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Neuropsychological Assessment and Rehabilitation of Patients with Impaired Monitoring as a Component of Executive
Ivan A Larin1, Alina Yu Komarova1, Yulia A Sandalova1
1Lomonosov Moscow State University, Russia.
Background:
There is a high prevalence of impairments in executive functions in various neurological diseases (stroke, traumatic brain injury, neurodegenerative disorders), which severely limits patients' independence and quality of life. The study integrates the theory of the systematic, step-by-step formation of mental actions and concepts by Galperin, Luria's approach to neuropsychology, and modern foreign rehabilitation techniques (e.g., strategies from the "Goal Management Training" program).
Objective:
To assess the impact of a specialized neuropsychological training program on monitoring process indicators in patients with brain damage of various etiology.
Design:
The study involved 48 patients with brain damage of various etiology, aged from 23 to 74 years (M age = 57.6; SD = 11.13; 17 women and 31 men). The patients were divided into an experimental group and a control group.
Results:
A specialized training program aimed at improving monitoring process indicators in patients with impaired executive functions was developed, as well as a neuropsychological diagnostic protocol for assessing monitoring. We did not observe a training effect when comparing the monitoring index values before and after the training within the experimental group. However, we found significant differences between the experimental and control groups when analyzing the indices based on the results of the post-test assessment (U = 170, p = .008, p bonferroni = .032), along with significant improvements in five monitoring indicators and the total Frontal Assessment Battery score in the patients of the experimental group.
Conclusion:
The training effect, when comparing the experimental and control groups at the post-test, may be interpreted within the framework of intra-systemic semantic reorganization and the initial formation of a new mental action of selection and implementation of a solution in which monitoring actively participates. This interpretation is preliminary and requires further empirical validation. In future research, we plan to focus the training on the formation of the mental action of control.
