Neuropsychological diagnostics and rehabilitation of patients with thinking disorders with brain lesions of various etiologies

Baulina Maria E. Federal Scientific Center of Psychological and Multidisciplinary Research

Varako Nataliya A. Federal Scientific Center of Psychological and Multidisciplinary Research, Lomonosov Moscow State University, Research Center of Neurology, Moscow, Russia

Kovyazina, M.S. Federal Scientific Center of Psychological and Multidisciplinary Research, Lomonosov Moscow State University, Research Center of Neurology, Moscow, Russia

Zinchenko, Yu. P. Federal Scientific Center of Psychological and Multidisciplinary Research, Lomonosov Moscow State University

Mikadze Yuri V. Lomonosov Moscow State University

Skvortsov Anatolii A. HSE University

Fufaeva Ekaterina V. Clinical and Research Institute of Emergency Pediatric Surgery and Traumatology

Fig. 1. Algorithms for patient management.

Overall neuropsychological examination

Needs a comprehensive neuropsychological examination?

Comprehensive neuropsychological examination

Symptomatic Syndrome Analysis

Is there a disturbance in thinking?

Assessment of rehabilitation potential and the need for rehabilitation

Does the patient need rehabilitation?

Preparation of a rehabilitation program (60 minutes)

Does not need a comprehensive neuropsychological examination

Are there violations in the HMF (higher mental functions) and mental activity in general?

Syndrome analysis of other identified symptoms and development of a rehabilitation plan

Neuropsychological rehabilitation is not carried out

Correction of the rehabilitation program (once in 10 days)

Assessment of the effectiveness of rehabilitation work (60 minutes)

Making recommendations for hospital discharge

Yes

No

Table 1. Table of methods and tests for diagnosing thinking disorders in brain injuries and correspondence with the International Classification of Functioning, Diasability and Health (ICF), 2001.

Test & Probes	Estimated Parameters	ICF Code
Understanding plot pictures	Estimates the level of generalization, the assessment of various options for completing a task	b1645
Understanding paintings with conflicting meanings	Assesses the ability to identify and analyze, finding contradictions	b1645 b1646
Understanding the figurative meaning of metaphors, proverbs	Assesses the level of generalization, the ability to abstract	b1640 d310
Definingconcepts	Assesses the level of generalization, the ability to abstract	b1640
Comparison of concepts	Assesses the level of generalization, the ability to abstract, assesses various options for completing a task	b1640 b1645
Establishing correspondence	Assesses the ability to identify and analyze, to solve problems	b1645 b1646
Verbal analogies	Assesses the level of generalization, the ability to abstract and make judgments, calculates various options for completing the task	b1640 b1645 b1646
Triads methods	Assesses the level of generalization, the ability to abstract	b1640
Search for essential features	Assesses the ability to solve problems, search for information, analyze, assesses the level of generalization	b1640 b1645 b1646
Problem solving	Assesses the ability to take bearings in the problem, establish a sequence of actions for a solution, analyze conditions and search for information to carry a solution	b1640 b1645 b1646
Raven Standard Progressive Matrices	Assesses the ability to analyze, calculates various options for solving a problem, identification, finding a solution, abstracting	b1640 b1645 b1646
Continuation Sequence Test	Assesses the ability to abstract	b1640
Subtest ‘Picture Arrangement’ from Wechsler Adult Intelligence Scale (WAIS)	Assesses the ability to manage time, analysis, task orientation, anticipation	b1645 b1646
Subtest ‘Similarities’ from Wechsler Adult Intelligence Scale (WAIS)	Assesses the ability to abstract	b1640
Subtest ‘Mosaic’ from Wechsler Adult Intelligence Scale (WAIS)	Assesses the ability to analyze information, calculates various options for solving the problem	b1645 b1646
Wisconsin Card Sorting Test	Assesses the ability to strategic planning, targeted search, the use of feedback from the environment and the change in cognitive attitudes, and changes in behaviour in relation to achieving the goal and modulating impulsive reactions	b1640 b1645 b1646

Table 2. Rating scheme for assessing accuracy level (Eccles et al., 1996).

Accuracy Level	Description
I	Meta-analyzes, systematic reviews, well-designed randomized controlled trials
II	Well-designed controlled non-randomized trials (cohort, case-control)
III	Uncontrolled research and collaborative efforts

Table 3. Rating scheme for assessing credibility of recommendations (Eccles et al., 1996). 

Credibility Level	Description
А	Directly based on Accuracy Level I
В	Directly based on Accuracy Level II or extrapolated from Accuracy Level I
С	Directly based on Accuracy Level III or extrapolated from Accuracy Level II

Fig. 2. ‘Solar chart’

How

Who

Why

What

Subject

When

Where

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