March 2006

ROSHI Complex Adaptive Protocol in the Treatment Of Severe TBI: Neuro Reorganization

                                                                                                                                        —Wm. G. Collins, Ph.D.

Brain plasticity refers to the potential for a brain to change its neural phenotype based upon
altered patterns of connections or activity (Casagrande & Wiencken-Barger 2001). Research
on the plasticity of the brain suggests that the brain retains its function despite extensive
lesioning and injury through a process of neural reorganization. This reorganization can be
quite dramatic. The plasticity hypothesis thus denies the localizationist concept of a
hierarchical, functional organization of the brain by postulating that the brain can produce
the same behavior through many different processes,or many behaviors through one process
(Kandel, Schartz & Jessal 1992).

In a paper titled Roshi Complex Adaptive Protocol in the Treatment of Severe TBI: Two
Month Pre and Post QEEG Report, I detail the QEEG results in treating my son with the
Roshi using the complex adaptive setting. In a second paper the treatment shifted to
coherence training utilizing Dr. Hudspeth’s connectivity database. The treatment focus was
delta hypo-coherence in the left hemisphere. That paper was an overview of the physical and
cognitive changes that had occurred as a result of the coherence training.

This paper will look at QEEG data related to a three-month period of no treatment, (7/23/04
and 11/6/04). I believe, as do many, that the brain needs time to reorganize itself relative to
periods of treatment. To test out this assumption I decided to suspend neurotherapy for three
months. I did a Q prior to this no treatment period and another one post. The pre no
treatment QEEG was also the post Q for the coherence training sited above. I therefore had a
measure of the results of that treatment as well as a pre measurement for the no treatment.

The pre and post QEEG data have been analyzed utilizing Dr. Thatcher and Hudspeth’s
databases. The NeuroGuide TBI Discriminant Analysis score and index were used as well as
Dr. Hudspeth’s Intrahemispheric and Subcortical percentile connectivity maps.

When looking at the NeuroGuide TBI Discriminant Score there is improvement from pre (0.68) to post (1.04).

The Probability Index shows similar improvement of nearly a 50% decrease.

Hudspeth connectivity database was used to guide the last series of treatments David had.

Below is a comparison of pre and post data. The most significant gains were made in the delta range, which was the target frequency prior to the three months of no treatment. The pre map indicates significant hypo-connectivity, particularly in the delta range both cortically and sub cortically.

Significant improvement is observed in the post map. The electrode placement was in the left
hemisphere and one can see clearly the map shows percentile changes. The gains are not only
in the delta range but also in the theta range.

The data presented here indicate that neurological change has in fact taken place during the
period of time when David was not receiving any treatment. The soft data is also impressive.
He is now better able to sequence tasks and organize his time. He continues to be more social
and has increased bowel control. He’s able to plan for future events. His ability to participate
in his treatment is normal. The hard and soft data would seem to indicate that reorganization
was taking place during the three-month period of no treatment.

The research in the area of severe TBI is extremely limited and therefore there are very few
clinical guidelines. Although this paper is a case study, it is an attempt to offer some direction
and treatment guidelines. An assumption could be made that periods of no treatment can be an
important part of the treatment of severe TBI. This study will be repeated in six months.


Casagrande,Vivien A., and Amy Wiencken-Barger.“Developmental plasticity in the
mammalian visual system.” In The Mutable Brain: Dynamic and Plastic Features of the
Developing and Mature Brain, edited by Jon H. Kaas.Singapore: Harwood Academic
Publishers, 2001.

Kandel,Eric R.,James, H.Schartz, and Thomas M. Jessell. Principles of Neural Science 4th ed.
New York: McGraw-Hill,2000.

William Collins