Neurotherapy for stroke rehabilitation: A single case study

Abstract

A 55-year-old male subject was treated with a two-tiered neurotherapy approach for a period of six months beginning approximately one year after a left-side CVA. Medical evaluation revealed left posterior temporal/parietal infarctions secondary to occlusion of the left internal carotid artery. The patient complained of hesitant speech with word finding difficulty and paraphasia, difficulty focusing his right eye, lack of balance and coordination, poor short-term memory, poor concentration, anxiety, depression, and tinnitus. A quantitative electroencephalograph (QEEG) analysis revealed increased left-side 4-7-Hz activity and alpha persistence on eye opening. Two neurotherapy approaches were used beginning with electroencephalographic entrainment feedback (EEF). This was followed by neurofeedback to inhibit 4-7 Hz and increase 15-21 Hz over sensorimotor and speech areas. At the conclusion of treatment there were significant reductions in slow-wave activity. Improvement was evident in speech fluency, word finding, balance and coordination, attention, and concentration. Depression, anxiety, and tinnitus were greatly reduced.

Neurofeedback as a Form of Cognitive Rehabilitation Therapy Following Stroke: A Systematic Review

“…Overall, study designs and NFT therapy and training protocols were diverse and heterogeneous in nature. Five of the interventions were case studies [41][42][43][44][45]. Three controlled trials were also included [6,46]; two were non-randomized and non-blinded (experiment 1 n = 32, experiment 2 n = 17) [6], and one was randomized but non-blinded (n = 27) [46].…”

“…6 months or more post-stroke) [41][42][43]. Two studies indicated participants were recruited from an inpatient rehabilitation hospital, possibly implying these participants were still in the sub-acute phase (i.e.…”

“…Individuals suffered from various lesions (see Table 1) and exhibited a number of cognitive deficits. NFT interventions directly targeted memory [6,41,44], emotional issues [41,43,45], concentration and distraction issues [41,43,45,46], fatigue and energy deficits [41,43], communication and speech deficits [41,42,45], visual perception deficits [45,46] and motivation [45]. Two patients complained of visual tracking deficits, [41,42] in addition to one of them suffering from tinnitus [41].…”

“…See Table 1. A few of the participants opted to try NFT after already having participated in conventional forms of stroke rehabilitation therapy; additional therapies included speech therapy [41], physical therapy [41,46], group and individual therapy [42], talk therapy [43] and neuropsychological therapy [45]. Participants in one study completed additional computer training (targeting attention, language, and memory) for 30 minutes immediately prior to their group-specific intervention [6].…”

“…Some authors also described the use of medications in addition to NFT use (i.e. for high blood pressure [41,42] and depression [42,43]). Authors of one investigation reported the cessation of anti-depressants during the course of the NFT intervention [43].…”