Cognition and Perceptual Disorders: Difference between revisions
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There is lack of awareness of the body structure. The patient even doesnt understand the relationship of body parts with oneself or to others. They may not be able to imitate the movements of the therapist.<ref name=":0" />They deny the existence of their body part and is also known as autotopagnosia.<ref>Nathanson M, Bergman PS, Gordon GG. Denial of illness: its occurrence in one hundred consecutive cases of hemiplegia. AMA Archives of Neurology & Psychiatry. 1952 Sep 1;68(3):380-7.</ref> | There is lack of awareness of the body structure. The patient even doesnt understand the relationship of body parts with oneself or to others. They may not be able to imitate the movements of the therapist.<ref name=":0" />They deny the existence of their body part and is also known as autotopagnosia.<ref>Nathanson M, Bergman PS, Gordon GG. Denial of illness: its occurrence in one hundred consecutive cases of hemiplegia. AMA Archives of Neurology & Psychiatry. 1952 Sep 1;68(3):380-7.</ref> | ||
Right and left discrimitation | Right and left discrimitation- The patient cannot discrimate between the commands of right and left handed task. | ||
Finger agnosia- In this conditon the client doesnt indicate, name , select/ differentiate the fingers of their own hand. It happens in the patients of cerebral lesion.<ref>Gerstmann J. Syndrome of finger agnosia, disorientation for right and left, agraphia and acalculia: local diagnostic value. Archives of Neurology & Psychiatry. 1940 Aug 1;44(2):398-408.</ref> | Finger agnosia- In this conditon the client doesnt indicate, name , select/ differentiate the fingers of their own hand. It happens in the patients of cerebral lesion.<ref>Gerstmann J. Syndrome of finger agnosia, disorientation for right and left, agraphia and acalculia: local diagnostic value. Archives of Neurology & Psychiatry. 1940 Aug 1;44(2):398-408.</ref> | ||
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There is failure of recognition. Commonly see in neurodegenrative diseases.<ref name=":2">Coslett HB. Apraxia, neglect, and agnosia. Continuum: Lifelong Learning in Neurology. 2018 Jun 1;24(3):768-82.</ref> | There is failure of recognition. Commonly see in neurodegenrative diseases.<ref name=":2">Coslett HB. Apraxia, neglect, and agnosia. Continuum: Lifelong Learning in Neurology. 2018 Jun 1;24(3):768-82.</ref> | ||
Tactile agnosia | Tactile agnosia- | ||
The tactile perceptions are intact but the patient cannot recognise the objects via palpation. There is parietal lobe lesion (unilateral/bilateral) | |||
Visual object agnosia | Auditory agnosia- | ||
Hearing ability is intact but there impairement in sound perception. Such patients have intact language and cognitive function.<ref>Shell AR. Auditory agnosia. Handbook of clinical neurology. 2015 Jan 1;129:573-87. | |||
</ref> | |||
Visual object agnosia- | |||
The patient cannot name the objects/faces/words presented in front of him. For example, the patient may call the bicycle , a pie. | The patient cannot name the objects/faces/words presented in front of him. For example, the patient may call the bicycle , a pie. | ||
Revision as of 07:38, 24 November 2021
Original Editor - Nupur Shah
Top Contributors - Nupur Smit Shah and Kim Jackson
Introduction[edit | edit source]
Cognition is the process of acquiring knowledge. It includes, reasoning, memory, awareness, judgement and intuition. Some authors include executive function under cognition too, such as problem solving, planning capacity, recognition of errors and abstract thinking. Many a times executive function is classified as higher level cognitive functions or metacongnitive functions.
Perception is the integration of sensations into information that is meaningful in terms of psycology. It is the ability to choose the stimuli that need attention and action, to integrate them with eachother and to interpret them.
Perception and sensation are not the same and should not be confused with eachother. Sensation is defined as the awareness of stimuli through eyes, ears, nose etc, internal receptions or the peripheral cutaneous system. And perception is far more complex than the individual sensation.[1]
Perception disorders[edit | edit source]
Body image impairments:[edit | edit source]
Unilateral neglect- It is reported nearly in 25% of the stroke patients who are referred for rehabilitation. It is commonly associated with right parietal lesions.
Anosognosia-
It is the denial of illness that may be seen in the patients of head injury. The patients presents either lack of concern about the deficit or verbal denial of their illness.[2]They dont realise the benefits of rehabilitation and are not willing to undergo any treatment. Visual field defect, apathy and unable to identify the pictures are the common in anosognosia.[3]It is commonly seen in neurological conditions such as Hemiplegia and Alzheimer's disease.[4]
Somatoagnosia-
There is lack of awareness of the body structure. The patient even doesnt understand the relationship of body parts with oneself or to others. They may not be able to imitate the movements of the therapist.[1]They deny the existence of their body part and is also known as autotopagnosia.[5]
Right and left discrimitation- The patient cannot discrimate between the commands of right and left handed task.
Finger agnosia- In this conditon the client doesnt indicate, name , select/ differentiate the fingers of their own hand. It happens in the patients of cerebral lesion.[6]
Spatial Relation impairements[edit | edit source]
Figure ground discrimitation- This is a process in which elements are selected and segregated from the background by the visual system.[7]
Form discrimitation
Spatial Relation
Position in space
Depth and distance perception
Topographical disorientation
Vertical disorientation
Agnosia[edit | edit source]
There is failure of recognition. Commonly see in neurodegenrative diseases.[8]
Tactile agnosia-
The tactile perceptions are intact but the patient cannot recognise the objects via palpation. There is parietal lobe lesion (unilateral/bilateral)
Auditory agnosia-
Hearing ability is intact but there impairement in sound perception. Such patients have intact language and cognitive function.[9]
Visual object agnosia-
The patient cannot name the objects/faces/words presented in front of him. For example, the patient may call the bicycle , a pie.
It can be assessed by copying /drawing of figures.[10]
Apraxia[edit | edit source]
It is a disorder in which the patient cannot perform skilled actions.[8]
Ideomotor apraxia -
Loss of ability to imitate hand gestures. The client understands the requirements but cannot execute appropriate movements. There occurs errors in gesture production.
Ideational apraxia-
There is transitive difficulty where the client does'nt understand the correct concept of the task. Faces difficulties like sequencing the tasks and the usage of objects.[11]
Cognitive deficits[edit | edit source]
Attention Deficit Disorders[edit | edit source]
Attention issues are commonly seen after stroke.[12] They are common among the ones who have right brain damage. [13]The attention system has connection with various cognitive functions like cognition, activity performance, language , memory and spatial organization hence attention deficits can highly affect the functional abilities of the person at home or at work.[12]
After the cerebrovascular accident, focused attention(selective) deficit gets cured in majority of the patients but higher order attentional problems may persist later. This includes, speed of processing, divided attention, working memory and vigilance.[14]
Neuropsycological assessment is used to classify the patients with cognitive issues like language, attention and memory.[15]
Selective attention-
Also known as focused attention. The capacity to do the task in presence of visual, auditory or environmental stimuli.[1]It is needed when the patient has to ignore certain stimuli.
For example, The patient stops the activity of dressing while talking to the therapist/by stander. Here, the focused attention is affected.
Sustained attention-
The capactity to address relevant information during the activity. The patient can respond effectively during the task.[1]
Divided attention-
The patient has the capacity to respond to two or more tasks at a time.
Alternating attention-
The capacity to do multiple tasks appropriately.[1]
Memory[edit | edit source]
Memory decline is common after stroke and affects the functional ability of the person. There are various memory deficits like long term memory loss, short term memory loss and immediate recall. Memory rehabilitation which is a part of cognitive rehabilitation plays an important role in such patients.[16]
References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 1.4 O'Sullivan SB, Schmitz TJ, Fulk G. Physical rehabilitation. FA Davis; 2019 Jan 25.
- ↑ Heilman KM. Anosognosia: possible neuropsychological mechanisms. Awareness of deficit after brain injury: Clinical and theoretical issues. 1991 Jan 24:53-62.
- ↑ Cutting J. Study of anosognosia. Journal of Neurology, Neurosurgery & Psychiatry. 1978 Jun 1;41(6):548-55.
- ↑ Bisiach E, Vallar G, Perani D, Papagno C, Berti A. Unawareness of disease following lesions of the right hemisphere: anosognosia for hemiplegia and anosognosia for hemianopia. Neuropsychologia. 1986 Jan 1;24(4):471-82.
- ↑ Nathanson M, Bergman PS, Gordon GG. Denial of illness: its occurrence in one hundred consecutive cases of hemiplegia. AMA Archives of Neurology & Psychiatry. 1952 Sep 1;68(3):380-7.
- ↑ Gerstmann J. Syndrome of finger agnosia, disorientation for right and left, agraphia and acalculia: local diagnostic value. Archives of Neurology & Psychiatry. 1940 Aug 1;44(2):398-408.
- ↑ Schnabel UH, Bossens C, Lorteije JA, Self MW, de Beeck HO, Roelfsema PR. Figure-ground perception in the awake mouse and neuronal activity elicited by figure-ground stimuli in primary visual cortex. Scientific reports. 2018 Dec 12;8(1):1-4.
- ↑ 8.0 8.1 Coslett HB. Apraxia, neglect, and agnosia. Continuum: Lifelong Learning in Neurology. 2018 Jun 1;24(3):768-82.
- ↑ Shell AR. Auditory agnosia. Handbook of clinical neurology. 2015 Jan 1;129:573-87.
- ↑ Coslett HB. Apraxia, neglect, and agnosia. Continuum: Lifelong Learning in Neurology. 2018 Jun 1;24(3):768-82.
- ↑ Clark D. Strategies to Cope with Cognitive Difficulties After a Stroke (SCOPE–Apraxia) (Doctoral dissertation, The University of Manchester (United Kingdom)).
- ↑ 12.0 12.1 Žagavec BS, Lešnik VM, Goljar N. Training of selective attention in work-active stroke patients. International Journal of Rehabilitation Research. 2015 Dec 1;38(4):370-2.
- ↑ Lincoln N, Majid M, Weyman N. Cognitive rehabilitation for attention deficits following stroke. Cochrane Database of Systematic Reviews. 2000(4).
- ↑ Michel JA, Mateer CA. Attention rehabilitation following stroke and traumatic brain injury. Europa medicophysica. 2006 Mar;42(1):59-67.
- ↑ Nøkleby K, Boland E, Bergersen H, Schanke AK, Farner L, Wagle J, Wyller TB. Screening for cognitive deficits after stroke: a comparison of three screening tools. Clinical rehabilitation. 2008 Dec;22(12):1095-104.
- ↑ das Nair R, Cogger H, Worthington E, Lincoln NB. Cognitive rehabilitation for memory deficits after stroke. Cochrane Database of Systematic Reviews. 2016(9).
