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Originalartikel

Auswirkungen eines Aufmerksamkeitstrainings auf die aphasische Symptomatik bei Schlaganfallpatienten

Published Online:March 25, 2011https://doi.org/10.1024/1016-264X/a000027

Abstract

Aufmerksamkeit kann als Kontrollsystem neuronaler Aktivität verstanden werden, welches Neuroplastizität top-down modulieren hilft. Bisher wurde selten versucht, durch deren gezielte Förderung Funktionswiederherstellungen nach Hirnschädigung zu begünstigen. In vorliegender Studie wurde dies am Beispiel der Aphasie erprobt. 15 Schlaganfallpatienten erhielten ein dreiwöchiges Training der selektiven Aufmerksamkeit mit den PC-Programmen CogniPlus und „Konzentration“ bei fünf Sitzungen pro Woche zusätzlich zur Standardtherapie, 13 weitere bildeten eine Kontrollgruppe ohne Aufmerksamkeitstraining. Zur Effektivitätskontrolle dienten zwei Versionen des Untertests Go/Nogo (Testbatterie zur Aufmerksamkeitsprüfung) und die Kurze Aphasieprüfung. Nach dem Training manifestierte sich zwischen den Untersuchungsgruppen kein Unterschied in Aufmerksamkeits- und Sprachfunktionen; das zusätzliche Aufmerksamkeitstraining war also wirkungslos. Allerdings zeigten Patienten mit deutlichen Aufmerksamkeitsverbesserungen tendenziell weniger Aphasie-Symptome, was die Hypothese aufmerksamkeitsvermittelter Plastizitätsmodulation nach Hirnschädigung partiell stützt.


Effects of an Attention Training on the Aphasic Symptomatology in Stroke Patients

Attention is a control-system of neuronal activity, which modulates neuroplasticity. Attempts to promote functional recovery after brain injury by improving attention have been infrequent. We tested this idea on aphasic patients. 15 stroke patients participated in a training of selective attention (PC programs CogniPlus and “Konzentration”; ca. 15 sessions over 3 weeks complementing standard therapy), whereas 13 further patients served as controls. Training effects were evaluated using the Go/Nogo test (2 versions; TAP) and the Kurze Aphasieprüfung. The training did not produce group differences in attention and aphasia and appeared ineffective under the given circumstances. However, the patients, who showed most attentional improvement, exhibited – as trend – fewest aphasic symptoms, supporting partially the hypothesis of plasticity modulation by attention.

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