Evaluation of differentiated neurotherapy programs for a patient after severe TBI and long term coma using event-related potentials

Abstract

SummaryBackgroundThis article examines the effectiveness of differentiated rehabilitation programs for a patient with frontal syndrome after severe TBI and long-term coma. We hypothesized that there would be a small response to relative beta training, and a good response to rTMS, applied to regulate the dynamics of brain function.Case ReportM. L-S, age 26, suffered from anosognosia, executive dysfunction, and behavioral changes, after a skiing accident and prolonged coma, rendering him unable to function independently in many situations of everyday life. Only slight progress was made after traditional rehabilitation. The patient took part in 20 sessions of relative beta training (program A) and later in 20 sessions of rTMS (program B); both programs were combined with behavioral training. We used standardized neuropsychological testing, as well as ERPs before the experiment, after the completion of program A, and again after the completion of program B. As hypothesized, patient M.L-S showed small improvements in executive dysfunction and behavioral disorders after the conclusion of program A, and major improvement after program B. Similarly, in physiological changes the patient showed small improvement after relative beta training and a significant improvement of the P300 NOGO component after the rTMS program.ConclusionsThe rTMS program produced larger physiological and behavioral changes than did relative beta training. A combination of different neurotherapeutical approaches (such as neurofeedback, rTMS, tDCS) can be suggested for similar severe cases of TBI. ERPs can be used to assess functional brain changes induced by neurotherapeutical programs.

Neuropsychology and the Neurophysiology of Perceptual Microgenesis

“…However, each ERP wave represents a sum of potentials generated by several spatially and temporally distributed sources (Kappenman & Luck, 2012). In order to separate such sources a group independent component analysis can be applied to the collection of ERPs obtained in a large number of subjects performing a visual discrimination task (Kropotov & Ponomarev2009;Pachalska, Łukowicz, Kropotov et al, 2011). The data were obtained in 1000 healthy subjects within the frames of a HBI database project (Kropotov & Mueller, 2009;.…”

Alexander Romanovich Luria (1902-1977) and the Microgenetic Approach to the Diagnosis and Rehabilitation of Tbi Patients

“…Luria's work was continued after his death all over the world, both by his colleagues with considerable academic achievements (Bejn, 1964;Akhutina & Tsvetkova, 1983) and supporters in the Soviet Union (Glozman, 1999) as well as Klimkowski] in other countries, such as Poland (Kaczmarek, 1984(Kaczmarek, , 1987(Kaczmarek, , 1993(Kaczmarek, , 1998(Kaczmarek, , 2012Kaczmarek et al 2003;Kądzielawa, 1983Kądzielawa, , 1986Kądzielawa, , 1993Kądzielawa, , 1996Kądzielawa, , 1997Klimkowski, 1975Klimkowski, , 1976Klimkowski & Herzyk, 1987;Maruszewski, 1966Maruszewski, , 1970Maruszewski, , 1972Maruszewski, , 1973Maruszewski, , 1974Tłokiński, 1986;Herzyk, 1992Herzyk, , 2000Herzyk, , 2004Herzyk, , 2005Herzyk, , 2011Pąchalska, 1986Pąchalska, , 1990Pąchalska, , 1999Pąchalska, , 2002Pąchalska, , 2003Pąchalska, , 20052007, 2008Pąchalska & Kaczmarek, 2013;Pąchalska & Kropotov 2013;Pachalska et al, 2011;PrzesmyckaKaminska, 1980PrzesmyckaKaminska, , 1990…”

Neurophysiological basis of microgenesis theory: stages of visual information flow as reflected in functionally defined components of event related potentials in man

“…After trying several different approaches we chose Independent Component Analysis (ICA). This method worked very well when applied to a collection of ERPs computed for a substantial number of healthy subjects performing a psychological task with varying stimulus-response associations (Kropotov & Ponomarev, 2009;Kropotov et al, 2011;Pachalska et al 2011).…”