Schwindel-Sprechstunde-Hamburg

Spezial-Ambulanz für Schwindel,
Gleichgewichts- und Augenbewegungsstörungen

Neurologie

Cognitive neuro-visual rehabilitation and driving ability II
W. H. Zangemeister, A. Becker, H. Hökendorf, Neurol Rehabil 2002; 8 (5): 247-255, Abstract.

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, such that they correlate with each other.
The results of both groups clearly show, despite a long latency between the time of lesion and the begin 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. This information transmits quickly through a complex parallel signal processing into a striatal visual buffer. We called this processing a quick fill of visual buffer. Once inside this visual buffer, the located attention window seems widely open after the training, as an expression of the subjective enlargement of interest through stimulation of the associative cortex. 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.

download full text