The Road Less Traveled: Integrating Neurotherapy with Holistic Neuropsychological Rehabilitation After Severe Head Injury

Abstract

Introduction: Traumatic brain injury (TBI) is associated with physical, cognitive, emotional, and behavioral disturbances. The cognitive deficits are common after TBI, and a holistic approach to neuropsychological rehabilitation is recommended in these patients. EEG neurofeedback training (EEG-NFT) is a state-of-the-art technique for neuropsychological rehabilitation. There is a paucity of studies exploring the use of EEG-NFT integrated with holistic neuropsychological rehabilitation. Method: Single case design was adopted for the present study. A 25-year-old single male, diagnosed with severe TBI, presented with physical, cognitive, and emotional-behavioral disturbances after 17 months of injury. A comprehensive neuropsychological assessment was carried out. The neuropsychological rehabilitation using EEG-NFT along with psychosocial interventions with the patient and the parents was carried out for 9 months. Results: The patient showed significant improvement in cognitive deficits such as attention, executive functions, and visuospatial ability. Emotional-behavioral problems such as irritability, sadness, and overall dysfunction also improved significantly. Conclusion: The present case study highlights that integrating EEG-NFT along with holistic neuropsychological rehabilitation helps to improve cognitive, emotional, and behavioral disturbances after TBI.

Memory rehabilitation: restorative, specific knowledge acquisition, compensatory, and holistic approaches

“…The results of this study demonstrated the beneficial and stable long-term effects of holistic neuropsychological rehabilitation but also highlighted some areas that require further consideration (Shany-Ur et al 2020 ). Similar studies have found positive effects of holistic rehabilitation on psychological, emotional, and quality of life measures, although the benefits on cognitive functions have been mixed (Afsar et al 2021 ; Exner et al 2021 ; Holleman et al 2018 ; Nilsson et al 2011 ; Sarajuuri et al 2018 ; Urech et al 2020 ).…”

“…In addition to cognitive impairments following ABI, deficits in metacognition and emotional disturbances including depression and anxiety can be present and impact daily functioning and community participation such as returning to work (Afsar et al 2021;Haskins et al 2012;Long et al 2014;Perna and Harik 2020;Robertson and Schmitter-Edgecombe 2015). Metacognition refers to the knowledge of one's own cognitive abilities and includes self-awareness, self-monitoring, and self-regulation (Al Banna et al 2015;Robertson and Schmitter-Edgecombe 2015;Sansonetti et al 2021).…”

“…Key factors in this approach involve (1) establishment of a therapeutic setting or community, (2) addressing knowledge of the deficit and subsequent impact on functional abilities through education, (3) addressing the cognitive deficit, usually with compensatory aids, (4) addressing the emotional and social consequences of the deficit through psychotherapy, and (5) involving family members in the rehabilitation process (Ben-Yishay 2000 ; Nilsson et al 2011 ; Prigatano 2013 ; Withiel et al 2019 ). This approach is underpinned by the notion that the multidimensional nature of cognition and the interaction with the other systems should be addressed together because they interact with and influence each other (Afsar et al 2021 ; Ben-Yishay 2000 ; Perna and Harik 2020 ; Prigatano 2013 ; Wilson 2013 ). The ultimate goal is to address the consequences of ABI in a manner that will allow for establishment of satisfactory life through community integration, social participation, and productivity whilst managing continued limitations (Cicerone et al 2008 ; Exner et al 2021 ; Holleman et al 2018 ; Shany-Ur et al 2020 ).…”

Single-Case Experimental Design in Rehabilitation

“…4 In rehabilitation, SCEDs have been used in a variety of areas. The main focus includes the evaluation of cognitive and behavioral interventions for aphasia, 8 neuropsychological rehabilitation, 9 and special education. 10 In recent years, SCEDs have been more widely applied to areas such as sport training, 11 and the effectiveness of animal-assisted therapy, 12 among others.…”