A subclass is the subordinate class which lines up a class and the above order in the bottom. It is important to divide the unilateral spatial neglect as a means of the focus diagnosis and clarify problems on the daily living and its intervention. I therefore suppose that possibility to improve the unilateral spatial neglect a little even if it doesn't cure. This paper is reported about unilateral spatial neglect that classified based on etiology, cerebral dominances, severities, lesions, sensory modalities, cognition-execute processes and mechanisms.

View full abstract

    Bottom-up approaches were quite common in traditional brain research such as recording a neural activity at cell level or description of neuropsychological symptoms. On the other hand, top-down approaches play a major role in the computational theories in neuroscience where the question is what brain is trying to solve, with what kind of computation and what the fundamental principle is. One of the problem that brain has to solve is called ill-posed problem;, i. e., in reaching movement, one has to choose an optimal trajectory out of possible immense number of trajectories to reach the target. In order to do so, the brain has to decide the constraints on reaching movement. Minimum torque change model satisfied the constraints for reaching movement. In this lecture, attention was focus upon the possible theoretical explanation of neuropsychological symptoms of movement based on computational theories.

View full abstract

    I described the research history of active touch, my own research on monkey somatosensory cortex, and more recent development of study on human somatosensory cortex. I also referred to recent studies on somatovisual integration in the somatosensory and posterior parietal association cortices in regard to mechanisms of active touch and tactile object recognition.

View full abstract

    Minisitry of Health, Labour and Welfare conducted a five-year model project for supporting persons with higher brain dysfunctions from 2001 to 2005. The objective of this model project is to develop the nation-wide welfare system serving persons with higher brain dysfunctions in their independence and social patricipation.
    For five years, 424 persons with such disabilities resulting from traumatic brain injury, cerebral vascular accidents or hypoxia were registered with informed consent and were provided continuum of care from medical field to community care on trial. Analysis of cumulative data on their properties including severity of disability and outcome of rehabilitation services successfully produced the evidence-based standards for diagnosis, training programme and care programme.

View full abstract

     During the national model project that support persons with higher brain dysfunction, 424 cases were registered to the database set up at the National Rehabilitation Center for Persons with Disabilities. Of those registered, 76 % were traumatic brain injuries : TBIs. In the United States, local and federal government support TBIs in various ways such as promoting the community-based rehabilitation under the rule of TBI Act. The Kanagawa Rehabilitation Center had participated in the model project. The number of new outpatients increased at the acquired brain injuries' clinic. Sixty-eight percent of those new outpatients were TBIs. Traumatic brain injuries usually require continuing support for re-entry to the community even after receiving a comprehensive in-patient rehabilitation program. Japanese prefectural government will designate a site where the coordinator support the people with higher brain dysfunction under the newly established law to promote independence and social participation of persons with disabilities.

View full abstract

    For the cognitive rehabilitation, a clinical psychologist does the following ; 1) training for improving the cognitive disorder and learning the coping strategy ; 2) psycho-education for making the supportive environment. Basically, a psychologist helps patients with higher brain dysfunctions adapt to social life. Actually, in the model projects, a psychologist spends the most time on patients with higher brain dysfunctions (40% of the participation time was for counseling). In Nagoya Rehabilitation Center, through an analysis of databases of the higher brain dysfunctions, we studied how patients recovered from higher brain dysfunctions following traumatic brain injuries. The results of the neuro-psychological tests show that patients recover better within the first year than the following years ; besides, the earlier he/she starts to rehabilitate or the younger he/she is, the better the patient recovers. Finally, the article reports the phases of his/her adaptation to the society through the rating of GAF and the practice of the approach to improve the adaptation.

View full abstract

    Many problems of patients with higher brain dysfunction centering on traumatic brain injury often rise to surface at the point in time they finished medical treatment, and shifted to vocational, social life in their community. Because of their cognitive disabilities for example memory and cautions⁄execution dysfunction and social behavior disorder, they cannot keep their vocational and social life well, maintenance relationships with the other people, and then they drop out. For such a problem, “Mie model” supplies a total rehabilitation program for vocational, social and cognitive disabilities to patients. This model is a comprehensive support system excludes each limits, and supplies cooperative networks between medical treatment, rehabilitation and welfare. The coordinator consults from the early stage and managements several specific supports or social resources. This is a summary of a new support system of medical-welfare for patients with higher brain dysfunction in “Mie model”.

View full abstract

    The evaluation and diagnosis of higher brain dysfunction is critical for the treatment and neurocognitive training of brain damaged patients. In this paper, a diagnostic criterion of higher brain dysfunction was introduced and the several problems in the clinical use of this criterion were pointed out. Moreover, we described seven patients whose cognitive, behavioral and psychiatric deficits may be difficult to be diagnosed as a higher brain dysfunction. The symptoms of these cases included the neuropsychological impairment superimposed with Posttraumatic Stress Disorder, abnormal social behavior caused by early frontal lobe damages, and psychotic disorder following traumatic brain injuries.

View full abstract

    Japan Society for Higher Brain Dysfunction (founded as Japanese Society of Aphasiology in 1977) developed the two standardized test batteries to evaluate the impairment of generalized attention and spontaneity in clinical session. The neuropsychological batteries ware named Clinical Assessment for Attention (CAT) and Clinical Assessment for Spontaneity (CAS). CAT and CAS include the seven subtests and five subscales, respectively. CAT and CAS demonstrated substantial inter-rater and test-retest reliabilities and the distinct aging effect specifically in CAT. The two batteries revealed the significant differences between the normal subjects and brain-damaged patients on the performances of the most neuropsychological subtasks or subscales to measure attentional deficits and aspontaneity. Using CAT and CAS in clinical practice, we are able to precisely detect and evaluate the impairments of attention and volition.

View full abstract

    To clarify the characteristics of memory impairment with dementia, we examined memory function using the auditory verbal learning test (AVLT). The subjects were 262 senile patients having amnesia as a complaint—including cases of 114 Alzheimer's disease (AD), 68 vascular dementia (VD), 6 dementia with Lewy body (DLB), 25 frontotemporal dementia (FTD), 49 mild cognitive impairment (MCI)—and 46 control subjects (CS). We discussed the scores of short-term memory (STM), total immediate memory (TIM), verbal learning ability (VLA), and retroactive interference effect (RI)in different types of dementia. In both STM and TIM, the scores of dementia were lower than those of MCI and CS, and the scores of MCI were lower than those of HS. In VLA, the scores of CS were higher than those of MCI and dementia, and the scores of AD were lower than those of MCI. There was significant difference in RI between CS and all types of dementia, between MCI and AD, and between AD and FTD. DLB scores on recognition were much lower compared with the scores of FTD, MCI and CS. These findings suggest that memory impairment with AD may owe to a mechanism different from that in patients with FTD. It is necessary for memory function to process encoding, storage and retrieval. Retrieval in MCI was preserved. Dementia impaired not only encoding and storage but also retrieval. We suggest that the AVLT is an efficient tool for distinguishing the process of memory impairment.

View full abstract

    To investigate the usefulness of the word fluency test (WFT) as a brief assessment for diagnosis in patients with dementia, we examined cognitive function using the category fluency test (CFT) and the letter fluency test (LFT). The subjects were 276 senile patients having amnesia as a complaint. A total of 170 could be diagnosed as having dementia, including 88 cases of Alzheimer's disease (AD), 21 of frontotemporal dementia (FTD), 5 of dementia with Lewy body (DLB), 56 of vascular dementia (VD) and 39 of mild cognitive impairment (MCI). We discussed the difference in scores between the various types of dementia. In both CFT and LFT, the scores of healthy persons were higher than those of MCI. MCI score on both CFT and LFT were much higher compared with the scores of all types of dementia. The scores of CFT were higher than those of LFT in all subjects. Based on these findings, it is suggested that WFT is an efficient tool to diagnose dementia, but it is difficult to distinguish among different types of dementia.

View full abstract