Neurorehabilitation following right thalamic infarct: effects of cognitive retraining on functional performance.

We treated the cognitive impairments of a 69-year-old male, that persisted 7 months after an infarction in the distribution of the right posterior cerebral artery. The infarct produced a 20% reduction in right cerebral blood flow, established by positron emission tomography (PET). Neuropsychological status was characterized by marked hemivisuospatial inattention, visuoperceptual and perceptuomotor dysfunction, and impaired visual memory. A multiple-baselines across behaviors design was utilized to assess effects of specific interventions on targeted cognitive functions. We found significant improvement in attention to left hemispace in response to directed interventions. Considerable gains were also realized in perceptuomotor abilities, mobility, and activities of daily living. Results indicated process-specific effects of strategic cognitive interventions, initiated 7 months postonset.