Incorporation of SPECT imaging in a longitudinal cognitive rehabilitation therapy programme

In this clinical study, five consecutive referrals to a cognitive rehabilit ation therapy (CRT) programme were followed in a longitudinal protocol invo lving a resting SPECT and neuropsychological evaluation at pre-treatment, p ost-treatment, and post non-treatment intervals. All clients had acquired b rain injury and initially demonstrated neuropsychological deficits and vari ous degrees of hypoperfusion on SPECT. Statistical Parametric Mapping (SPM) was used to evaluate change in successive SPECT images. Following CRT, all clients were able to return to productive employment or schooling. Examina tion of the neuropsychological testing results revealed significant improve ment in performance following CRT which were generally maintained during th e non-treatment period. SPM analysis of the SPECT data revealed that, in a majority of cases, most of the significant increases in relative cerebral b lood flow redistribution were seen during the treatment period, rather than the non-treatment period. The results suggest that, even in individuals wh o are more than 2 years post-brain damage, relative increases in rCBF can b e demonstrated following individualized CRT and that most of these changes can be related to improvements on neuropsychological tests.