CASE REPORT
Application of ERPs neuromarkers for assessment and treatment of a patient with chronic crossed aphasia after severe TBI and long-term coma – Case Report
 
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1
Academy of Physical Education, Department of Physiotherapy, Wroclaw, Poland
 
2
Jan Kochanowski University in Kielce, Faculty of Medicine and Health Sciences, Kielce, Poland
 
3
Old Polish University, Kielce, Poland
 
4
Academy of Physical Education Department of Psychology, Wroclaw, Poland
 
5
Laboratory for Action Programming Neurobiology, Institute of the Human Brain, Russian Academy of Sciences, St. Petersburg, Russia
 
6
Chair of Neuropsychology and Neurorehabilitation, The Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
 
7
Center of Cognition and Communication, New York, NY, USA
 
 
Corresponding author
Jolanta Góral-Półrola   

Old Polish University, Kielce, Poland
 
 
Ann Agric Environ Med. 2017;24(1):141-147
 
KEYWORDS
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 1st 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 2nd recording, slight improvements in cognitive control, and language functions were found. In the 3rd 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

REFERENCES (38)
1.
McAllister TW, Neurobehavioral sequelae of traumatic brain injury: evaluation and management. World Psychiatry. 2008; 7(1): 3–10.
 
2.
Yousefzadeh-Chabok S, Ramezani S, Reihanian Z, Safaei M, Alijani B, Amini N. The role of early posttraumatic neuropsychological outcomes in the appearance of latter psychiatric disorders in adults with brain trauma. Asian J Neurosurg. 2015; 10(3): 173–80.
 
3.
Whyte J, Polansky M, Cavallucci C. Inattentive behavior after traumatic brain injury. J Int Neuropsychol Soc. 1996; 2: 274–281.
 
4.
Ben-Yishay Y, Diller L. Cognitive remediation in traumatic brain injury: update and issues. Arch Phys Med Rehabil. 1993; 74: 204–213.
 
5.
Cicerone K, Dahlberg C, Kalmar K. Evidence-based cognitive rehabilitation: recommendations for clinical practice. Arch Phys Med Rehabil. 2000; 81: 1596–1615.
 
6.
McAllister TW. Neurobiological consequences of traumatic brain injury. Dialogues Clin Neurosci. 2011; 13(3): 287–300.
 
7.
Lehtonen S, Stringer AY, Millis S. Neuropsychological outcome and community re-integration following traumatic brain injury: the impact of frontal and non-frontal lesions. Brain Inj. 2005; 19: 239–256.
 
8.
Chantsoulis M, Mirski A, Rasmus A, Kropotov JuD, Pachalska M. Neuropsychological rehabilitation for traumatic brain injury patients. Ann Agric Environ Med. 2015; 22(2): 368–379. doi: 10.5604/12321966.1152097.
 
9.
Mathias JL, Wheaton P. Changes in attention and information-processing speed following severe traumatic brain injury: a meta-analytic review. Neuropsychology. 2007; 21: 212–223.
 
10.
Hart T, Whyte J, Millis S. Dimensions of disordered attention in traumatic brain injury: further validation of the Moss Attention Rating Scale. Arch Phys Med Rehabil. 2006; 87: 647–655.
 
11.
Vakil E. The effect of moderate to severe traumatic brain injury (TBI) on different aspects of memory: a selective review. J Clin Exper Neuropsychol. 2005; 27: 977–1021.
 
12.
Ruff RM, Levin HS, Mather S. Recovery of memory after mild head injury: a three center study. In: Levin HS, Eisenberg HM, Benton AL, editors. Mild head injury. New York: Oxford University Press; 1989. pp. 176–188.
 
13.
O’Jile JR, Ryan LM, Betz B. Information processing following mild head injury. Arch Clin Neuropsychol. 2006; 21: 293–296.
 
14.
Rassovsky Y, Satz P, Alfano MS. Functional outcome in TBI. Verbal memory and information processing speed mediators. J Clin Exper Neuropsychol. 2006; 28: 581–591.
 
15.
Ewing-Cobbs L, Barnes M. Linguistic outcomes following traumatic brain injury in children. Semin Pediatr Neurol. 2002; 9: 209–217.
 
16.
Weintraub S, Mesulam MM, Kramer L. Disturbances in prosody. A right-hemisphere contribution to language. Arch Neurol. 1981; 38: 742–744.
 
17.
Pąchalska M, Kaczmarek BLJ, Kropotov JD. Neuropsychologia kliniczna: od teorii do praktyki. Warszawa: Wydawnictwo Naukowe PWN. 2014.
 
18.
Mauritz W, Wilbacher I, Majdan M, Leitgeb J, Janciak I, Brazinova A, Rusnak M. Epidemiology, treatment and outcome of patients after severe traumatic brain injury in European regions with different economic status. Eur J Public Health. 2008; 18(6): 575–80.
 
19.
Benedictus MR, Spikman JM, van der Naalt J. Cognitive and behavioral impairment in traumatic brain injury related to outcome and return to work. Arch Phys Med Rehabil. 2010; 91(9): 1436–41.
 
20.
Tomaszewski W, Buliński L, Mirski A, Rasmus A, Kowalczyk J, Bazan M, Pąchalska M. An evaluation of anti-social behaviour in children after traumatic brain injury – prospects for improving the quality of life in rehabilitation. Ann Agric Environ Med. 2014; 21(4): 649–653. doi: 10.5604/12321966.1120620.
 
21.
Pachalska M. Neuropsychologia kliniczna: urazy mózgu. Warszawa: Wydawnictwo Naukowe PWN. 2014.
 
22.
Półrola P, Kaczmarek BLJ, Góral-Półrola J, Kropotov JD, Sucharska I, Pąchalska M. Event-related potential studies of combined Mild Traumatic Brain Injury/Post-Traumatic Stress Disorder in a retired Polish Army Lieutenant Colonel. Acta Neuropsychologica 2016; 14(1): 69–91. DOI:10.5604/17307503.1201710.
 
23.
Duff J. The usefulness of quantitative EEG (QEEG) and neurotherapy in the assessment and treatment of post-concussion syndrome. Clin EEG Neurosci. 2004; 35(4): 198–209.
 
24.
Trystuła M, Zielińska J, Półrola P, Goral-Połrola J, Kropotov ID, Pąchalska M. Neuromarkers of anxiety in a patient with suspected schizophrenia and TIA: the effect of individually-tailored neuro feed-back. Acta Neuropsychologica 2015; 13(4): 395–404.
 
25.
Pascual-Leone A, Walsh V, Rothwell J. Transcranial magnetic stimulation in cognitive neuroscience – virtual lesion, chronometry, and functional connectivity. Current Opinion in Neurobiology 2000; 10(02): 232–237.
 
26.
Rao V, Rosenberg P, Bertrand M, Salehinia S, Spiro J, Vaishnavi S, Rastogi P, Noll K, Schretlen DJ, Brandt J, et al. Aggression after traumatic brain injury: prevalence and correlates. J Neuropsychiatry Clin Neurosci. 2009; 21(4): 420–9.
 
27.
Milders M, Ietswaart M, Crawford JR, Currie D. Social behavior following traumatic brain injury and its association with emotion recognition, understanding of intentions, and cognitive flexibility. J Int Neuropsychol Soc. 2008; 14(2): 318–26.
 
28.
Pachalska M, Moskała M, MacQueen BD, Polak J, Wilk-Frańczuk M. Early neurorehabilitation in a patient with severe traumatic brain injury to the frontal lobes. Med Sci Monit. 2010; 16(12): CS157–67.
 
29.
Kropotov JD. Quantitative EEG, Event Related Potentials and Neurotherapy. 2009; Academic Press, Elsevier, San Diego, 542 p.
 
30.
Pachalska M. Rehabilitacja neuropsychologiczna [Neuro psycho logical Rehabilitation]. Lublin 2008, Wydawnictwo UMCS.
 
31.
Mariën P, Engelborghs S, Vignolo LA, De Deyn PP. The many faces of crossed aphasia in dextrals: report of nine cases and review of the literature. European Journal of Neurology 2001; 8(6): 634–658.
 
32.
Meinzer M, Harnish S, Conway T, Crosson B. Recent developments in functional and structural imaging of aphasia recovery after stroke. Aphasiology. 2011; 25(3): 271–290.
 
33.
Nitsche MA, Doemkes S, Karakose T, Antal A, Liebetanz D, Lang N, Tergau F, Paulus W. Shaping the effects of transcranial direct current stimulation of the human motor cortex. J Neurophysiol. 2007; 97: 3109–3117.
 
34.
Kropotov JD, Grin-Yatsenko VA, Ponomarev VA, Chutko LS, Yakovenko EA, Nikishena IS. ERPs correlates of EEG relative beta training in ADHD children. Int J Psychophysiol. 2005; 55(1): 23–34.
 
35.
Zielińska J, Góral-Półrola J, Półrola P, Łuckoś M, Kropotov JD, Pąchalska M. Hyper-frontality in an OCD patient – evidence from event-related potentials in a cued GO/NOGO task. Ann Agric Environ Med. 2016; 23(2): 276–279. doi: 10.5604/12321966.1203890.
 
36.
Pape TL, Rosenow J, Lewis G. Transcranial magnetic stimulation: a possible treatment for TBI. J Head Trauma Rehabil. 2006; 21(5): 437–451.
 
37.
Bashir S, Mizrahi I, Weaver K, Fregni F, Pascual-Leone A. Assessment and modulation of neural plasticity in rehabilitation with transcranial magnetic stimulation. PM R. 2010; Suppl 2: 253–268.
 
38.
Bolognini N, Pascual-Leone A, Fregni F. Using non-invasive brain stimulation to augment motor training-induced plasticity. Neuroeng Rehabil. 2009; 6–8.
 
eISSN:1898-2263
ISSN:1232-1966
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