Case Study: Balance and Memory Problems – Roger
At the time of presentation to APEX Brain Centers, Roger was a 70-year-old male struggling with severe balance problems, clumsiness, fatigue, and a general disinterest in life. He used to enjoy life as a family man, successful entrepreneur and golfer. Just over 10 years prior he had undergone radiation therapy for cancer that damaged his 8th cranial nerve (the balance and hearing nerve). He had also undergone prism therapies and surgery for eye position abnormalities, which have caused further insult to his ability to maintain good balance and to learn effectively. Although not listed as a primary complaint, he also suffered from significant cognitive decline in several areas as evidenced by very low to low average scores on standardized cognitive testing.
Roger sought care at APEX Brain Centers in Asheville, NC in May of 2015 and underwent an intensive course of Brain Training. He was admitted into in an individualized program directed by extensive diagnostic testing, and led by clinicians highly experienced in functional neurology. What follows is a sampling of some of the cutting-edge clinical interventions and amazing functional gains Roger experienced during his time at APEX.
Intervention for balance and cognitive decline
Roger underwent comprehensive Brain Training at a frequency of 3 times per day over the course of 15 days (with 2 days off between each for much needed rest and recovery). His brain function was carefully monitored throughout the training process with measurement of EEG brainwaves, vital signs, eye movements, balance, mental and physical timing, and more to ensure he was receiving the proper amount therapy to be effective, but not too much so as to be counter-productive. Modalities implemented included, but were not limited to: neurofeedback (NFB), Interactive Metronome, vestibular rehabilitation, metabolic/nutritional therapies, eye movement and neurological rehabilitation, whole body vibration, electrical stimulation, breathing exercises and home care recommendations.
Outcomes after Brain Training
Subsequent to his Brain Training program, Roger reported subjective improvements in the vast majority of his pre-intensive complaints. More profound than that; his wife was quoted as saying, “it’s like I have my old husband back”. She noted that he used to be the life of the party and had been slowly deteriorating over time to the point of sitting in his chair all day and sleeping more and more often. He was finally plugging back into life, putting an end to his isolation and apathy. As is demonstrated by his balance testing, he is also experiencing a renewed ability to maintain balance, allowing him to be safer and more efficient in navigating his physical environment.
Actual, measurable objective improvements recorded with post-intensive diagnostic testing include:
- Cognitive Testing: Increase in his Neurocognition Index of 48%. This is a standardized overall score of cognitive performance. Increases in various aspects of memory, attention, processing speed and more as great as 21%.
- Interactive Metronome: 56% improvement in task average with motor timing, and normalization of hyper-anticipatory timing tendency with motor tasks (i.e. responding prematurely to a pre-set reference tone).
- Computerized Assessment of Postural Stability (CAPS): 20.5% improvement in balance on an unstable surface with eyes closed – bringing him from severe to mild reduction in balance compared to his peers. Elimination of a posterior center of pressure (CoP); significantly reducing his risk of falling backwards.
- Videonystagmography (VNG): Significant improvements in numerous aspects of oculomotor (eye movement) functionality including: gaze holding, slow and fast eye movements, optokinetic responses, and spontaneous/involuntary eye movements.
With an alarming increase in the number of baby boomers and seniors experiencing balance issues and cognitive decline (that are in fact related), it is important to recognize the symptoms of these potentially debilitating disorders and, more importantly, that something can be done about them. Early intervention is key, as the longer one waits and the more function is lost, the more difficult it is to recover and have full engagement with life!
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