T.B.I. Case Study
Nicole Slifcak, Patient, New Mind CenterBelow is the story of Nicole. In addition we have presented pre and post training qEEG and LORETA brainmaps as well as TOVAs and CPT cognitive performance graphs. For many they will be difficult to interpret. Our primary purpose in doing so is to demonstrate that we employ cutting edge technology that empirically documents the effects of our training. We have this data on file for hundreds of cases we have worked on.

The most difficult aspect of being a neurofeedback practitioner is to hear day after day about other professionals in the healthcare industry who have told their patients who need help that neurofeedback is a waste of time. As a scientist I was taught to never render an opinion until I carefully reviewed the data. I believe it is unethical as a professional to offer an opinion based on ignorance rather than informed analysis. We continually make dramatic improvements in the lives of others who were told there is nothing further that can be done for them. There are literally millions who could profoundly benefit from neurofeedback. Unfortunately they do not know about neurofeedback. Nicole was lucky, because one medical doctor did look at the research and refer her to us. We applaud her courage to share her story with others in the hope that they too will discover neurofeedback and the benefits it has to offer.


Nicole's Story
Nicole Slifcak graciously offered to allow us to present her case on our website in order to encourage others like her with Traumatic Brain Injury (TBI) not to give up hope, but to keep searching and to try neurofeedback as a solution.

 

Nicole suffered a serious closed head injury in a car accident. The accident left her with poor executive function, problem solving ability and memory. She had difficulty with sustained attention and organization. She spoke in short sentences in a monotone. Her articulation was poor and difficult to understand at times. She had a flat affect and demonstrated poor judgment. Her balance was very poor and she walked with a clear limp. Fortunately Nicole’s mother brought her to us within a few months of the accident. We knew from the research that recovery is faster if individuals begin training as soon as possible after the accident.

 

When we ran the qEEG brainmap on her we did a LORETA analysis to focalize the areas of worst damage. Since her hospital report indicate left frontal lacerations, we were not surprised to find posterior damage from the contra coup of the impact. The LORETA images are in the low frequency ranges of theta, indicating there was some cortical damage. The occipital damage also suggested cerebellar damage as well, since the occipital area is so close in proximity and the brain stem is frequently an area where considerable stress builds up in an impact. Nicole’s balance problem and speech articulation problems supported this theory. No damage was noted to more frontal speech areas such as Broca’s or Wernicke’s area.

 

Our initial training was to address attentional problems that showed up in tests. Once Nicole’s attention had been normalized, we continued training for cognitive improvement. As her attention and cognitive performance improved, her gait and speech articulation also began to show dramatic improvement. When her testing began to show her in the normal range, I asked Nicole what she would like to work n next. She told me that she couldn’t run and that she missed that ability very much. So we began training cerebellar function in the posterior cortex to improve her balance and timing. Within 8 sessions she was able to run again and even began riding a bike. 

 

Nicole has gone on to college and is on the swim team. Her mother tells me she cannot even tell she had a speech problem sometimes when she talks to her on the phone. Nicole is doing very well in school and is leading a normal life.

What Testing Reveals

LORETA

Below are two LORETA images showing the location of areas of the brain generating abnormal brainwave activity in the 5hz and 6hz frequency ranges. The red areas indicate problems in the posterior regions of the brain and in the motor strip from the contra coup from Nicole’s accident.

Loreta Images, New Mind Center

Loreta Images, New Mind Center

qEEG Brainmaps

The two images below show the pre and post training qEEG Brainmaps. Each of the circles represents one frequency of brainwave and the colors show the distribution of that frequency. Yellow and orange indicate too much activity in an area, while blue indicates too little activity. The 5hz damage that appears in the LORETA above shows up in the pre map but has been trained out in the post map. In addition the region where the parietal contusion was reported shows excess 12hz and 13hz activity. This also has been dramatically reduced in the post map.

 

qEEG Brainmaps, New Mind Center

qEEG Brainmpas, New Mind Center

Tova

The TOVA is a Computerized Performance Test that measures in real time how well people are able to attend to a task. Individuals sit in front of a screen that flashes images at them and they have to click a hand switch when the correct image appears. It is a widely used test for evaluating attention. The dotted line shows an average performance level. The pretest shows that Nicole’s performance becomes very poor after ten minutes at Q3 and overall a lot of variability in her response time. The posttest shows a strong performance in almost every area for the full 20 minute test.

TOVA, New Mind CenterTOVA, New Mind Center

The graph below shows the trend of Nicole’s performance on a cognitive performance test she took before each training session for a period of several months. The test is a particularly good measure of working memory which was poor when Nicole began. At the end of her training, after 44 sessions, it is clear that she has made tremendous progress from below average to normal function.

Nicole's Performance Graph, New Mind Center