[Towards a comprehensive theory of the rehabilitation of cerebral function as a basis for programmes of rehabilitation in brain damaged patients].

INTRODUCTION: Definition of the programme on integral rehabilitation needed by each patient after a cerebral lesion is today a clinical challenge which still requires much investigation. The many advances in all fields of the neurosciences give a great stimulus and fresh hope in tackling these problems. For practical advances in treatment it is important that clinicians make an effort to explain which are the theoretical models used in this complex field of the CNS, or which models may be used to develop new programmes of treatment. DEVELOPMENT: In this paper we summarize some of the current models of rehabilitation of psychic and neuropsychological functions based on experience acquired in the rehabilitation of chronic psychiatric patients and the newer findings of neurophysiology, neuro-imaging, neuropharmacology, neuropsychology etc. We also offer suggestions for effective organization of the work of rehabilitation teams. The newer models to be developed in the future should be suitable for the determination of what should be rehabilitated? (altered functions), how? (substitution, restitution, integration, activation, etc.) and when? (in what chronological order should these interventions take place and at what point).
CONCLUSION: Work with definite theoretical models on which to base diagnosis and treatment of psychic function would facilitate comparison of results and allow better understanding of the working of the normal brain.