NR615_Kurt Goldstein

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SCHWERPUNKTTHEMA St. Frisch 29. Métraux A. Philosophy, Neurology, and the Pathology of Symbolic Consciousness: On two unpublished letters from Ernst Cassirer to Kurt Goldstein. Sci Cont 1999; 12: 645-660. 30. Poppelreuter W. Zur Psychologie und Pathologie der optischen Wahrnehmung. Z ges Neurol Psych 1923; 83: 26-152. 31. Steinfeld J. Ein Beitrag zur Analyse der Sexualfunktion. Z ges Neurol Psych 1927; 107: 172-183. 32. Teuber HL. Kurt Goldstein’s role in the development of neuropsychology. Neuropsychologia 1966; 4: 299-310. 33. Wilson BA. The clinical neuropsychologist‘s dilemma. J Int Neuropsych Soc 2005; 11: 488-493. Interessenvermerk Es besteht kein Interessenkonflikt. Korrespondenzadresse: Dr. Stefan Frisch Klinik für Neurologie Universitätsklinikum Frankfurt/Goethe-Universität Schleusenweg 2-16 60528 Frankfurt am Main frisch@med.uni-frankfurt.de 326 | Neurologie & Rehabilitation 6 · 2015
SCHWERPUNKTTHEMA Kurt Goldstein’s innovative approach of neuropsychological assessment Neurol Rehabil 2015; 21(6): 326–328 © Hippocampus Verlag 2015 DOI 10.14624/NR201512005 P. Eling Zusammenfassung When Kurt Goldstein was asked in 1916 to set up and organize a rehabilitation clinic for braininjured soldiers in Frankfurt am Main, he developed his full talent as a clinical neurologist with a great interest in his patients and the philosophical and psychological background of his work. This project stimulated him to introduce significant innovations in all aspects of his work. In this essay, I will highlight several of these, in particular with respect to the assessment procedures he developed together with the psychologist Adhémar Gelb. Goldstein developed a neuropsychological test battery, used for screening various cognitive domains and motor functioning. The screening battery was also designed for providing suggestion for areas of rehabilitation. Moreover, Goldstein already distinguished between laboratory tests and ›ecologically valid‹ procedures, for which he used the terms ›lebensfremd‹ and ›lebenswahr‹. He emphasized that one should observe how a patient performs a task, rather than rely on objective scores. Finally, the Wisconsin Card Sorting Test is derived from the sorting tasks Goldstein and Gelb used to analyze the concrete and abstract attitude of patients. This all happened long before neuropsychological assessment became fashionable in the 1960’s illustrating that Goldstein clearly was a significant innovator in the area of neuropsychological assessment. Schlüsselwörter: Kurt Goldstein, neuropsychology, assessment, ecological validity, Wisconsin Card Sorting Test Dep’t of Psychology, Radboud University, Nijmegen, The Netherlands Goldstein’s rehabilitation clinic Kurt Goldstein (1878–1965) received his neurological and psychiatric training to a large extent from Carl Wernicke (1848–1905) in Breslau. Here he learned that brain-injured patients may suffer from isolated cognitive deficits and a variety of simple tests, that we currently would regard as neuropsychological tests, was required to unravel the basic deficit. In 1914 Goldstein went, for the second time, to the Senkenbergische Neurologische Institut in Frankfurt am Main, where he became assistant to Ludwig Edinger (1855–1918). During the ›Great War‹, it was decided that specialized centers were needed for the treatment of soldiers with brain injuries, away from the battlefront. Edinger’s neurological clinic was chosen as one of these centers and Goldstein was offered in 1916 the chance to develop this specialized rehabilitation center and thus founded the »Institut für die Erforschung der Folgeerscheinungen von Hirnverletzungen« (Institute for the study of aftereffects of brain lesions), a clinic with 100 beds. The Villa Sommerhof was used for this purpose, with several buildings in the park used for psychological assessment, and for different types of therapeutical activities such as carpentry, bookbinding, production of brooms, shoes and small leather objects such as bags and wallets (for a detailed description, [13]). Assessment oldstein and Gelb Goldstein developed a screening battery together with the psychologist Adhémar Gelb (1887–1935), head of the psychological laboratory in the institute (Fig. 1). Unfortunately, we do not know very much about him, but the two worked closely together and Gelb was a first author on some of the publications resulting from the studies on the patients from the clinic [4]. Immediately after the war, Goldstein described the battery in a book, titled »Die Behandlung, Fürsorge und der Begutachtung der Hirnverletzten« (The care for treatment and assess- Neurologie & Rehabilitation 6 · 2015 | 327
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NR615_Kurt Goldstein

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