Diagnostic Procedures
Functional Assessment
Neuropsychological testing tells us how the patient’s cortex is functioning. A neuropsychological test battery assesses various cognitive domains such as information processing speed, attention, learning, memory and executive systems. Emotional and behavioral assessments are also included. These tests are combined with a comprehensive medical history, neurological and psychiatric examination.
Neuroimaging
At NCI, we use both electrical neuroimaging and fMRI brain mapping techniques collectively. The advantage of this is the enhanced capacity for the examiner to assess without delay changes in the brain while the patient completes various cognitive tests and to be able to see precisely what is going on in the brain during activation and while at rest. This approach enhances diagnostic accuracy and our ability to identify the cause of the patient’s symptoms and deficits.
Functional brain mapping combines neuropsychological test results of cortical functions such as attention and
executive functioning, with brain mapping to more accurately diagnose a variety of cognitive, neurobehavioral and
neuropsychiatric disorders.
Comparing a patient’s functional brain mapping results to a normative database of age, education and gender matched healthy controls, assists in making accurate diagnoses to get closer to understanding the cause of the disorder and how best to treat it. For example, we can map various cortical networks in the brain, such as the attention, executive, language, mood or the pain network. If abnormalities are detected, we can identify the precise location within the network and determine if these deviations are due to cortical tone, connectivity and/or timing abnormalities or some other cause.
In addition, to normative database comparisons, we can compare brain mapping results to various clinical databases to generate a Probability Index score for a variety of etiologies. For instance – we can assess the probability that the abnormalities are due to central nervous system disorders such as ADHD, Alzheimer’s disease, Seizures, Traumatic Brain Injury or a Learning Disability.
Interventional Brain Mapping
Non-invasive neuromodulation treatment applications such as transcranial direct current stimulation (tDCS), rapid transcranial magnetic stimulation (rTMS) and EEG Neurofeedback can be used to treat clinically significant brain abnormalities detected on brain mapping.
These interventions are used to treat cognitive and neuropsychiatric disorders, as well as, Epilepsy and Pain. Some of these interventions are available only through research and others have been FDA-approved to treat certain disorders.
Among these various neuromodulation applications, Neurofeedback currently has the widest range of clinical applications. Although Neurofeedback has been used as a clinical tool since the 1960s, brain mapping neurofeedback using LORETA software is a relatively recent development dating back to approximately 2008. This technology uses advancements made over the past 15 years mapping multiple brain circuits responsible for various human experiences; from basic functions such as sustaining wakefulness to complex functions such as decision-making.
Clinically, sLORETA Neurofeedback is rapidly growing around the globe as a treatment application to alter brain networks that are not functioning at their optimal levels. At NCI once we modulate a cortical region or network, we then find rehabilitation interventions to further active that area of the brain. Our patients are then given ‘homework’ assignments to further strengthen the cortical regions we are modulating. Brain mapping and neuromodulation interventions such as neurofeedback are clinical procedures and reimbursed by most 3rd party healthcare insurance carriers. NCI participates in most healthcare plans including Medicare and Medicaid.
In non-clinical populations, brain mapping Neurofeedback and tDCS are also being used to enhance performance and cognitive functions such as reaction time and decision speed in individuals who are functioning in highly-competitive environments.
For additional information on these and other recently developed diagnostic tests, treatment interventions and peak performance training, please call The NeuroCognitive Institute and schedule a consultation.
Download PDF “Functional Brain Mapping and Neuromodulation Enhanced Cognitive Rehabilitation“
Scientific Readings on Functional Brain Mapping
One of Many Scientific References on Functional Brain Mapping and Neuromodulation
Functional Brain Mapping and the Endeavor to Understand the Working Brain: Signorelli and Chirchiglia (2013).
Mind Over Chatter: Plastic up-regulation of the fMRI salience network directly after EEG Neurofeedback. Neuroimage, 65, 324-335
