Purpose: The loss of calculation skills due to brain lesions leads to a major reduction in the quality of life and is often associated with difficulties of returning to work and a normal life. Very little is known about the neural mechanisms underlying performance improvement due to calculation training during rehabilitation. The current study investigates the neural basis of training-induced changes in patients with acalculia following ischemic stroke or traumatic brain lesions. Methods: Functional hemodynamic responses (fMRI) were recorded in seven patients during calculation and perceptual tasks both before and after acalculia training. Results: Despite the heterogeneity of brain lesions associated with acalculia in our patient sample, a common pattern of traininginduced changes emerged. Performance improvements were associated with widespread deactivations in the prefrontal cortex. These deactivations were calculation-specific and only observed in patients exhibiting a considerable improvement after training. Conclusion: These findings suggest that the training-induced changes in our patients rely on an increase of frontal processing efficiency. According to the triple code model (Cohen and Dehaene, 1995;Dehaene and Cohen, 1997), quantity manipulations required for subtraction are performed in the bilateral intraparietal sulci, whereas addition and multiplication are represented in the left hemisphere.Neuroimaging studies have thus far provided conflicting evidence. A recent study found that all arithmetic operations, with the exception of addition, elicited systematic activation of the left posterior intraparietal sulcus and deactivations in the right posterior angular gyrus. Multiplication and addition were both
Background: The most used assessments in neuro-rehabilitation were often criticized because of their insufficient sensitivity. For this purpose, the Kliniken Schmieder in Germany have developed the Assessment of the Kliniken Schmieder/C (AKS/C) in order to collect motor function, cognition, communication and self-care competence of post-primary rehabilitation patients. Objective: To determine validity, reliability and responsiveness of the AKS/C motor domain. Method: Patients with various neurologic diagnoses in post-primary rehabilitation (n = 31 at admission, n = 24 at discharge) were tested. For concurrent validity determination AKS/C data were compared with those of FIM mobility and locomotor items. For assessing reliability intraclass correlation coefficients (ICC) and Cronbach's Alpha and for assessing responsiveness standardised response mean (SRM) were calculated.
Results:Validity (ICC = 0.93) and reliability (ICC = 0.86 -0.99; Cronbach's Alpha = 0.95) of AKS/ C were good. Responsiveness of the AKS/C was slightly higher (SRM = 1.3) than of FIM motor items (SRM = 1.2). Combination of AKS/C and FIM items did not increase responsiveness. Conclusion: The motor domain of the AKS/C proved to be a valid, reliable and responsive motor function assessment tool for patients in postprimary neuro-rehabilitation. Starrost K et al. Motorische Funktionen in… physioscience 2011; 7: 99 -111
Originalarbeit 99Heruntergeladen von: University of Pennsylvania Libraries. Urheberrechtlich geschützt.
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