Improvement in Processing Speed, Fluid Cognitive Ability, Saccadometry, Stability Scores and Decrease in Symptom Severity Scores Following Neurological Rehabilitation for a 22-year-old Male Patient with Post Concussive Syndrome

Matthew M. Antonucci1, Paul E. Link1, Michael Greenwell1 and Derek A. Barton1*

1Plasticity Brain Centers, United States

Presentation: A 22-year-old male patient presented to Plasticity Brain Centers for evaluation and treatment of persistent symptoms of post concussive syndrome (PCS) following a traumatic brain injury that occurred seven months prior. His symptoms included headaches, sleeping difficulties, and fatigue.

Findings: During neurocognitive testing on the C3 Logix program, upon intake, his Trials-making test time for Trails B was 68.0 seconds. His digit symbol matching score was 54 in 120 seconds (50th percentile being 59). A Comprehensive Assessment of Postural Systems (CAPS®) (Pagnacco 2014) was performed assessing balance and stability, on both a solid and foamed surface, with eyes opened, eyes closed, and with multiple head positions. His overall average stability score on intake was 75.31%. When testing eye saccades on a saccadometer he produced a score of 55 correct eye movements and 13 incorrect eye movements. He reported a symptom severity score of 15 on the graded symptom checklist (GSC) (Simon 2017).

Methods: A 5-day, multi-modal program of neurological exercises was administered in 10 one-hour treatment sessions (Carrick 2017). Each session consisted of repetitive peripheral somatosensory stimuli, cognitive exercises, neuromuscular re-education exercises, vestibular rehabilitation exercises, orthoptic exercises, and off-vertical axis rotation (Gdowski 1999) utilizing a multi-axis rotational chair (MARC).

Outcome: Upon exit, Trails B time decreased to 53.3 seconds (-21.62%) (50th percentile equals 42.46 seconds). Digit symbol matching score representing processing speed was 61 in 120 seconds (+11.48%). Stability scores improved, with the average stability score calculated as 84.61% (+11.00%). After doing a final saccadometer test he produced a score of 99 correct movements with 0 incorrect movements (+80.00% in correct eye movements and was able to complete without any incorrect eye movements). When re-tested on the graded symptom checklist, his symptom severity score decreased to 8 (-46.67%).

Conclusion: The authors suggest further investigation into multi-modal, intensive approaches to decrease symptom severity and improve processing speed, fluid cognitive abilities, saccadometry, stability scores and decrease in symptom severity scores in patients with PCS.


  1. Carrick FR, Clark JF, Pagnacco G, Antonucci MM, Hankir A, Zaman R and Oggero E (2017) Head–Eye Vestibular Motion Therapy Affects the Mental and Physical Health of Severe Chronic Postconcussion Patients. Front. Neurol. 8:414. doi: 10.3389/fneur.2017.00414
  2. Gdowski GT, McCrea RA. Integration of vestibular and head movement signals in the vestibular nuclei during whole-body rotation. J Neurophysiol (1999) 82:436–49
  3. Pagnacco G, Carrick FR, Wright CH, Oggero E. In-situ verification of accuracy, percision and resolution of force and balance platforms. Biomed Sciences instrumentation (2014) 50:171-8
  4. Simon M, Maerlender A, Metzger K, Decoster L, Hollingworth A, McLeod TV. Reliability and Concurrent Validity of Select C3 Logix Test Components. Developmental Neuropsychology (2017) Oct; 0: 1-14. Doi: 10.1080/87565641.2017.1383994. Epub 2017 Oct 25.
  5. Salthouse T. What Cognitive Abilities are Involved in Trail-Making Performance? Intelligence. 2011 July-August; 39(4): 222–232.

Plasticity Centers ©