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BRAIN INJURY, NEUROTHERAPY, & COGNITIVE REHABILITATION Neurotherapy has become a major part of Ms. Larsen's cognitive rehabilitation practice. She had worked with people with brain injuries for many years and knew that cognitive rehabilitation was useful but limited. For example, essentially all clients had deficits in attention, concentration, and memory, which were very difficult to remediate to a satisfying degree. When, thirteen years ago, it appeared that neurotherapy could be effective in reducing attention deficits in children with ADHD, Ms. Larsen decided to use it with brain damaged people, with the hope that it would do the same for them. Happily, it has, and much more, including providing improvement for the deficits listed in the previous section on cognitive rehabilitation. Neurotherapy offers a substantial step up from her prior work. Controlled studies of the efficacy of neurotherapy for brain damage have been problematic because most injuries are complex and varied, so true comparison of one group of people with a matched control group is almost impossible. Additionally, neurotherapy practitioners have used a variety of sites to treat clients, so clinicians might obtain differing results. In the last few years, however, the use of Quantitative EEGs to plan neurotherapy treatment has changed that situation. Now each individual can have his or her own EEG based blueprint for therapy, so while the control group problem still exists, differences between clinician practice is reduced. Jonathon Walker, M.D., a neurologist, based his study of the use of coherence neurotherapy (affecting the connections between two sites) for persons with mild closed head injuries on the Quantitative EEG results. Twenty-six patients were seen three to seventy months after their head traumas and were given, on the average, nineteen, individualized sessions of EEG biofeedback. Greater than fifty percent improvement was seen in eighty-eight percent of the patients. All persons who had been working prior to their injury were able to return to work. (Journal of Neurotherapy, 2002; 6:31-43) Daniel Hoffman, M.D., found that as a result of neurotherapy treatment, patients improved between twenty-three and sixty-two percent on the Microcog assessment. (Hoffman et al, Clinical Encephalography 1996 2:6) In a 2001 study, nine cognitively impaired patients improved on an average of eighty-seven percent of their symptoms, including attention, concentration, memory, disorientation, and irritability. Improvement was calculated when the patient, physician, and caretakers all agreed. (Bounias et al, Journal of Neurotherapy 2001; 4:23-40) Tinius (Timothy and Kathleen) provided cognitive rehabilitation tasks at the same time mild brain injured clients and ADHD adults were given visual and auditory feedback from neurotherapy. On a continuous performance test for attention (IVA) both groups scored significantly lower than the normal control group before treatment, while post-treatment there was no difference. On the Neuropsychological Impairment Scales, both brain injured and ADHD groups had significantly fewer symptoms after treatment. There were significant improvements on the Verbal I.Q., Performance I.Q., and Full Scale I.Q. and on the Wisconsin Card Sort Test for both experimental groups. There were no improvements in the control group. Treatment was discontinued after twenty sessions. (Journal of Neurotherapy, 2000; 4:27-41) |