Schwindel-Sprechstunde-Hamburg

Spezial-Ambulanz für Schwindel,
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Neurologie

Cognitive neuro-visual rehabilitation and driving ability I
W. H. Zangemeister, A. Becker, H. Hökendorf . Neurol Rehabil 2002; 8 (4): 173-186, Abstract.

In the first part, we report about a quantitative evaluation, where we compare eye movements (EM) of 20 hemianopic patients with EM of healthy subjects while viewing abstract and realistic pictures before and after a special training. After this special training, the viewed pictures were presented again, and after this presentation, the viewed pictures with the registered EM were distributed into geometric a priori regions of interest (ROIs) and subjective a posteriori ROIs. The evaluation of the EM was performed by application of Region-String-Editing (RSE),
Vector-String-Editing (VSE) and Markov analysis (MA). In the second part, we report the results of ten years of training experience with neurological patients using the car driving simulator used at the neurological rehabilitation clinic at the REHA-Center Soltau. Our results showed that although the patients showed distinct deficits in the laboratory tests they were able to perform very well in the driving test. This discrepancy demonstrates that we have to develop lab tests that are really relevant for testing driving abilities and record more accurately the true driving capabilities of the patients, in order to receive a better correlation.
The results of both groups clearly show, despite a long latency between the time of lesion and the beginning of training, that there was a significant success of rehabilitation. This finds its neuropsychological-neurophysiological correlation in a facilitated mobilisation of information, integration and reorganisation of extrastriatal high level information. After the training, there was a strong top-down-component during viewing the picture, that was in contrast to the maladapted bottom up component before training. It is particularly significant that these cognitive aspects of human vision in the rehabilitation of hemianopic patients will be considered in a special training.

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