The neuropsychologist of the Institute of Neurological Specialties (IENSA), Olga Prian Serrano, discusses in this article how to approach neuropsychological treatment, according to diagnostic variability, through NeuronUP.

Introduction

Mild cognitive impairment is one of the most frequent diagnoses in our center. Being a specific neurological pathology center, the possible causes of such impairment are highly variable. On the one hand, some patients after the neuropsychological study present a profile of cortical involvement, more likely to develop Alzheimer’s disease. On the other hand, others present a subcortical affectation more typical of a vascular or metabolic cause, vitamin deficiency and/or mood alteration such as depression, among others.

How is the treatment carried out?

Once assessed, we propose a neuropsychological treatment. In this treatment, we give specific guidelines for home, both to the patient and his or her close relatives, encouraging social interaction, physical exercise, sleep habits and leisure activities that are pleasant for the person. We also include specific cognitive stimulation work for each patient, which will be done in the center.

The objective with each patient will vary according to the diagnostic suspicion. But undoubtedly, the cognitive stimulation work as well as the dynamization of the exercises in the center, lead to cognitive improvement sometimes, as well as an improvement in mood.

Neuropsychological treatment with NeuronUP

NeuronUP is a magnificent tool that gives us the basis to adapt the work material to the cognitive and educational level of each patient. For example, it allows us to work on different cognitive functions with the same worksheet even in patients with greater impairment. We like to work with digital sessions, especially during the first months of treatment, since it allows us to work intensively for about 45 to 50 minutes.

But without a doubt, what has helped us the most about NeuronUP is its digital format. Thanks to it, we can work remotely with patients who cannot come to the clinic because they live in other cities. Especially during the strict confinement we suffered in March 2020 for 3 months.

Three weeks into the confinement, a patient’s daughter told me that she observed her father very down and very disoriented. For that reason, we spent the whole morning thinking and testing how we could get him to work online. Finally, through a video call platform and a tablet or laptop, all he had to do was accept the video call, and it was done. I would share my screen and they would see the exercises I wanted to work on without having to touch or handle anything. 

Patients with the autonomy to work were registered in NeuronUP2GO. They independently performed the stimulation part of the therapy with their keys. This was a great help during that time and we have left it in place for specific occasions. For example, when the patient cannot move, nor does he/she have a center to go to in his/her place of residence.

Real case: How to approach neuropsychological treatment?

I would like to present a case with which we have been able to execute a very diverse work thanks to the variability that the platform provides us.

It is a middle-aged person with alteration in executive functions. Specifically with impulsivity and failures in the use of feedback and planning strategies. In addition, the person had difficulty concentrating, deficit in verbal memory and anxious-depressive disorder. The patient came for the symptoms and suspicion of undiagnosed ADHD in childhood with great limitation in his daily life in the work and family environment. A mixed work schedule was programmed in which he worked four days a week: two in the center and two at home.

In the clinic, one day was focused on cognitive-behavioral psychotherapy, and another day to work on day-to-day planning strategies, training in image memorization techniques and mnemonic rules. For example, we worked with worksheets to memorize words by syllables, or to form stories. In short, dynamic sessions led by the neuropsychologist.

The other two days he had to work at home with NeuronUP2GO, having been previously instructed on how to perform the exercises, mainly to control organization, planning and impulsive responses.

Final results

After 3 months of treatment there was a very significant improvement from the neuropsychological point of view, reflected not only in the tests but also in his daily life and in his quality of life and well-being. He acquired planning and memorization strategies, as well as behaving less impulsively. But the most important thing is that the patient, through cognitive stimulation exercises, learned new strategies that he was able to generalize to daily life.

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