Craniosacral Therapy for Traumatic Brain Injury Clients with Neurobehavioral Disorders
Gregory J. Murrey in Alternate Therapies in the Treatment of Brain Injury and Neurobehavioral Disorders, 2017
Often when a TBI survivor's life is falling apart, it is difficult for them to put what is happening into perspective (Workman, 2002). In addition to their cognitive impairments, which interfere with their ability to understand what is happening to them, patients often suffer from agnosia due to the injuries. As discussed elsewhere in this text, agnosia is a condition brought on by the brain injury itself that may make it impossible for the patient to understand his or her deficits. Such patients believe that they are functioning as they have always functioned even though it is evident to their families, friends, and peers that they are not. Agnosia is a severe condition that limits the patient's insight into what is happening and interferes with internal motivation to change in ways that would be of benefit. Agnosia can at times lead the patient into having little to no desire to change nor any sense of a need to change. Agnosia is often one of the biggest challenges for a TBI survivor to overcome.
Visual Object Agnosia
Alexander R. Toftness in Incredible Consequences of Brain Injury, 2023
For example, in various cases of apperceptive visual agnosia, the medial occipital cortex contributes especially to perceiving texture, while the lateral occipital cortex contributes especially to perceiving shapes (Kirshner, 2021). In contrast, a person with the typical case of associative object agnosia may have their symptoms because the visual area of their brain has been disconnected from the verbal area of their brain due to damage to the brain's white matter, which is sort of like the wires that connect one area of the brain to another area (Pelak, 2019). This disconnection means that the visual and verbal areas can no longer effectively share information, and so even though the person can both see and speak, they have trouble speaking about what they are seeing. Because so many visual information processing systems are located close together in the brain, visual object agnosia frequently seems to occur in conjunction with other disorders, especially other agnosias such as face blindness (Haque et al., 2018).
Rehabilitation and management of visual dysfunction following traumatic brain injury
Mark J. Ashley, David A. Hovda in Traumatic Brain Injury, 2017
Diagnosis of visual agnosias is important in deciding the proper course of treatment: therapy or compensation. Associative agnosias may be due to lesions in the pathway that connect the visual “what” pathway with memory areas. De Haan, Young, and Newcombe170 have shown that covert recognition of objects and faces may exist in the absence of overt recognition. They suggest that this may provide a foundation for rehabilitation. Sergent and Poncet171 report some restoration of overt face recognition under specific circumstances in one patient. Although, in some cases, restoration of function may be possible, therapy to directly address the agnosia is likely to be a long process, and success is not guaranteed. Compensatory strategies, as for low vision or blind patients, may be the best alternative for immediate management of agnosia.
Therapist-assisted vision therapy improves outcome for stroke patients with homonymous hemianopia alone or combined with oculomotor dysfunction
Published in Neurological Research, 2018
Peter Smaakjær, Signe Tornøe Tødten, Rune Skovgaard Rasmussen
The exclusion criteria were patients with reduced ability to perceive visual impressions correctly (apperceptive agnosia – defect in perception); ability to see clearly, but without the ability to associate what is seen with what is known. Reduced ability to recognise an object (associative agnosia – defect in association); inability to recognise more than one letter at a time or to recognise the form of a word. The patient sees only individual parts of a picture, but not the picture as a whole (simultanagnosia); patients with cognitive or physical problems who lack the motivation required to receive teaching or training in stereopsis; and markedly low scores in cognitive tests such as the Montreal Cognitive Assessment (MoCA) [13], Multidimensional Fatigue Inventory (MFI-20) [14,15] or the Rivermead Behavioural Memory Test [16], which would indicate an inability to complete the training. Furthermore it was expected that patients could take care of themselves in their own homes and not have memory problems that would prevent them from understanding or taking part in lessons.
Neuro-Ophthalmic Literature Review
Published in Neuro-Ophthalmology, 2019
David Bellows, Noel Chan, John Chen, Hui-Chen Cheng, Panitha Jindahra, Rauan Kaiyrzhanov, Peter MacIntosh, Michael Vaphiades, Konrad P. Weber, Sui Wong
This paper attempts to outline the current concepts of anatomy and neurophysiology underlying selective disorders of higher visual processing, i.e. the visual agnosias, and to describe the clinical conditions themselves. Every new case of agnosia has the potential to provide greater insight into the way the brain processes vision, as reflected in the ever-increasing number of related publications in the fields of visual physiology, neuropsychology, and neuroimaging. There is currently little that can be offered by way of treatment for most cases of visual agnosia, but an increase in our understanding has the potential to change this. Owing to the limitations of space, several disorders simply could not be covered, including congenital prosopagnosia, blindsight, hemispatial neglect, various forms of specific anomia and amnesia, and the different types of alexia. Given our aging population, these disorders will become more common and are more likely to be detected if they are specifically looked for, particularly in the context of stroke and degenerative disease. If physicians are familiar with the visual agnosias then their existence in patients will be more readily detected.
The neuropsychological rehabilitation of visual agnosia and Balint’s syndrome
Published in Neuropsychological Rehabilitation, 2019
Joost Heutink, Dana L. Indorf, Christina Cordes
First, for the treatment of agnosia, Groh-Bordin and Kerkhoff (2010) suggested that, based on their clinical experience, it might be more effective to treat deficits that co-occur with agnosia (e.g., hemianopia) rather than focusing on the agnosia itself. This approach is based on the view that, if other visual deficits are enhanced, recognition will likely be improved as well. However, Zihl (2011) failed to prove this approach. He attempted to improve identification and recognition by training oculomotor scanning in patients with homonymous visual field loss and disorientation, which resulted in improvement of the trained skill, yet none for recognition. Nevertheless, it seems plausible that improved lower visual functions will increase the chances to rehabilitate recognition as well. We would argue that clinicians need to consider how much the patients are – subjectively and objectively – impaired by the agnosia. If the agnosia dominates impairment caused by other deficient visual functions, rehabilitation should target the specific agnostic deficit at least by training compensatory strategies.
Related Knowledge Centers
- Acquired Brain Injury
- Apperceptive Agnosia
- Neurological Disorder
- Visual Agnosia
- Brodmann Area 37
- Two-Streams Hypothesis
- Stimulus Modality
- Associative Visual Agnosia
- Prosopagnosia
- Auditory Verbal Agnosia