Neurocognitive Rehabilitation Using Non-Emotionally Charged Material to Re-Learn How to Learn: A Case Report

Murray R. Berkowitz

Department of Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine, Director of Family Medicine/OMM Clerkships, Director of Preventive and Community-Based Medicine, Philadelphia College of Osteopathic Medicine—Georgia Campus, 625 Old Peachtree Road NW, Suwanee, Georgia 30024, USA.

DOI: 10.4236/psych.2014.52023                

Abstract

Cognitive disorders following hypoxic ischemic brain injury involve a variety of disorders including consciousness, behavior, mood and affect, impairment of attention, and memory dysfunction. The case of a 45-year-old former military aviator and engineer, now a physician in residency training, presenting with cognitive difficulties, is described. The patient described having difficulty remembering medical knowledge and feeling fatigued. After almost nine months without any medical intervention and the patient’s deteriorating condition, the patient was finally evaluated medically. It was ultimately discovered that the patient suffered from a variety of neurologic impairments that were the direct result of exposures to various toxic substances during his military service. Significant diagnoses included hypoxic ischemic brain damage, severe mixed sleep apnea, and cognitive disorder NOS. Relevant literature about the application of neurocognitive rehabilitation and retraining to treating patients suffering from brain injuries is discussed. The overlap of the neuroscience of emotion with cognitive learning and how emotion and affect impacts learning and education is presented. This case also serves to demonstrate the application of learning and cognition to individual differences and disabilities. Further research is needed to evaluate whether this result is reproducible and generalizable to other patients with similar presenting signs and symptoms.

Keywords

Neurocognitive Rehabilitation; Hypoxic Ischemic Brain Damage; Learning; Effects of Emotion on Learning; Re-Learning How to Learn

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Berlucchi, G. (2011). Brain plasticity and cognitive neurorehabilitation. Neuropsychological Rehabilitation, 21, 553-559. http://dx.doi.org/10.1080/09602011.2011.573255
[2]	Bhatoe, H. S. (2011). The hypoxic-ischemic brain injury: Beyond semantics. Indian Journal of Neurotrauma, 8, 65-66. http://dx.doi.org/10.1016/S0973-0508(11)80001-8
[3]	Craik, F. I. M., Winocur, G., Palmer, H., Binns, M.A., Edwards, M., Bridges, K., Glazer, P., Chavannes, R., & Stuss, D. T. (2007). Cognitive rehabilitation in the elderly: Effects on memory. Journal of the International Neuropsychological Society, 13, 132-142. http://dx.doi.org/10.1017/S1355617707070166
[4]	Cullen, N. K., Crescini, C., & Bayley, M. T. (2009). Rehabilitation outcomes after anoxic brain injury: A case-controlled comparison with traumatic brain injury. PM & R Journal, 1, 1069-1076. http://dx.doi.org/10.1016/j.pmrj.2009.09.013
[5]	Dalrymple, K. A., Oruc, I., Duchaine, B., Pancaroglu, R., Fox, C. J., Iaria, G., Handy, T. C., & Barton, J. J. S. (2011). The anatomic basis of the right face-selective N170 in acquired prosopagnosia: A combined ERP/fMRI study. Neuropsychologia, 49, 2553-2563. http://dx.doi.org/10.1016/j.neuropsychologia.2011.05.003
[6]	Dams-O’Connor, K., & Gordon, W. A. (2010). Role and impact of cognitive rehabilitation. Psychiatric Clinics of North America, 33, 893-904. http://dx.doi.org/10.1016/j.psc.2010.08.002
[7]	DeGutis, J. M., Bentin, S., Robertson, L. C., & D’Esposito, M. (2007). Functional plasticity in ventral temporal cortex following cognitive rehabilitationof a congenital prosopagnosic. Journal of Cognitive Neuroscience, 19, 1790-1802. http://dx.doi.org/10.1162/jocn.2007.19.11.1790
[8]	Diamant, J. J., & Hakkaart, P. J. W. (1989). Cognitive reghabilitation in an information-processing perspective. Cognitive Rehabilitation, 22-29.
[9]	Fernandez-Ballesteros, R., Botell, J., Zamarron, M. D., Molina, M. A., Cabras, E., Schettini, R., & Tarraga, L. (2012). Cognitive plasticity in normal and pathological aging. Clinical Interventions in Aging, 7, 15-25. http://dx.doi.org/10.2147/CIA.S27008
[10]	Fernandez-Ballesteros, R., Zamarron, M. D., Tarraga, L., Moya, R., & Iniguez, J. (2003). Cognitive plasticity in healthy, mild cognitive impairment (MCI) subjects and Alzheimer’s disease patients: A research project in Spain. European Psychologist, 8, 148-159. http://dx.doi.org/10.1027//1016-9040.8.3.148
[11]	Immordino-Yang, M. H., & Damasio, A. (2007). We feel, therefore we learn: the relevance of affective and social neuroscience to education. Mind, Body, and Education, 1, 3-10. http://dx.doi.org/10.1111/j.1751-228X.2007.00004.x
[12]	Levine, B., Stuss, D. T., Winocur, G., Binns, M. A., Fahy, L., Mandic, M., Bridges, K., & Robertson, I. H. (2007). Cognitive rehabilitation in the elderly: Effects on strategic behavior in relation to goal management. Journal of the International Neuropsychological Society, 13, 143-152. http://dx.doi.org/10.1017/S1355617707070178
[13]	McDonald, A., Haslam, C., Yates, P., Gurr, B., Leeder, G., & Sayers, A. (2011). Google calendar: A new memory aid to compensate for prospective memory deficits following acquired brain injury. Neuropsychological Rehabilitation, 21, 784-804. http://dx.doi.org/10.1080/09602011.2011.598405
[14]	Minnebusch, D. A., Suchan, B., Koster, O., & Daum, I. (2009). A bilateral occipitotemporal network mediates face perception. Behavioural Brain Research, 198, 179-185. http://dx.doi.org/10.1016/j.bbr.2008.10.041
[15]	Rajan, J., Udupa, S., & Bharat, S. (2010). Hypoxia: Can neuropsychological rehabilitation attenuate neuropsychological dysfunction. Indian Journal of Psychological Medicine, 32, 65-68. http://dx.doi.org/10.4103/0253-7176.70544
[16]	Sales-Galan, A., Melendez-Moral, J. C., & Mayordomo-Rodriguez, T. (2013). Using a cognitive plasticity measure to detect mild cognitive impairment. Archives of Clinical Neuropsychology, 1-8.
[17]	Samuel, R. (2008). Cognitive rehabilitation for reversible and progresssive brain injury. Indian Journal of Psychiatry, 50, 282-284. http://dx.doi.org/10.4103/0019-5545.44752
[18]	Wilson, B. A., Evans, J. J., & Keohane, C. (2002). Cognitive rehabilitation: A goal-planning approach. Journal of Head Trauma Rehabilitation, 17, 542-555. http://dx.doi.org/10.1097/00001199-200212000-00006
[19]	Winocur, G., Craik, F. I. M., Levine, B., Robertson, I. H., Binns, M. A., Alexander, M., Black, S., Dawson, D., Palmer, H., McHugh, T., & Stuss, D. T. (2007). Cognitive rehabilitation in the elderly: Overview and future directions. Journal of the International Neuropsychological Society, 13, 166-171. http://dx.doi.org/10.1017/S1355617707070191