半側空間無視（unilateral spatial neglect：USN）の症状は，机上検査と生活場面とで，その発現頻度に乖離が生じる場合があると報告されている（Azouvi ら 2003）。その要因としては，身体からの距離の違いや，二重課題か否かの差によるもの等が挙げられる。今回，二重課題条件下で出現するUSNに対して，筆者らは歩行中に実施可能なバーチャルリアリティ（virtual reality：VR）課題（歩行VR課題）を開発した。歩行VR課題を用い，60歳代右利き男性で右被殻出血後のUSN症例1名の無視症状について，健常高齢者4名（平均年齢69.3 ± 5.7歳，男性1名，女性3名）と健常若年者6名（平均年齢23.8 ± 1.6歳，男性2名，女性4名）の課題結果と比較し，検討した。USN症例は机上検査の得点が正常範囲内であったが，歩行VR課題では健常高齢群や健常若年群と比較し，評価結果に乖離や低下が認められた。本研究の結果から，筆者らが開発した歩行VR課題は，二重課題条件下のUSN症状を定量的に提示できる可能性を示唆した。

神経心理検査とは、注意、記憶、言語、視空間、遂行などの能力を測るテストであり、高次脳機能の十分な知識と熟達した検査技能を併せ持つ専門家が行う必要があるが、対象者の多さに比して数が不足している。このアンバランスを解決する一つの方法が、遠隔技術を用いた検査の実施である。新型コロナウイルスの感染拡大により医療機関などの受診に制限が生じている現状において、その意義はさらに高まったと言える。本稿では、①ビデオ会議システムを用いて高齢者に行う神経心理検査の信頼性のレビュー、②利用者満足度のレビュー、③自験例における具体的な実施方法と留意点、④私たちが現在行っている一般的なweb会議システムを用いた標準失語症検査の予備的検証を紹介し、今後の方向性と課題を述べた。

Long-term cognitive outcome and brain imaging of 6 patients after cardiac arrest due to ventricular fibrillation were presented.

Brain areas vulnerable to ventricular fibrillation were watershed areas between the territories of the major cerebral arteries, damage of which is demonstrated by functional imaging, such as single photon emission computed tomography, rather than structural imaging, such as magnetic resonance imaging.

Cognitive impairment includes mainly memory dysfunction and transcortical sensory aphasia, which are often compatible with the results of functional imaging.

Lack of bystander cardiopulmonary resuscitation might deteriorate long-term cognitive impairment.

We report that the patient with severe traumatic brain injury (TBI), who was diagnosed psychogenic polydipsia, succeeded to control his compulsive water drinking by psychoeducation combined using compensated strategies upon therapeutic milieu.

A 30’s years old male who sustained TBI 7 years ago, drank over 5 little water a day. After our intervention program he got to drink about 2.5 little water a day.

It was suggested that psychoeducation with using strategies practically on preparing therapeutic milieu could be effective for modifying behavior of even patient with severe brain injury.

We provided language training, psychological support, and environmental adjustment to a woman with aphasia who experienced depression, difficulty continuing employment, and economic hardship after suffering a stroke.

In this case, public services such as Japan's long-term care insurance system and support for living and working were not effectively utilized because they did not meet her needs.

In supporting people with aphasia who are of working age, we believe that it is necessary to establish a support system that can provide integrated support for language function and employment, as well as a comprehensive and holistic support system, while assessing physical and psychological conditions.

Our remote outpatient group program might be useful to some extent for individuals with cognitive dysfunction in acquiring awareness of their disabilities although its effectiveness is limited in terms of experiencing and deep understanding of their disabilities.

Staff members are recommended to give consideration to maintaining both executive function and motivation of individuals with cognitive dysfunction as well as their family situations.

We report a case of central photophobia after bilateral putamen injury. Although the patient complained of photophobia from the onset, he was able to perform activities of daily living without major problems. Approximately 150 days after the onset, dizziness and lightheadedness developed, which greatly interfered with his daily life. He visited various departments for detailed examinations resulting in suspicion of impairment in the vestibulo-ocular reflex. Symptoms such as photophobia, dizziness, and lightheadedness can be alleviated by colored filters. It is possible that the central photophobia in this case was caused by damage near the photophobic neural circuit. Symptoms including dizziness and light-headedness have been associated with central photophobia and may be caused by damage to a part of the photophobic neural circuit or the area adjacent to it. Furthermore, following a course of cognitive rehabilitation, tracing reading and gaze stability exercises were effective in alleviating the symptoms associated with central photophobia.

The support law for people with developmental disorders (2005) and the Act for Eliminating Discrimination against Persons with Disabilities (2016) have made significant progress in providing employment support for persons with developmental disabilities, which include autism spectrum disorder, attention deficit and hyperactivity disorder and learning disorder. Kaien Inc., which was founded in 2009, has also grown its achievements in this trend. Through the support of more than 5,000 people, the organization has demonstrated the combination of traditional approaches to intellectual disabilities and mental disorders and the advanced approaches deprived from business methods is valid and practical. In the future, based on the concept of neurodiversity, the success cases should be expanded even into general employment. This paper summarizes the history and future prospects of support for developmental disabilities through the case of Kaien.