Incorporation of SPECT imaging in a longitudinal cognitive rehabilitation therapy programme.

In this clinical study, five consecutive referrals to a cognitive rehabilitation therapy (CRT) programme were followed in a longitudinal protocol involving a resting SPECT and neuropsychological evaluation at pre-treatment, post-treatment, and post non-treatment intervals. All clients had acquired brain injury and initially demonstrated neuropsychological deficits and various 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. Examination of the neuropsychological testing results revealed significant improvement in performance following CRT which were generally maintained during the non-treatment period. SPM analysis of the SPECT data revealed that, in a majority of cases, most of the significant increases in relative cerebral blood flow redistribution were seen during the treatment period, rather than the non-treatment period. The results suggest that, even in individuals who are more than 2 years post-brain damage, relative increases in rCBF can be demonstrated following individualized CRT and that most of these changes can be related to improvements on neuropsychological tests.