LETTER N-NEUROCOGNITION

Neurocognition refers to brain functions in an umbrella term  of ‘Cognitive functions’. The term cognition (Latin: cognoscere, “to know” or “to recognize”) refers to the processing of information. It is the art or process of knowing.

Many times patient’s underlying neurocognitive deficits are overlooked and termed as ‘personality traits’.

For e.g., Once we had a patient with Right hemisphere stroke, clinically he had left-sided hemiparesis (partial weakness on one side of the body)and good speech. He faced difficulties in simple activities even on the unaffected side, appeared confused, and did not seem to follow the instructions for walking. He often got confused over the proper step sequences.  Many had dismissed the patient as uncooperative, intellectually inferior, stubborn and confused. What was forgotten was that he could have neuro-cognitive issues. On assessment, it was found that he had problems in Spatial relations, Right left discrimination, Left side neglect, Vertical disorientation, and Apraxia.

He suffered from serious neuro-cognitive disorders but was simply sidelined as “patient’s nature”!

When one part of the brain is damaged the behavior observed is not merely the result of the brain operating precisely in an intact individual minus function of the area subjected to injury.All the major parts of neuro-cognition – awareness, judgment,memory,intuition and reasoning need equal attention for examination .

 

Brain function observed after injury ≠ Normal brain function – the function of the affected part!

Well, Mathematics doesn’t work in Neurology!

Why??

As Mathematics doesn’t have re-organization!

Whenever there is brain damage the patient must cope with a nervous system operating without normal sensory inputs at various cortical and sub-cortical levels and hence there is RE-ORGANISATION of the entire Central Nervous system at MULTIPLE LEVELS working to compensate the loss.

Functional recovery can be attributed to structural re-organization of the central nervous system into a new dynamic system widely dispersed within the cerebral cortex and lower segments.

The “mental muscles” we can train include attention, stress and emotional management, memory, visual/spatial skills, auditory processes and language, motor coordination, and executive functions like planning and problem-solving.

The presence of neuro-cognitive disorders is neglected and focus is made only on counseling the patient for proper behavior. A thorough examination of Cognition and its impact on patient recovery is the missing link in most neurological cases.

Task analysis with assessment of each component like motor(muscle level), sensory(nerve level), perception and cognition (brain level) is the key to successful rehabilitation. Expert Physiotherapists always keep this structure in mind and incorporate a holistic cognitive rehabilitation with the use of appropriate approaches like Retraining, Sensory Integrative, Neuro-functional, Compensatory/Functional Approach, Cognitive Rehabilitation, And The Quadraphonic approach.

Let’s make it easier for those suffering from neurological disorders by checking out the presence of neuro-cognitive disorders and if found working on it instead of simply blaming it as a “personality trait”.