurotechnology

Finally, further increasing the complexity of the selected tool, we find the so-called neurotechnology. Is about devices by which a computer can establish a connection with the brain of a person, measuring certain parameters and even managing to alter them, by means of electrical impulses.

This is the most complex form of cognitive rehabilitation. It allows the development of specific programs to work on the specific damages suffered by a individual, which is a great advantage over other methodologies, which may be more general. Obviously, it also has a series of drawbacks, starting with the technological devices necessary for its application.

This conditioning factor supposes that neurotechnology can only be used in very specific places and therefore for people who have sufficient resources to be able to afford such extraordinary treatment on a daily basis. today.

Fortunately, technology advances at a frenetic pace and that also means a reduction in production costs, so that in the future all people with brain damage may have easy access to cognitive rehabilitation based on neurotechnology.

Bibliographic 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 in behavioral Neuroscience.
• Ginarte-Arias, Y. (2002). Cognitive rehabilitation. Theoretical and methodological aspects. Journal of Neurology.
• Horvath, J.C., Forte, J.D., Carter, O. (2015). Quantitative review finds no evidence of cognitive effects in healthy populations from single-session transcranial direct current stimulation (tDCS). Brain stimulation. Elsevier.
• Mateer, C. Introduction to cognitive rehabilitation. Advances in Latin American Clinical Psychology.