From fundamental principles of memory organization towards neurorehabilitation: a literature review and case report

Background. Contemporary rehabilitation of memory impairments relies on the use of external compensatory strategies. In Russian neuropsychological tradition, rehabilitation is understood as a transformation of a higher mental function, based on intact elements of that function and on use of external and internal means. Such a restructuration approach may be applied to memory. Objective. This article describes the basic principles underlying memory rehabilitation and gives an example of their successful implementation in a clinical case. Design. A 62-year-old patient was admitted 6 months after severe traumatic brain injury with primary damage to his left frontal and temporal lobes. He faced difficulties in social living and activities of daily life, mainly due to memory impairment. Neuropsychological assessment revealed moderate impairment of different memory types: modal nonspecific impairment with mild but persistent impairments in autobiographic and semantic memories. During a 3-week rehabilitation program, an algorithm involving the use of text was developed in consideration of the structure of memory impairment (impaired selectiveness, excessive inhibition and pathologic inertness of memory traces). Results. After multiple trials and modifications, the resulting algorithm (written retelling with the use of keywords, self-correction with writing correct variants instead of errors), allowed reproduction of the presented text with 100% recall of significant information and no false memories. The use of the developed memorization technique in everyday life allowed the patient to effectively memorize relevant information. Conclusion. The described approach-restructuration of memory on the basis of preserved chains-is a feasible strategy of memory rehabilitation.