Historical Introduction
In the last two decades, the focus has been mainly on people suffering from brain injury (Carvalho, 2017). This is due to the increase in survival rates in recent years. According to Carvalho (2017), this increase is possible thanks to a deeper medical and neuropsychological knowledge about the consequences of the damage, as well as the creation of more advanced treatments, which allow a faster and more accurate diagnosis.
Neuropsychological rehabilitation has a long history (Carvalho, 2017). The beginning of this discipline is related to the great world wars, in which combatants suffered different types of brain injuries, required immediate treatment and prompt recovery. In this case, according to Carvalho (2017), the German neurologist Kurt Goldstein stands out, where his cooperation with soldiers during the First World War provided extensive experience, theoretical and practical, on the behavior and consequences of brain injuries.
Later, during World War II, in the Soviet Union, highlights the neuropsychologist Alexander Luria, whose observations of patients with focal brain damage, expanded the understanding of language, perception, memory and executive dysfunction (Carvalho, 2017). In the same way, according to Carvalho (2017), he bequeathed the idea that it should be restored not only physically but also in a social context.
What is Neuropsychological Rehabilitation?
Neuropsychological rehabilitation are all those activities aimed at improving the overall cognitive performance of patients with damage to the central nervous system or any of its processes and/or components (Carvalho, 2017; Paúl, Bilbao & Ríos, 2011; Aso, n.d.; Castillero, n.d.). Likewise, it is considered as a dynamic process in which patients, families, treatment teams and the closest members of the community interact (Carvalho, 2017). Therefore, according to Carvalho (2017), the relevance of biological, psychological and social factors in relation to the disease or disability is established, which demonstrates the importance of biopsychosocial methods in neuropsychological rehabilitation.
On the other hand, neuropsychological deficits can be very numerous and depend on many factors, such as, for example, the type of injury, the location of the damage, the extent of the injury and the characteristics of the person (Guzman, 2019). According to Guzmán (2019), physical changes are usually the most evident, however, cognitive, emotional and behavioral sequelae are more common and long-lasting, which may limit the person's ability to benefit from the rehabilitation process and affect the family environment.
Therefore, according to Arevalo (2020) and Aso (n.d.), neuropsychological rehabilitation is a therapy that focuses on treatment, and includes all methods, techniques and means necessary to reduce the underlying disability of those diseases that affect any emotional, behavioral or cognitive domain, such as attention, memory, perceptual motor processes, executive functions, among others.
In other words, according to Carvalho (2017), neuropsychological rehabilitation includes a system of therapeutic activities based on the relationship between brain and behavior, which aims to achieve functional changes in order to restore or reinforce previously learned patterns of behavior and cognitive activity, establish new models of cognitive activity through alternative strategies, help patients and their families to adapt to new disabling conditions and improve overall functioning.
It is therefore essential to highlight the importance of performing a complete neuropsychological assessment in order to determine the altered functions and the functions that are preserved, since the latter will be the basis of the rehabilitation process (Arévalo, 2020; Carvalho, 2017). According to Arevalo (2020) and Carvalho (2017), it is important to mention that rehabilitation should be performed with both the patient and the family, providing them with information about the patient's difficulties, indications, guidance, emotional support, among others.
Objectives of Neuropsychological Rehabilitation
Neuropsychological rehabilitation includes any method or process whose ultimate goal is to reduce the cognitive and behavioral sequelae of patients who suffer a brain injury, so as to reduce the impact on their daily life (Carvalho, 2017; Guzmán, 2019). In other words, according to Guzman (2019), the purpose of rehabilitation is to enhance the recovery of affected cognitive abilities, improve the functional capacity of individuals and emotionally help people who have suffered brain injury and their families.
Likewise, according to Guzmán (2019) and Paúl, Bilbao & Ríos (2011), the neuropsychological rehabilitation program seeks to promote people's autonomy, improve cognitive functions that have been affected, accompany the person to realize their own difficulties and the impact they have on daily life, and accompany them when necessary to draft new life projects.
In the same vein, some of the objectives of neuropsychological rehabilitation, according to Carvalho (2017), are to describe in detail the consequences of brain injury according to cognitive functioning, define the clinical characteristics that manifest as neuropsychological impairment and objectively determine the state of each patient, identify prognostic factors and test hypotheses about the relationship between the brain and behavior, which allows a better understanding of how the brain processes information.
To do this, a rehabilitation plan is designed that includes specific and important functional goals to help individuals and their families, adjust these goals and make them as realistic as possible (Guzman, 2019). According to Paúl, Bilbao & Ríos (2011), the activities used should be stimulating, gradually increasing the difficulty of the task.
Principles of Neuropsychological Rehabilitation
In the literature on cognitive processes, attention, memory and executive function are generally treated separately (Paúl, Bilbao & Ríos, 2011). In contrast, in the field of neuropsychological rehabilitation, several reasons justify a joint approach to deficits in these processes. The different cognitive processes cannot be understood as independent entities; on the contrary, the human cognitive system is based on the interrelation of different neuropsychological processes. According to Paúl, Bilbao & Ríos (2011), these mutually affect development and rehabilitation, and may even share underlying neural structures.
Also, there is an interdependence between cognitive skills and emotional and behavioral disorders, variables that should be included in any rehabilitation design (Paúl, Bilbao & Ríos, 2011). The type of strategy or method to be chosen will be determined by the type of difficulties presented by the patient such as preserved abilities and the demands of the environment. According to Paúl, Bilbao & Ríos (2011), it is sometimes necessary to test the treatment and see how the person reacts to the chosen method.
Neuropsychological rehabilitation must be personalized and adapted to the individual characteristics of the patient (Paúl, Bilbao & Ríos, 2011). For this, several factors must be considered, such as the patient's medical and psychological background, his or her level of awareness of the deficit, his or her ability to take initiative and regulate his or her own emotions and behaviors, as well as the type and severity of the cognitive deficits. Furthermore, in correspondence with Paúl, Bilbao & Ríos (2011),it is also important to take into account the needs of the family and the specific goals to be achieved with rehabilitation.
Finally, according to Paúl, Bilbao & Ríos (2011) and Carvalho (2017), a rehabilitation program should take into account different perspectives and approaches to address the specific needs of the patient. For example, a patient with anterograde amnesia and an executive function deficit may need an external support program in addition to neuropsychological interventions.
What is Rehabilitated?
Memory Rehabilitation
Memory is a cognitive process through which certain information can be encoded, stored and retrieved (Lubrini, Periañez & Ríos, 2009). This is one of the most important basic skills in daily life (Castillero, n.d.), and at the same time, according to Aso (n.d.), memory impairment is one of the most common problems encountered by neuropsychologists.
Memory is composed of three types of storage: sensory memory, short-term or immediate memory and long-term or remote memory, each of which has different characteristics and specific operating rules (Aso, n.d.; Ojeda, et al., 2010; Lubrini, Periañez & Ríos, 2009). Long-term memory is a "storehouse" in which memories that have been accumulated throughout life, understanding of the world, images, concepts and action strategies are stored (Aso, n.d.; Ojeda, et al., 2010; Lubrini, Periañez & Ríos, 2009). According to Lubrini, Periañez & Ríos (2009), its storage capacity is unlimited and so is the persistence of information.
Immediate or short-term memory refers to the ability to remember information immediately after it appears (Aso, n.d.; Ojeda, et al., 2010). The storage system has a limited capacity and the persistence of information is of short duration (Lubrini, Periañez & Ríos, 2009). According to Lubrini, Periañez & Ríos (2009), it is a temporary store of rapid encoding in which information is analyzed, interpreted and organized for subsequent storage in long-term memory.
Finally, sensory memory is a system that can capture a large amount of information in a very short period of time (Aso, n.d.; Ojeda, et al., 2010; Lubrini, Periañez & Ríos, 2009). According to Lubrini, Periañez & Ríos (2009), sensory memory is outside the voluntary control of the subject, and its function is automatic and spontaneous, i.e., unmediated by consciousness.
Rehabilitation of Attention
Of all the cognitive processes that occur in the human brain, perhaps attention is one of those that occupies a more central position (Lubrini, Periañez & Ríos, 2009). When talking about attention, it usually refers to the state of alertness or vigilance that a person possesses when performing a certain activity (Aso, n.d.). But, according to Aso (n.d.), attention can also imply the ability to concentrate, divide or maintain mental effort.
Therefore, attention is not a unified process, but is composed of multiple factors such as direction, exploration, concentration, or vigilance (Aso, n.d.). According to Aso (n.d.), the attentional process is not only composed of these elements, but also has multiple brain locations that underlie these attentional processes.
On the other hand, five components of attention that can be rehabilitated are proposed (Ojeda, et al., 2010). According to Lubrini, Periañez & Ríos (2009), focal attention gives basic response to a given stimulus; sustained attention refers to the ability to maintain a constant response over a prolonged period of time; selective attention involves the ability to select relevant information, thus inhibiting attention to other stimuli; alternating attention is the ability to switch focus between tasks that involve different cognitive requirements, and to control the information processed at all times; and divided attention refers to the ability to respond to two tasks at the same time.
Rehabilitation of Executive Functions
The advance of neuroscience in general and neuropsychology in particular, has been accompanied by a growing interest in understanding the neural substrates and functions of the most complex cognitive processes (Lubrini, Periañez & Ríos, 2009). An autonomous person is a person who has the capacity to govern him/herself and to decide for him/herself. To achieve such autonomy, the individual must be able to consciously control and coordinate his or her thoughts, actions and emotions. According to Lubrini, Periañez & Ríos (2009), the cognitive abilities that allow the individual to modulate the operations of various cognitive subprocesses and, therefore, the dynamics of the most complex aspects of human cognition, are known as executive functions.
The set of executive functions is one of the aspects in which more neuropsychological rehabilitation is performed (Castillero, n.d.). Executive functions are a set of cognitive skills that allow anticipating, planning and setting goals, making plans, initiating activities, among other things (Aso, n.d.; Ojeda, et al., 2010). Deficiencies in this type of functions make it difficult for patients to make decisions and perform functions in daily life (Aso, n.d.), therefore, according to Ojeda, et al. (2010) they should be a fundamental objective of any cognitive rehabilitation program.
In the clinical context, according to Aso (n.d.), the term disejective syndrome is coined to define the cognitive and behavioral changes characteristic of executive function deficits, which implies difficulty in concentrating on completing a task and finishing it without external environmental control, showing rigid, perseverative and stereotyped behaviors, difficulties in establishing new behavioral tables, lack of ability to use operational strategies, and lack of cognitive flexibility.
Language Rehabilitation
In recent years there has been a strong increase in interest in language and its pathology (Lubrini, Periañez & Ríos, 2009). According to Lubrini, Periañez & Ríos (2009), the complexity of this function requires the participation of professionals from different fields to better understand the normal process of language and its pathology, as well as to achieve adequate assessment and rehabilitation techniques.
Perceptual Rehabilitation
Perception is understood as the way information captured by the senses is interpreted and understood (Lubrini, Periañez & Ríos, 2009). Everything that can be perceived in the world and everything that can be done in it, is done through the sense organs (Lubrini, Periañez & Ríos, 2009). According to Lubrini, Periañez & Ríos (2009), everything is initially sensory information and it is the brain that encodes the content captured by the sensory organs.
It is very common for a brain injury to induce changes in perception, some kind of agnosia or a lack of recognition of stimulation (Castillero, n.d.). According to Castillero (n.d.), an appropriate neuropsychological evaluation and subsequently an adequate neuropsychological rehabilitation can achieve significant improvements in the perception of patients.
Problems to Which it is Usually Applied
Acquired Brain Injury
Acquired brain injury refers to an injury to the brain that affects various cognitive processes (Calderón et al., 2018). The main causes of acquired brain injury are: cerebrovascular accidents or stroke and traumatic brain injury (Aso, n.d.). According to Calderón et al. (2018), acquired brain injury causes cognitive, behavioral, emotional and even social changes both in the individual and in the academic and professional order.
When this type of injury occurs, its nature, degree, location, the time elapsed since the injury and the sociodemographic, medical and biological variables of the patient should be considered, since if all these factors are taken into account, the success rate of the intervention will be higher. It should also be taken into account that after an injury, there is a "window of opportunity" in which patients can benefit to a greater extent from neuropsychological rehabilitation, so this should be done as soon as possible. At this point, according to Aso (n.d.), it is necessary to know which functions have changed and which have not, in order to be able to intervene correctly.
Cranioencephalic Trauma.
A very common cause of brain damage is traumatic brain injury, which is often caused by traffic accidents, falls or even assaults (Castillero, n.d.). Traumatic brain injury is an acquired brain injury caused by a mechanical force that interferes with the functioning of the brain, causing an alteration in consciousness, such as drowsiness, confusion, stupor or a coma (Vales, 2019). In turn, according to Vales (2019), this impairment of brain function is not caused by neurodegenerative, congenital, or neurodevelopmental diseases.
Among trauma survivors, a significant number of them have important consequences that prevent them from returning to their previous activities or accessing or reentering academic, professional, and social activities (Vales, 2019). According to Castillero (n.d.), symptoms and dysfunction depend, to a large extent, on the location and extent of the injury.
Cerebrovascular Accidents.
Cerebrovascular accidents, either in the form of ischemia or hemorrhage, are a major problem that has become one of the main causes of death in the population (Castillero, n.d.). In them, there is a blockage and interruption of the oxygen supply to a part of the brain, which causes the death of a large number of neurons and, depending on the area in which neuronal death occurs, generates deficits that may be more or less permanent. According to Castillero (n.d.), neuropsychological rehabilitation is of great help to restore or compensate for lost abilities.
Cognitive Impairment
Cognitive impairment constitutes a kind of "borderline" between normal cognitive function and dementia (Diaz & Sosa, 2010). In it, subjects show significant cognitive impairment, but not enough to impair their function (Diaz & Sosa, 2010). While dementia may not occur, according to Castillero (n.d.), cognitive impairment leads to a decline in some functions that can be alleviated with rehabilitation or neuropsychological stimulation.
Neurosurgery
Sometimes it may be necessary to resort to neurosurgery to solve some kind of medical problem, as in the case of epilepsy or a brain tumor (Castillero, n.d.). These interventions can save lives or prevent major problems arising from different pathologies. However, according to Castillero (n.d.), they can cause difficulties and affect other functions, which may require neurorehabilitation to return to normal.
Dementias and Neurodegenerative Diseases
Over the years, early detection of dementia syndrome and early detection of cognitive impairment in dementia have been improving, so early treatment can be performed, sometimes even from pre-dementia stages of these patients (Arroyo, Poveda & Chamorro, 2012). Currently, the key to suspect a dementia syndrome should focus on assessing whether the patient's adaptation to work, social or family life is affected by cognitive impairment (Arroyo, Poveda & Chamorro, 2012). According to Castillero (n.d.), some of the best known neurodegenerative diseases are Alzheimer's disease, Parkinson's disease, frontotemporal dementia or Huntington's chorea.
The symptoms of people with dementia are not only cognitive, but also emotional and behavioral, so rehabilitation should include behavior modification, family interventions and occupational or vocational rehabilitation (Aso, n.d.). In this case, according to Castillero (n.d.), neuropsychological rehabilitation does not focus on restoring functions, but on maintaining them as long as possible.
Epilepsy
Epilepsy is a neurological disease characterized by: at least two unprovoked seizures occurring more than 24 hours apart; an unfounded seizure; and the possibility of a new event in the next 10 years, similar to the general risk of recurrence after two unfounded seizures (Carvajal & López, 2019). According to Carvajal & Lopez (2019), it is a chronic disease that affects between 45 and 50 million people worldwide, likewise, it represents 1% of the global burden of disease.
Suffering epileptic seizures can cause alterations and decreases in cognitive functions and in the functioning of daily life (Castillero, n.d.). In some cases, according to Castillero (n.d.), neuropsychological rehabilitation may be required. For optimal rehabilitation, according to Carvajal and Lopez (2019), associated factors should be considered such as, for example, age of onset of the disease, frequency and type of seizure, medication, psychiatric comorbidity, sociocultural deprivation, lateralization of the epileptogenic focus, neuroplasticity, type of lesion, among others.
Poisoning or Effects of Prolonged Substance Use
Some substances can also cause brain damage, such as poisoning by consumption of a toxic element (Castillero, n.d.). According to Castillero (n.d.), when such damage occurs, neuropsychological rehabilitation can be of great help in restoring functionality and some of the functions that may have been damaged to some extent.
Neurological Basis
For centuries, from a functional and anatomical point of view, the central nervous system has been considered as an immutable and irreparable structure, as well as a closed and definitive system once embryonic development is completed (Lubrini, Periañez & Ríos, 2009). Currently, according to Lubrini, Periañez & Ríos (2009), these concepts have changed and new ideas can only be understood through a proper understanding of the concept of neuroplasticity.
When talking about brain plasticity, the possibility of adapting the function of the central nervous system to minimize the impact of structural and functional changes is mentioned (Lubrini, Periañez & Ríos, 2009). Brain plasticity can adapt to changing environments, including abnormal environments and damage caused by seizures to brain tissue (Lubrini, Periañez & Ríos, 2009). According to Lubrini, Periañez & Ríos (2009), this is due to the ability of the nervous system to change due to endogenous and exogenous influences.
Recent findings support the idea that the recovery observed in patients undergoing neuropsychological rehabilitation is related to the reorganization of brain networks and even to the restoration of functional connectivity patterns (Paúl, Bilbao & Ríos, 2011). According to Paúl, Bilbao & Ríos (2011), this reorganization can take place through different mechanisms, which can increase, or reduce when necessary, the number and value of the interactions that make up the network, and even reorganize its topology.
Mechanisms and Strategies of Neuropsychological Rehabilitation
In the current literature one can find the use of various terms or concepts to refer to different mechanisms used in neuropsychological rehabilitation (Carvalho, 2017; Castillero, n.d.). The basic mechanisms of neuropsychological rehabilitation can be diverse and can coexist, i.e., different mechanisms can be combined at the same time (Carvalho, 2017; Castillero, n.d.). According to Castillero (n.d.), these are different forms of treatment, focusing on restoring the possibility of loss of function.
Restoration
This approach assumes that altered cognitive processes can be restored through stimulation (Ojeda, et al., 2010). This mechanism involves stimulating and improving different cognitive functions by working directly on them (Carvalho, 2017; Paúl, Bilbao & Ríos, 2011; Paúl, Bilbao & Ríos, 2011; Lubrini, Periañez & Ríos, 2009). Specifically, according to Carvalho (2017), this method is used when the loss is partial and limited to one area, resulting in a decrease of one or more elementary functions.
They are characterized by interventions that restore or improve cognitive processes through repeated exercises and tasks (Paúl, Bilbao & Ríos, 2011; Ojeda, et al., 2010; Lubrini, Periañez & Ríos, 2009). The premise is to train the neural networks involved in its execution, which can promote axonal growth or pathway stimulation (Paúl, Bilbao & Ríos, 2011). To improve results, it is recommended to combine it with feedback and positive reinforcement (Paúl, Bilbao & Ríos, 2011; Lubrini, Periañez & Ríos, 2009). However, according to Castillero (n.d.), restoration is not always possible, especially when brain damage is involved.
Compensation
Based on this approach, it is assumed that brain mechanisms and cognitive processes can hardly be restored (Ojeda, et al., 2010). Compensation of cognitive changes involves the reorganization of processes, which promotes that preserved capacities are responsible for minimizing the effects of altered functions (Paúl, Bilbao & Ríos, 2011; Castillero, n.d.; Lubrini, Periañez & Ríos, 2009). In short, according to Castillero (n.d.) and Carvalho (2017), when the altered function cannot be restored, the use of preserved skills will be promoted with the ultimate goal of achieving greater functional autonomy.
Compensation strategies are designed to enable patients to learn or relearn how to perform meaningful activities of daily living (Lubrini, Periañez & Ríos, 2009). In this way, the patient can learn to perform these activities even if the impaired function does not particularly improve (Lubrini, Periañez & Ríos, 2009). For example, a student who showed innumerable impairments was trained to remove all objects from the table that could attract his attention while studying.
Substitution
It is based on the principle that cognitive processes are not usually completely eliminated, but reduce their effectiveness, so it is useful to develop other structures or brain circuits not affected to ensure their functioning (Ojeda, et al., 2010). Substitution, in correspondence with Paúl, Bilbao & Ríos (2011), refers to a new way of dealing with the deficit when the two previous strategies are not possible.
Partly similar to the compensation strategy, this mechanism is based on acquiring different learning strategies, in order to minimize the sequelae caused by an injury or damage (Carvalho, 2017; Paúl, Bilbao & Ríos, 2011; Castillero, n.d.). Specifically, according to Castillero (n.d.) and Carvalho (2017), the use of alternative skills that promote functional reorganization through intact systems is maximized.
Multidisciplinary Work
Persistent illnesses, whether physical, cognitive, emotional, social or psychological, are so complex that they cannot be addressed specifically by any one professional, but require the joint and coordinated participation of interdisciplinary teams (Ojeda, et al., 2010). The multidisciplinary team is composed of professionals in neurology, neuropsychology, physiotherapy, occupational therapy, speech therapy, psychiatry, nursing, internal medicine, rehabilitative medicine and social work (Paúl, Bilbao & Ríos, 2011; Castillero, n.d.). Therefore, according to Paúl, Bilbao & Ríos (2011), ideally neuropsychologists should not work alone, but with several professionals.
Teamwork requires sharing information, expectations and goals (Paúl, Bilbao & Ríos, 2011). All members should understand the different aspects of the pathology being worked with and should maintain a flexible attitude towards the functions and role assignments of each professional. According to Paúl, Bilbao & Ríos (2011), they must put into practice sufficient resources and social skills to achieve the team's objectives and also promote decision-making by consensus.
Finally, neuropsychological rehabilitation involves not only the work and effort of a treatment team composed of the patient and the rehabilitator, but also the families, who provide the necessary support throughout the process (Carvalho, 2017). In short, according to Carvalho (2017), neuropsychological rehabilitation cannot be considered as an isolated process, but as an interactive process.
Why is Neuropsychological Rehabilitation Necessary?
According to the National Institute of Statistics, the average for men a few decades ago in was 73 years, compared to women 81 years and currently in 2018 the average is around 80 years for men and 85 years for women (Cruz, 2021). For this reason, living longer is likely to make it easier to inflict any kind of damage or for any kind of disease to emerge (Cruz, 2021). On the other hand, increased stress, work life and many other factors have a negative effect, such as diabetes, high blood pressure, among others (Cruz, 2021).
In most cases of patients with some type of brain injury, neurodevelopmental disorder, neurodegenerative disease, mental disorder or intellectual disability there is some deficit at the cognitive, motor, behavioral and emotional level that can affect personal, academic performance and/or social development. Therefore, according to Carvalho (2017), with this type of treatment, neuropsychologists aim to create new learning strategies, through different mechanisms, which will allow patients to regain a higher level of functionality, thus reducing possible pathological defects.
References
Arévalo, L. (2020). ¿QUÉ ES LA REHABILITACIÓN NEUROPSICOLÓGICA?. Clínica de Neurorehabilitación. Recuperado 11 February 2021, a partir de http://www.bobath-es.com/que-es-la-rehabilitacion-neuropsicologica/
Arroyo, E., Poveda, J., & Chamorro, J. (2012). Técnicas de rehabilitación neuropsicológica en demencias: hacia la ciber-rehabilitación neuropsicológica. Recuperado 18 February 2021, a partir de http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S1657-89612012000100008
Aso, U. (s.f.). ¿Qué problemas trata la neuropsicología?. Psicologiaymente.com. Recuperado 15 February 2021, a partir de https://psicologiaymente.com/clinica/que-problemas-trata-neuropsicologia
Calderón, J., Montilla, M., Gómez, M., Ospina, J., Triana, J., & Vargas, L. (2018). Rehabilitación neuropsicológica en daño cerebral: uso de herramientas tradicionales y realidad virtual. Medigraphic.com. Recuperado 18 February 2021, a partir de https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=85929
Carvajal, J., & López, K. (2019). REHABILITACIÓN NEUROPSICOLÓGICA EN ADULTOS CON EPILEPSIA FOCAL. Neuropsychologylearning.com. Recuperado 18 February 2021, a partir de https://neuropsychologylearning.com/wp-content/uploads/pdf/pdf-revista-vol2/vol2-n2-2-rehabi-neuropsi-adultos-epilepsia-focal.pdf
Carvalho, C. (2017). ¿Qué es la Rehabilitación Neuropsicológica?. Hablemos de Neurociencia. Recuperado 11 February 2021, a partir de https://hablemosdeneurociencia.com/la-rehabilitacion-neuropsicologica/
Cruz, M. (2021). La importancia de la Rehabilitación Neuropsicológica. ISANEP - Neuropsicología y Psicoterapia. Recuperado 18 February 2021, a partir de http://www.neuropsicologosensevilla.com/la-importancia-la-rehabilitacion-neuropsicologica/
Castillero, O. (s.f.). Rehabilitación neuropsicológica: así se usa en pacientes. Psicologiaymente.com. Recuperado 15 February 2021, a partir de https://psicologiaymente.com/clinica/rehabilitacion-neuropsicologica
Díaz, E., & Sosa, A. (2010). Intervención cognitiva en pacientes con deterioro cognitivo ligero y demencia leve. Recuperado 18 February 2021, a partir de http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-30192010000600015
Guzmán, A. (2019). La importancia de la rehabilitación neuropsicológica. Neuron. Recuperado 11 February 2021, a partir de https://neuronrehab.es/blog/la-importancia-de-la-rehabilitacion-neuropsicologica/
Lubrini, G., Periañez, J., & Ríos, M. (2009). Introducción a la estimulación cognitiva y la rehabilitación neuropsicológica. En E. Muñoz, et al., Estimulación cognitiva y rehabilitación neuropsicológica (1ra ed., pp. 13 - 34). Barcelona: Editorial UOC.
Ojeda, N., Peña, J., Bengoetxea, E., & García, A. (2010). REHACOP: PROGRAMA DE REHABILITACIÓN COGNITIVA EN PSICOSIS. Psiquiatria.com. Recuperado 17 February 2021, a partir de https://psiquiatria.com/trabajos/19cof945441.pdf
Paúl, N., Bilbao, A., & Ríos, M. (2011). Recuperado 11 February 2021, a partir de https://www.researchgate.net/publication/270822798_Rehabilitacion_Neuropsicologica
Vales, L. (2019). Rehabilitación Neuropsicológica en pacientes con traumatismo craneoencefálico. Ejemplo de un plan de Rehabilitación Neuropsicológica. Cnps.cl. Recuperado 18 February 2021, a partir de https://www.cnps.cl/index.php/cnps/article/view/384
