fNCI-directed treatment of sports related post-concussion syndrome ion syndrome

Abstract

Purpose We propose that our individualized Enhanced Performance in Cognition (EPIC) Treatment can effectively address PCS in sports-related concussions by employing functional NeuroCognitive imaging (fNCI) in conjunction with post-concussion symptom scale measurements to inform and direct treatment modalities. fNCI is a specialized application of fMRI that utilizes a normative reference sample and biomarkers for concussion to provide sensitive and specific predictive diagnostic values. The fNCI addresses neurovascular coupling (NVC) dysregulation that commonly arises in PCS. These results inform individualized EPIC Treatment to restore normal NVC function with a treatment protocol that strategically integrates cardiovascular therapies with cognitive training. Methods Two hundred four sports concussion patients were assessed pre- and post-treatment using both objective (fNCI) and subjective Post- Concussion Symptom Scale (PCSS) measures, establishing pretreatment benchmarks to measure therapeutic effectiveness. Patients underwent EPIC Treatment, which is a week-long, multiple treatments per day period consisting of cognitive, occupational, and neuromuscular therapy informed by fNCI and standardized PCSS findings. Results fNCI Severity Index Score (SIS) reported an average 80 percent reduction in objective measurements from the pre-treatment scan. Subjective measurements from the Post-Concussion Symptoms Scale (PCSS) reveal 59 percent reduction of symptoms as described by patient report. The SIS measurements are stable in follow-up scans 1-year post-treatment. Conclusion We provide evidence that fNCI can be used in assessment and treatment of chronic PCS resulting from SRC. Furthermore, the results provide evidence that our fNCI-guided treatment has positive outcomes in both objective and subjective measurements. This supports the hypothesis that our treatment effectively addresses PCS symptoms resulting from SRC. Follow-up fNCI scans indicate that improvements are stable following treatment.