Cognitive rehabilitation for patients with cerebrovascular disease accompained by unilateral spatial neglect : Use of Computer-assisted Attention Training

半側視空間無視(USN)は, 右大脳半球損傷に高頻度に出現する高次脳機能障害である。そこで今回, UNSを伴う右大脳半球損傷患者7例に対して, Computer-assisted Attention Training(CAT)を4週間実施（介入）し, 介入前後でBehavioural inattention test(BIT)とFunctional Independence Measure(FIM)を利用してCATの有用性を比較検討した。その結果, (1)USN評価であるBITが全例改善を示しかつ統計的に有意な改善を認めた。また(2)ADL評価であるFIMも全例改善を示しかつ統計的に有意な改善を認めた。しかしながら(3)BIT改善率とFIMの改善率との相関関係においては有意な相関関係が認められなかった。これらの結果を総合的に考えると, 対象が全例回復期であり通常のリハビリテーションも実施しているので自然回復の要因も一部含んでいると思われるが, CATはUSNに有用な一訓練方法であると思われた。一方, USNの改善がADLの改善に直接結びつくとは考えにくく, 他の要因との関連性も検討する必要がある。Unilateral spatial neglect (USN) is a higher brain dysfunction that appears with high frequency in cases of right-hemisphere stroke. Here, we implemented four weeks of Computer-assisted Attention Training (CAT) for seven right-hemisphere stroke patients with USN, and comparatively evaluated the efficacy of CAT using the Behavioral inattention test (BIT) and Functional Independence Measure (FIM) before and after intervention. Both BIT (a USN test) and FIM (an activities of daily living (ADL) test) were significantly improved in all cases. However, there was no significant correlation between BIT and FIM improvement rates. Collectively, these results suggest that, while factors of natural recovery may be involved because all patients were in the recovery stage and normal rehabilitation (physical therapy and occupational therapy) was also being performed, CAT may be an effective training method for USN. On the other hand, because it is unlikely that improvements in USN directly lead to improvements in ADL, it is necessary to examine the relationship with other factors