Application of ERPs neuromarkers for assessment and treatment of a patient with chronic crossed aphasia after severe TBI and long-term coma – Case Report

Abstract

Objective. The study aimed to evaluate the application of ERPs neuromarkers for the assessment and treatment of a patient with chronic crossed aphasia after severe TBI and a long-term coma. Case report. An ambidextrous female patient, aged 29, suffered from posttraumatic chronic crossed aphasia, severe TBI and a prolonged coma after a car accident. The patient took part in two differentiated rehabilitation programmes of neurotherapy included 20 sessions of relative beta training and 20 sessions of rTMS; both programmes were combined with behavioural training. The patient was tested 3 times: before the experiment, after completion of programme A, and after completion of programme B. Results. In the 1 st recording, the neuromarker of aphasia was found -an excess of the P2 wave over the left temporal area. There was a cognitive control deficit -an excess of omission errors and an increase of RT variability -all indexes of sporadic ADHD. In the 2 nd recording, slight improvements in cognitive control, and language functions were found. In the 3 rd recording, after the rTMS sessions most of her cognitive dysfunctions had been resolved, including language functions. It should be stressed that the activation (especially the increase in the ERP potential of the right side over the frontal lobe) was found. The neuromarker of aphasia did not change, only the location had slightly moved frontally. Conclusions. The application of ERP neuromarkers assists in the diagnosis, treatment, and academic success of an ambidextrous patient with chronic posttraumatic aphasia and sporadic ADHD. ERPs can be used to assess the functional brain changes induced by neurotherapeutical programmes.

The use of repetitive transcranial magnetic stimulation (rTMS) following traumatic brain injury (TBI): A scoping review

“…Leung et al, 2018;. There was also some promising initial evidence for a therapeutic effect of rTMS for the management of dizziness (Paxman et al, 2018), central pain (Choi et al, 2018), Aphasia (Chantsoulis et al, 2017), and visual neglect (Bonni et al, 2013) after TBI. However, and consistent with previous reviews (Dhaliwal et al, 2015;Herold et al, 2014), results were less encouraging for improving states of altered consciousness (e.g.…”

“…However, in the latter study, as most patients performed near to the maximum score on the Montreal Cognitive Assessment (MoCA; Nasreddine et al, 2005) at baseline, there was little room for improvement following the rTMS intervention. Chantsoulis et al (2017) examined the efficacy of two differentiated neurotherapy programmes (see Pachalska et al, 2011) in a 29-year-old female with severe TBI and chronic crossed aphasia. Small improvements were seen across a number of neuropsychological domains (e.g.…”

Nonverbal communication of trauma patients in a state of minimal consciousness

“…There are very few studies on nonverbal communication of minimally conscious patients described in the Polish subject literature. However, there are some case reports on specific technology applications, such as: brain-computer interface or cyber-eye [13,14]. The authors believe that natural methods which build human-human relations and nonverbal communication observation, which even amongst healthy represents up to 90% of all communication [3,5,17], are neglected in the light of the recent technology-focused approach.…”

Inhibition of Lats1/p‐YAP1 pathway mitigates neuronal apoptosis and neurological deficits in a rat model of traumatic brain injury

“…TBI-induced apoptosis as a complex network signaling process involves many molecules and different mechanisms, although many study results of TBI have been reported and significant advances in the technological and medical treatments have been made. 32,33 However, in the treatment of clinical TBI patients, the results are always unsatisfactory. Therefore, the key to effective treatment of cell death in TBI is to identify the pivots in different regulatory mechanisms in the complex network signal of apoptosis.…”

“…TBI‐induced apoptosis as a complex network signaling process involves many molecules and different mechanisms, although many study results of TBI have been reported and significant advances in the technological and medical treatments have been made . However, in the treatment of clinical TBI patients, the results are always unsatisfactory.…”