Patent Publication Number: US-2021161926-A1

Title: Methods for Treatment of Brain Injury and Brain Dysfunction

Description:
FIELD OF THE INVENTION 
     The present disclosure relates to the field of medical treatment of brain illnesses, diseases, disorders and injuries. In particular, the present disclosure relates to compositions and methods for treatment of brain illnesses, diseases, and disorders, including conditions such as multiple sclerosis and post-traumatic stress disorder. Further, the present disclosure relates to compositions and methods for treatment of brain injuries, such as concussions. 
     BACKGROUND TO THE INVENTION 
     Brain injuries and brain dysfunction due to brain illness, diseases and disorders cause a great deal of suffering to affected patients, as well as their families and friends. Brain injuries commonly occur due to a swift impact to or sudden forceful motion of the head. Brain dysfunction due to brain illness, diseases and disorders can have many causes including prior brain injuries, genetic causes and environmental causes. 
     Treatment for brain injuries and brain dysfunction are wide ranging, but can be invasive, expensive, ineffective, and/or associated with adverse side effects. There remains a need in the art for treatments which are less invasive, financially accessible, effective and relatively free of side effects. 
     Brain injuries and brain dysfunction are associated with abnormal release of neurotransmitters as well as abnormal neuronal ion fluxes. More research is needed to fully understand the wide range of implications for brain biochemistry due to brain injuries and brain dysfunction. While much is not understood about neurometabolism, it is understood that the systems and processes involved in fueling the brain are highly complex and interdependent. Much like the peripheral nervous system, the brain has a great range of backstop measures to ensure that a consistent supply of fuel is always available. 
     The primary source of fuel for the brain is glucose (d), also known as dextrose. In recent studies, growing consensus in the scientific community indicates lactate as an additional substrate for brain metabolism. Ketones have also been widely studied as a source of neurobioenergetics. 
     Despite all the interest and investigation into the effects of brain injuries and brain dysfunction on neurometabolism, the identification, diagnosis, and treatment of brain injuries and brain dysfunction continues to be imprecise, inaccurate, and ineffective in many cases. Consequently, many brain injuries and brain dysfunctions are undetected, undiagnosed and/or inadequately treated. 
     Thus, there remains a need in the art for compositions and methods for effective treatment of traumatic brain injuries and brain dysfunction, including the symptoms associated with these conditions. 
     SUMMARY OF THE INVENTION 
     Methods are disclosed for treating a patient experiencing a traumatic brain injury and/or brain dysfunction by administering to the patient a course of treatment comprising administration of at least one dose of dextrose. 
     In one aspect, a method is disclosed for treating traumatic brain injury, multiple sclerosis, or post-traumatic stress disorder comprising administering to a patient in need thereof a number of separate doses of dextrose in one day, wherein the number is selected from the group consisting of one, two, three, four, five and six separate doses of dextrose, further wherein each separate dose of dextrose comprises at least 10 grams of dextrose. 
     In another aspect, a method is disclosed for treating traumatic brain injury, multiple sclerosis, or post-traumatic stress disorder wherein the administration of dextrose is repeated over a course of treatment lasting at least 2 days, wherein the number of separate doses of dextrose administered on any one day of the course of treatment is selected independent of the number of separate doses of dextrose administered on any other day of the course of treatment and wherein the amount of dextrose comprised per separate dose is selected independent of the amount of dextrose comprised in any other separate dose administered during the course of treatment. In one aspect, over the course of treatment enough dextrose is administered to the patient to provide for cerebrospinal fluid levels of dextrose in the range of 45 to 80 mg/deciliter. In another aspect, the course of treatment lasts for N weeks, wherein N=1 to 52, further wherein N is not limited to a whole number. 
     In some embodiments, each dose of dextrose administered to a patient experiencing a brain injury or brain dysfunction comprises between 10 and 300 grams of dextrose per dose. 
     In some embodiments, each dose of dextrose administered to a patient experiencing a brain injury or brain dysfunction comprises between 20 and 30 grams of dextrose per dose. 
     In one aspect, the number of separate doses of dextrose administered to a patient experiencing a brain injury or brain dysfunction in one day is three or four. 
     In another aspect, the number of separate doses of dextrose administered to a patient experiencing a brain injury or brain dysfunction in one day is one or two. 
     In some embodiments, the separate doses of dextrose administered to a patient experiencing a brain injury or brain dysfunction comprise purified dextrose. 
     In some embodiments, each of the separate doses of dextrose administered to a patient experiencing a brain injury or brain dysfunction is administered orally. The orally administered dose can be in a dosage form selected from the group consisting of a liquid, a solid, a gel, a semisolid and a combination thereof. When the dosage form is a solid, the dosage form can be selected from the group consisting of a tablet, a capsule, a powder, a solid crystal and a combination thereof. 
     In some embodiments, each of the separate doses of dextrose administered to a patient experiencing a brain injury or brain dysfunction is administered intranasally. The intranasally administered dose can be in a dosage form selected from the group consisting of a liquid, a solid, a semisolid and a combination thereof. 
     In one aspect, the traumatic brain injury treated with dextrose is selected from the group consisting of concussion without loss of consciousness, concussion with loss of consciousness, post-concussion syndrome, mild traumatic brain injury, diffuse traumatic brain injury without loss of consciousness, diffuse traumatic brain injury with loss of consciousness, chronic traumatic encephalopathy, focal traumatic brain injury without loss of consciousness and focal traumatic brain injury with loss of consciousness. In a further aspect, the patient having the traumatic brain injury has been diagnosed as having experienced a concussion within 5 days of first administration of dextrose. In another aspect, the patient having the traumatic brain injury has been diagnosed as having experienced a concussion within 24 hours of first administration of dextrose. 
     In another aspect, the patient experiencing a brain injury or brain dysfunction 
     The following numbered paragraphs [0021]-[0040] contain statements of broad combinations of the inventive technical features herein disclosed: 
     1. A method for treating traumatic brain injury comprising administering to a patient in need thereof a number of separate doses of dextrose in one day, wherein the number is selected from the group consisting of one, two, three, four, five and six separate doses of dextrose, further wherein each separate dose of dextrose comprises at least 10 grams of dextrose. 
     2. The method of claim  1 , wherein the administration of dextrose is repeated over a course of treatment lasting at least 2 days, wherein the number of separate doses of dextrose administered on any one day of the course of treatment is selected independent of the number of separate doses of dextrose administered on any other day of the course of treatment and wherein the amount of dextrose comprised per separate dose is selected independent of the amount of dextrose comprised in any other separate dose administered during the course of treatment. 
     3. The method of clam 1, wherein each dose of dextrose comprises between 10 and 300 grams of dextrose per dose. 
     4. The method of clam 1, wherein each dose of dextrose comprises between 20 and 30 grams of dextrose per dose. 
     5. The method of claim  1 , wherein the number of separate doses of dextrose in one day is three or four. 
     6. The method of claim  1 , wherein the number of separate doses of dextrose in one day is one or two. 
     7. The method of claim  1 , wherein the separate doses of dextrose comprise purified dextrose. 
     8. The method of claim  1 , wherein each of the separate doses of dextrose is administered orally. 
     9. The method of claim  8 , wherein each of the separate doses of dextrose is in a dosage form selected from the group consisting of a liquid, a solid, a gel, a semisolid and a combination thereof. 
     10. The method of claim  9 , wherein the dosage form is solid and selected from the group consisting of a tablet, a capsule, a powder, a solid crystal and a combination thereof. 
     11. The method of claim  2 , wherein enough dextrose is administered to the patient to provide for cerebrospinal fluid levels of dextrose in the range of 45 to 80 mg/decilitre. 
     12. The method of claim  1 , wherein each of the separate doses of dextrose is administered intranasally. 
     13. The method of claim  12 , wherein each of the separate doses of dextrose is in a dosage form selected from the group consisting of a liquid, a solid, a semisolid and a combination thereof. 
     14. The method of claim  1 , wherein the traumatic brain injury is selected from the group consisting of concussion without loss of consciousness, concussion with loss of consciousness, post-concussion syndrome, mild traumatic brain injury, diffuse traumatic brain injury without loss of consciousness, diffuse traumatic brain injury with loss of consciousness, chronic traumatic encephalopathy, focal traumatic brain injury without loss of consciousness and focal traumatic brain injury with loss of consciousness. 
     15. The method of claim  1 , wherein the patient has been diagnosed as having experienced the traumatic brain injury within 5 days of first administration of dextrose. 
     16. The method of claim  1 , wherein the patient has been diagnosed as having experienced a concussion within 5 days of first administration of dextrose. 
     17. The method of claim  1 , wherein the patient has been diagnosed as having experienced a concussion within 24 hours of first administration of dextrose. 
     18. The method of claim  2 , wherein the course of treatment lasts for N weeks, wherein N=1 to 52, further wherein N is not limited to a whole number. 
     19. A method for treating multiple sclerosis comprising administering to a patient in need thereof a number of separate doses of dextrose in one day, wherein the number is selected from the group consisting of one, two, three, four, five and six separate doses of dextrose, further wherein each separate dose of dextrose comprises at least 10 grams of dextrose. 
     20. A method for treating post-traumatic stress disorder comprising administering to a patient in need thereof a number of separate doses of dextrose in one day, wherein the number is selected from the group consisting of one, two, three, four, five and six separate doses of dextrose, further wherein each separate dose of dextrose comprises at least 10 grams of dextrose. 
    
    
     DETAILED DESCRIPTION 
     Reference will now be made in detail to representative embodiments of the invention. While the invention will be described in conjunction with the enumerated embodiments, it will be understood that the invention is not intended to be limited to those embodiments. On the contrary, the invention is intended to cover all alternatives, modifications, and equivalents that may be included within the scope of the present invention as defined by the claims. 
     Unless defined otherwise, technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art(s) to which this invention belongs. Although any methods, devices, and materials similar or equivalent to those described herein can be used in the practice or testing of the invention, the preferred methods, devices and materials are now described. 
     All documents, or portions of documents, cited in this application, including but not limited to patents, patent applications, articles, books, and treatises, are hereby expressly incorporated by reference in their entirety. 
     As used herein, “a” or “an” may mean one or more than one of an item. 
     As used herein, “about” may mean up to and including plus or minus five percent, for example, about 100 may mean 95 and up to 105. 
     As used herein, “administer”, “administering” and “administration” are used interchangeably to include administration of dextrose by any route of administration. Providing a patient dextrose with instructions for self-administration is also considered administration of dextrose by the prescriber. 
     As used herein, “brain dysfunction” or “brain disorder” means any and all conditions categorized and coded/or in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (also referred to as the DSM-5). 
     As used herein, “course of treatment” means a period of continual treatment with dextrose, sometimes with variable dosage. The course of treatment may be considered to continue, even if dextrose is not administered on one or more days, as long as dextrose is subsequently administered within a week. 
     As used herein, “dextrose” means the D-isomer of glucose. Dextrose and glucose (d) are used interchangeably herein. Dextrose may be administered in a purified, substantially purified or unpurified form. 
     As used herein, “dose” or “dosage” means the amount of dextrose to be given. 
     As used herein, “route of administration” means the path by which the dextrose is taken into the body. Routes of administration include, but are not limited to, oral administration, intravenous delivery, and intranasal administration. 
     As used herein, “traumatic brain injury” or “brain injury” means any physical injury to the brain, including those resulting from one or more episodes of acute force to the head. The terms “traumatic brain injury” or “brain injury” include concussions. Concussion can include loss of consciousness or no loss of consciousness. The terms “traumatic brain injury” or “brain injury” include but are not limited to conditions which may occur later in time than the experience of force to the head, such as post-concussion syndrome and chronic traumatic encephalopathy. 
     The present disclosure describes the use of dextrose as a treatment for concussions, other traumatic brain injuries, and a wide range of brain disorders, illnesses, and mental illness. Further, dextrose treats many of the most troubling and persistent symptoms of concussions, traumatic brain injuries, and other brain disorders/mental illnesses. 
     Dextrose is commercially available without a prescription and is sold in a variety of dosage forms. Routes of administration of dextrose include, but are not limited to, oral administration, intravenous delivery, and intranasal administration. Oral dosage forms include, but are not limited to, dextrose tablets, dextrose gel, dextrose drinks, as well as bulk dextrose powdered products and dextrose beverages. 
     Dextrose is a naturally occurring monosaccharide. Naturally occurring monosaccharides include not only dextrose but also fructose, galactose, mannose, ribose and deoxyribose to name just a few. Dextrose is catabolized from disaccharides and polysaccharides through hydrolysis and can be obtained in limited amounts via more complex nutrition in a normal diet. However, dietary sources of dextrose are inadequate to provide the levels of dextrose necessary for the methods of treatment of the present disclosure. 
     It has been found through clinical study that there is a Dextrose Limiting Factor (DLF) and/or a Dextrose Regulating Factor (DRF) that emerges following concussive and traumatic brain injuries. This finding is supported by neuropsychological, vestibular, balance, and clinical report data that substantiate deficits in memory, visual-spatial, balance, visual, language, attentional, physical, emotional and psychological functioning following concussive and traumatic brain injuries, along with rapid elimination of concussive symptoms (headache, tinnitus, visual problems, pressure in the head and nasal cavities, anxiety, depression, anger, light sensitivity, etc.) following administration of doses of dextrose. 
     The dose of dextrose administered may be a little as about 10 grams per dose or as much as about 300 grams per dose, including all dosage amounts between 10 grams and 300 grams. Thus, each individual dosage of dextrose can be, while not limited to, about 10 grams, 15 grams, 20 grams, 25 grams, 30 grams, 35 grams, 40 grams, 45 grams, 50 grams, 55 grams, 60 grams, 70 grams 80 grams, 90 grams, 100 grams, 150 grams, 200 grams, 250 grams and 300 grams of dextrose. 
     The number of separate doses of dextrose administered in one day to a patient in need thereof can be one, two, three, four, five, six, seven, eight, nine or ten doses of dextrose. 
     The course of dextrose treatment can be one or more days. The course of dextrose treatment can last for N weeks, wherein N=1 to 52, wherein N is not limited to whole numbers. During the course of treatment, one or more days can pass without a patient receiving dextrose administration wherein the course or treatment is still considered to continue and include the subsequent administration of dextrose. The amount and frequency of dextrose administration can vary from day to day during the course of treatment. 
     While not wishing to be limited to any mechanism of action, it is believed that the brain injury or disorder may limit or regulate dextrose or dextrose uptake into cerebral tissue (e.g. cerebral spinal fluid, interstitial brain fluid and ventricular spaces), possibly causing neuronal hyperglycolyisis, which the administration of dextrose effectively treats. 
     A normal diet does not provide dextrose in sufficient amounts, or via the necessary pathways, to resolve the symptoms that are identified with concussive or traumatic brain injuries and brain disorders. 
     Individuals who have suffered concussive or traumatic brain injuries who are eating normal or even high-sugar diets continue to have symptoms related to concussions on neuropsychological assessment and balance, vestibular, and vision testing. 
     Individuals who have taken dextrose in tablet or liquid form, in addition to normal diet, have had statistically-significant improvement on follow-up neuropsychological testing. 
     For the DRF and/or DLF there is an inverted ratio of dextrose CSF and serum levels after injury. Current literature indicates a 0.6 ratio of CSF dextrose to serum in healthy individuals. This equates to CSF dextrose levels in the range of 45-80 mg/dL depending on peripheral serum levels. After neuronal damage during concussive force injuries the resulting cerebral hyperglycolyotic process reduces this ratio dramatically, to as low as 0.1-0.2. 
     Due to the efficiency of the body&#39;s insulin system, normal dietary intake of carbohydrates and complex sugars appears to be inadequate to drive serum blood sugar levels high enough to supply the brain with sufficient fuel after a lowered dextrose CSF/serum ratio. With an apparent limiting or regulation mechanism of cerebral dextrose, this ratio may be kept exceptionally low until adequate dextrose levels return to the brain and a resulting “reset” of normal dextrose uptake can be resumed. It is also important to note that the current medical knowledge base is highly limited when referring to dextrose transport to the brain. Careful consideration must be followed as undefined mechanisms may be present in dextrose transport within the brain and cerebral dextrose levels may be dramatically different between cerebral spinal fluid, brain interstitial fluid and any ventricular spaces. Types of dextrose transport between these areas are still yet to be discovered. 
     During head injury a significant cascade of neurochemical reactions takes place within the brain. During brain injury, whether impact or concussive inertial force, the brain, at a cellular level, undergoes a stretching and compression of neurons. This force “squeezes” neurotransmitters into the synaptic cleft and thus causes a systemic cascade of neuro reaction. This neuro reaction ultimately depolarizes the function of the brain. 
     The term commonly used to define a neuropathophysiological cascade resulting in depletion of sugar is hyperglycolysis, or the result of cellular energy demands in direct response to ionic fluxes. The result of hyperglycolysis is an arrested neuro-bioentergetic, fuelling system due to the exhaustion of available fuel. 
     The arrested neuro fuelling system creates long term covert and overt biological signs and symptoms due to a dynamic state of functional defueling within the brain. The brain elects to operate only the most important functions in any given time frame depending on external loads and stressors to compensate for the lack of adequate fuel to supply all energy demands. This accounts for most, if not all signs and symptoms of mTbi or concussion. This dynamic defueling is the bedrock of most brain conditions. As the brain automates function, defueled systems become the norm and are permanently arrested, causing a wide range of compensatory mal-adaptations that present as brain disease or dysfunction. 
     The brain fuels primarily on glucose (d), or more specifically dextrose. Glucose (d) is defined as a monosaccharide and is recognized in two forms, glucose (d) and glucose (L). As the body and brain cannot metabolize glucose (L), also known as cellulose, glucose (d) (i.e. dextrose) is understood to be a building block of neuro bioenergetics. Dextrose can be catabolized from more complex carbohydrates or sugars. This metabolic mechanism however is an expensive biological step and time consuming. With too great a latency period during this metabolism, pancreatic response produces an insulin reaction which shuttles most dextrose to the core or peripheral system where it is stored as glycogen rather than crossing the blood-brain barrier and fuelling the brain. 
     The clinical research underlying the present disclosure has found that oral administration of dextrose in appropriate therapeutic doses relieves all symptoms and signs of concussion. The administration of dextrose also has positive effects on a range of other brain injuries and brain dysfunctions as well. 
     Dextrose has been found to be useful in the treatment of a variety of brain injuries and dysfunctions, including but not limited to, multiple sclerosis, GluT1 deficiency syndrome, seizure control, chronic traumatic encephalopathy, vision and vestibular dysfunction, delayed and immediate recall mechanisms, attention, depression, anxiety, appetite control, sleep disturbances, and addictions. 
     In particular, dextrose is an effective treatment for mood disorders, including but not limited to, bipolar disorder type I, bipolar disorder type II, major depressive disorder, cyclothymia, dysthymia. Symptoms treated by dextrose for bipolar disorder types I and II and cyclothymia: manic symptoms, depressive symptoms, mood swings, anger, irritability frequency, intensity, and duration are all reduced by dextrose treatment as measured by performance on objective psychometric testing, clinician observation, and self and other report. Symptoms treated by dextrose for major depressive disorder and dysthymia: depressive symptoms, suicidal ideation, feelings of guilt, lack of energy, lack of motivation, appetite disruption frequency, intensity, and duration are all reduced by dextrose treatment as measured by performance on objective psychometric testing, clinician observation, and self-report. 
     Further, in particular, dextrose is an effective treatment for anxiety disorders, including but not limited to, generalized anxiety disorder, social anxiety disorder, separation anxiety disorder, panic disorder, and agoraphobia. Symptoms treated by dextrose for generalized anxiety disorder: anxiety, irritability, and avoidant behaviors have frequency, intensity, and duration all reduced by dextrose treatment as measured by performance on objective psychometric testing, clinician observation, and self and other report. Symptoms treated for social anxiety disorder, separation anxiety disorder, and agoraphobia: anxiety, irritability, avoidance of others, clinging to others, avoidance of public places have frequency, intensity, and duration are all reduced by dextrose treatment as measured by objective psychometric testing, clinician observation, and self and other report. Symptoms treated for panic disorder: panic attacks, avoidant behaviors, sleep difficulty have reduced frequency, intensity, and duration by dextrose treatment as measured by performance on objective psychometric testing, clinician observation, and self and other report. 
     In another aspect, dextrose is an effective treatment for seizure disorder/epilepsy. Symptoms treated by dextrose include seizure frequency, intensity, and duration which are reduced by dextrose treatment as measured by performance on objective psychometric testing, EEG results, clinician observation, and self and other report. 
     In another aspect, dextrose is an effective treatment for diabetes, including Type I, Type II and pre-diabetes. Symptoms treated by dextrose include elevated blood sugars, which are reduced by dextrose treatment as measured by blood glucometer, AIC tests, clinician observation, and self and other report. 
     In another aspect, dextrose is an effective treatment for dementias, including but not limited to, major neurocognitive disorder, minor neurocognitive disorder, Alzheimer&#39;s dementia, vascular dementia, dementia with Lewy bodies, and frontotemporal dementia. Symptoms treated by dextrose for all dementias included reduced frequency, intensity, and duration of memory difficulty, headaches, impulsivity, poor judgment, aphasias, ataxias, apraxias as measured by neuropsychological testing, clinician observation, and self and other report. 
     Dextrose is successful in treating these conditions because of its simplistic chemical form requiring no metabolic reaction to render it useful. Dextrose enters the glycolytic pathway immediately with no other anabolic or catabolic reaction being necessary. Outcome data indicates the introduction of dextrose provides a much needed energy supplement to brain metabolism, and helps “jump start” the neuro bioenergetic system back into primary fuelling mechanisms and away from automated secondary and tertiary fuelling systems. As full functional operation of the brain returns and compensatory mechanisms are reduced, signs and symptoms resolve. 
     The treatment of the above-listed conditions consists of the following steps: self-administration of dextrose 2-4 times per day and clinician monitoring and adjusting of the dose to ensure adequate dextrose levels are attained in the brain. For some of the conditions listed above, such as anxiety disorders, depressive disorders, concussive disorders, addictive disorders, psychotic disorders, etc., cognitive-behavioural therapy administered 2-4 times per month also promotes recovery from the conditions. Finally, visual, vestibular, attention, and memory drills are utilized in some cases to enhance recovery. The essential treatment for all conditions, however, is the dextrose treatment. 
     EXAMPLES 
     The following examples are provided for illustrative purposes only and are not intended to limit the scope of the invention as defined by the appended claims. All examples described herein were carried out using standard techniques, which are well known and routine to those of skill in the art. 
     Example 1 
     Diagnosis: Chronic Traumatic Encephalopathy 
     68 year-old male. History of 20+ concussions and/or traumatic brain injuries. Neuropsychological test scores all at or below the 1 st  percentile at time of first appointment. Headache, head pressure, balance, dizziness, anger, anxiety, depression all at 90 th  percentile or higher at time of first appointment. Began with 20 grams of glucose (d) on initial appointment. This dose reduced all symptoms to below the 50 th  percentile during initial appointment. Recommended increasing dose that day to 50 grams, 3 times per day. That dose reduced symptoms to 20 th  percentile after 1 week. Increased dose to 100 grams 4 times per day. That dose eliminated all headaches, head pressure, with return of ability to “multi-task, no longer needing to hold on to the walls in the shower, and no more symptoms.” Neuropsychological test scores all at or above the 70 th  percentile at conclusion of treatment. Headache, head pressure, balance, dizziness, anger, anxiety, and depression all resolved at conclusion of treatment. Glucose (d) discontinued. 
     Example 2 
     Diagnosis: Post-Concussion Syndrome 
     17 year-old female. History of 3 identified concussions; most recent concussion 12 months prior to first appointment. Cumulative high school GPA: 4.3. Currently failing classes. Neuropsychological test scores ranged from 27 th  percentile to 84 th  percentile. Headache, tinnitus, light sensitivity, anxiety, depression ranged from 50 th  to 90 th  percentile at time of first appointment. Began with 12 grams of glucose (d) on initial appointment and all symptoms reduced to below the 20 th  percentile by the end of the initial appointment. Did not take glucose (d) for the 3 days until next appointment. At that appointment anxiety in the 70 th  percentile and depression in the 90 th  percentile; headache, tinnitus, light sensitivity all above the 50 th  percentile. Increased glucose (d) dose to 28 grams at time of appointment and all symptoms disappeared. Continued taking glucose (d) for 3 months at 28 grams 3 times per day. All symptoms continued to be resolved with no depression, anxiety, headache, tinnitus, or light sensitivity. Neuropsychological test scores ranged from 75 th  percentile to 93 rd  percentile at conclusion of treatment. Glucose (d) discontinued at conclusion of treatment with no return of symptoms. 
     Example 3 
     Diagnosis: Concussion without Loss of Consciousness 
     17 year-old male. Treatment after concussion with a history of 1 prior concussion. Neuropsychological test scores ranged from 4 th  percentile to the 41s t  percentile. Symptoms included headache, light sensitivity, tinnitus, difficulty paying attention at 80 th  percentile at time of initial appointment. Began with 16 grams of glucose (d) at initial appointment that eliminated all symptoms by the end of the initial appointment. Recommended to take 16 grams 3 times per day until next appointment. At time of second appointment headache, head pressure, tinnitus, remained at 20 th  to 30 th  percentile. Glucose (d) dose recommended to increase to amount needed to eliminate all symptoms. Achieved elimination of symptoms at 80 grams of glucose (d) per dose, 4 times per day. Concluded treatment after 3 months and glucose (d) discontinued. All symptoms resolved. Neuropsychological test scores ranged from the 55 th  to the 77 th  percentile. 
     Example 4 
     Diagnosis: Major Depressive Disorder, PTSD 
     64 year-old male. History of depressive episodes throughout his lifetime. Depression rated at 60 th  percentile at time of initial appointment. History of rocket and gun attacks in Afghanistan during State Department missions. Anxiety, sleep disruption at 50 th  percentile at time of initial appointment. Began with 20 grams of glucose (d) at initial appointment. Depression and anxiety reduced to 10 th  percentile by the end of appointment. Recommended 40 grams of glucose (d) 4 times per day. Continued at that dose with no further symptoms of depression or anxiety for 4 months. Depression, anxiety, sleep problems eliminated at conclusion of treatment. Glucose (d) discontinued at that time. 
     Example 5 
     Diagnosis: Post-Concussion Syndrome, Suspected Chronic Traumatic Encephalopathy 
     41 year-old male. History of “dozens of concussions.” Neuropsychological test scores ranged from the 1 st  percentile to the 25 th  percentile. Depression, anxiety, tinnitus, head pressure, memory problems, sleep difficulty, and anger all rated at the 80 th  percentile or higher. Began with 40 grams of glucose (d) at initial appointment, which reduced all symptoms down to the 20 th  percentile or lower by the conclusion of the initial appointment. Recommended dose of 100 grams of glucose (d) 4) times per day by the third appointment. This dose maintained symptoms at or below the 20 th  percentile. Dose increased to 160 grams 4 times per day by the fourth appointment, which eliminated all symptoms. Treatment concluded after 5 months with no return of symptoms. Glucose (d) discontinued apart from occasional 40 to 50 gram one-time administration during times of high stress. Neuropsychological test scores ranged from 50 th  to 78 th  percentile at time of discharge from treatment. 
     Example 6 
     Diagnosis: Concussion with LOC, Suspected Chronic Traumatic Encephalopathy 
     63 year-old female. Immediate reason for referral was motor vehicle accident with concussion with loss of consciousness. Neuropsychological test scores at the time of initial appointment were artificially elevated due to her familiarity with neuropsychological testing as a result of her career as a rehabilitation/occupational therapy specialist and having given neuropsychological screening instruments to many of her patients. Her neuropsychological test scores ranged from the 16 th  percentile (despite specific familiarity with this task) to the 92 nd  percentile. Depression, anxiety, headache, head pressure, mental “fogginess”, memory problems, “word-finding” difficulty, anger, balance problems all rated at the 80 th  percentile or higher at the time of initial appointment. Began with 60 grams of glucose (d) at initial appointment, which reduced all symptoms to 30 th  percentile or lower during initial appointment. Recommended dose of 100 grams 4 times per day at conclusion of initial appointment. At second appointment she reported that this dose reduced symptoms to the 30 th  or 40 th  percentile or lower. Recommended dose increase to 160 grams 4 times per day. At third appointment she reported this dose reduced symptoms consistently to 20 th  percentile or lower, with some intermittent higher intensity of symptoms. By 5 th  appointment she was taking between 200 and 240 grams 4 times per day, which eliminated all symptoms. She continued on this dose for 5 months, at which time all symptoms had been eliminated for a month and she discontinued use of glucose (d) apart from occasional doses of 20 to 40 grams during times of high stress. Neuropsychological test scores at the time of completion of treatment ranged from the 84 th  to the 97 th  percentile. 
     Example 7 
     Diagnosis: Chronic Traumatic Encephalopathy 
     39 year-old male. History of “more than 50 fights with light flashes or dark spots in vision;” motor vehicle accident at 100-120 mph, which resulted in 30-day medically induced coma; incarceration in Department of Corrections for 3 years with multiple more fights resulting in concussion. Neuropsychological test scores at initial appointment ranged from 0.1 of the 1 st  percentile to the 27 th  percentile. Headache, head pressure, tinnitus, mental “fogginess,” anger, anxiety, depression, “word finding difficulty,” memory, dizziness, balance problems all rated at the 90 th  percentile or higher at the initial appointment. Began with 160 grams of glucose (d), which eliminated all symptoms by the conclusion of the initial appointment. Has been taking 160-240 grams of glucose (d) 4 times per day, with no return of symptoms, for three weeks. Treatment is continuing. 
     Example 8 
     Table 1 provides the results of dextrose treatment of patients with the following ages, genders, primary diagnoses, and comorbid diagnoses. Pre-RBANs Total refers to the pre-treatment patient score on the Repeatable Battery for the Assessment of Neuropsychological States (RBANS) as described in Duff, K., Hobson, V. L., Beglinger, L. J, O&#39;Bryant, S. E. (2010). Diagnostic Accuracy of the RBANS in Mild cognitive impairment: Limitations on Assessing Milder Impairments. Archives in Clinical Neuropsychology, 25 (5), 429-441. Similarly, Post-RBANs Total refers to the post-treatment patient score for the same patient. The Hamilton score refers to the score on the Hamilton Anxiety Rating Scale as described in Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol 1959; 32:50-55. The Beck score refers to the score on the Beck Depression Inventory. The majority of Hamilton Anxiety Rating Scale and Beck Depression Inventory scores were for assessment purposes at the beginning of treatment. For the treatment length specified, dextrose treatment was administered at a dosage range of 24 to 100 grams per dose and dosages of dextrose were administered 4 times per day for 7 days each week. 
     
       
         
           
               
               
               
               
               
               
               
               
               
               
             
               
                 TABLE 1 
               
               
                   
               
               
                 Length of 
                   
                   
                 Primary 
                 Comorbid 
                 Pre-RBANS 
                 Post-RBANS 
                 Beck 
                 Hamilton 
                   
               
               
                 Treatment 
                 AGE 
                 Gender 
                 Diagnosis 
                 Diagnoses 
                 TOTAL 
                 TOTAL 
                 Score 
                 Score 
                 Comments 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
               
               
               
               
               
               
               
               
            
               
                 8 
                 56.00 
                 F 
                 Concussion 
                 Chronic Post- 
                 90 
                 119 
                 5 
                 11 
                 Post-Concussive 
               
               
                 months 
                   
                   
                 w/o LOC 
                 concussion 
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                   
                 Headache, 
                   
                   
                   
                   
                 Significant increase 
               
               
                   
                   
                   
                   
                 Sleep Disturbance 
                   
                   
                   
                   
                 in Immediate/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Delayed Memory, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Visuospatial/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Constructional, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Language, and 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Attention abilities. 
               
               
                 10 
                 25.00 
                 F 
                 Concussion 
                 Sleep Disturbance, 
                 80 
                 80 
                 20 
                 27 
                 Post-Concussive 
               
               
                 months 
                   
                   
                 with LOC 
                 Chronic Post- 
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                   
                 concussive 
                   
                   
                   
                   
                 Significant increase 
               
               
                   
                   
                   
                   
                 Headache 
                   
                   
                   
                   
                 in Visuospatial/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Constructional, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Language and 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Delayed Memory 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Abilities. 
               
               
                 4 
                 22.00 
                 M 
                 Post- 
                 Depression 
                 88 
                 100 
                 N/A 
                 N/A 
                 Post-Concussive 
               
               
                 months 
                   
                   
                 Concussive 
                 and Anxiety 
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                 Syndrome 
                   
                   
                   
                   
                   
                 Significant increase 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 in Language abilities. 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Relational skills 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 impaired by concussive 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 injuries reported by 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 client to have 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 significantly improved. 
               
               
                 6 
                 33.00 
                 F 
                 Concussion 
                 Chronic Post- 
                 60 
                 86 
                 7 
                 0 
                 Post-Concussive 
               
               
                 months 
                   
                   
                 with LOC 
                 concussion 
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                   
                 Headache 
                   
                   
                   
                   
                 Significant increase 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 in Immediate/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Delayed Memory, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Language, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Visuospatial/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Constructional, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Language, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Attention abilities. 
               
               
                 8 
                 57.00 
                 F 
                 Concussion 
                 Sleep 
                 61 
                 92 
                 24 
                 20 
                 Post-Concussive 
               
               
                 months 
                   
                   
                 w/o LOC 
                 Disturbance 
                   
                   
                   
                   
                 &amp; Bipolar DO 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Significant increase 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 in Immediate/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Delayed Memory, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Visuospatial/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Constructional, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Language, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Attention abilities. 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Manic episodes 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 decreased from 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 2x per month 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 to none and 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 psychotropic 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 medications we 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 discontinued by 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 client&#39;s doctor at 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 client&#39;s request. 
               
               
                 7 
                 11.00 
                 M 
                 Concussion 
                 Chronic Post- 
                 102 
                 108 
                 4 
                 7.5 
                 Post-Concussion 
               
               
                 months 
                   
                   
                 w/o LOC 
                 concussion 
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                   
                 Headache 
                   
                   
                   
                   
                 Resolved issues 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 of inattention 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 and ADHD-like 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 symptoms via a 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 significant increase 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 in Immediate/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Delayed Memory 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 and Language 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 abilities. 
               
               
                 7 
                 13.00 
                 M 
                 Adjustment 
                 N/A 
                 81 
                 88 
                 3 
                 3 
                 Resolved issues 
               
               
                 months 
                   
                   
                 Disorder 
                   
                   
                   
                   
                   
                 with adjustment 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 disorder via a 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 significant increase 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 in Immediate/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Delayed Memory 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 and Visuospatial/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Constructional 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 abilities. 
               
               
                 7 
                 39.00 
                 F 
                 Concussion 
                 Depression 
                 91 
                 105 
                 N/A 
                 N/A 
                 Post-Concussion 
               
               
                 months 
                   
                   
                 with LOC 
                 and Anxiety 
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 resolved issues 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 of depression/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 anxiety and a 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 significant increase 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 in function of 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Visuospatial/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Constructional 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 abilities, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Language and 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Attention. 
               
               
                 5 
                 59.00 
                 F 
                 Concussion 
                 Chronic Post- 
                 98 
                 102 
                 4 
                 13 
                 Post-Concussion 
               
               
                 months 
                   
                   
                 w/o LOC 
                 concussion 
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                   
                 Headache 
                   
                   
                   
                   
                 resolved severe 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 depression and 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 PTSD symptoms and 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 a significant increase 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 in function of 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Visuospatial/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Constructional abilities. 
               
               
                 6 
                 57.00 
                 F 
                 Concussion 
                 Severe 
                 51 
                 95 
                 17 
                 25 
                 Post-Concussion 
               
               
                 months 
                   
                   
                 w/o LOC 
                 Depression 
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                   
                 and Anxiety 
                   
                   
                   
                   
                 Resolved depression/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 anxiety and a 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 significant reduction 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 in anxiety/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 depression via 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 increase in 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 functions of Memory 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 (immediate/delayed), 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Visuospatial/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Constructional deficits, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Language and 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Attention. 
               
               
                 7 
                 60.00 
                 M 
                 Concussion 
                 Depression 
                 96 
                 100 
                 20 
                 9 
                 Post-Concussion 
               
               
                 months 
                   
                   
                 w/o LOC 
                 and 
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                   
                 Inattention 
                   
                   
                   
                   
                 Resolved depression/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 anxiety and a 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 significant increase 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 in functions of Memory 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 (immediate/delayed) 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 and Visuospatial/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Constructional deficits 
               
               
                 5 
                 51.00 
                 M 
                 Concussion 
                 Sleep 
                 78 
                 89 
                 18 
                 12 
                 Post-Concussion 
               
               
                 months 
                   
                   
                 w/o LOC 
                 Disturbance 
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Resolved sleep 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 disturbance, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 depression/anxiety 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 and a significant 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 increase in 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 functions of Memory 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 (immediate/delayed), 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Visuospatial/Constructional 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 deficits, Object 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 identification/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Semantic Fluency. 
               
               
                 5 
                 15.00 
                 F 
                 Concussion 
                 Depression, 
                 92 
                 106 
                 5 
                 6 
                 Post-Concussion 
               
               
                 months 
                   
                   
                 with LOC, 
                 Inattention/ 
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                 Chronic Post- 
                 ADHD 
                   
                   
                   
                   
                 Significant increase 
               
               
                   
                   
                   
                 concussion 
                   
                   
                   
                   
                   
                 in functions 
               
               
                   
                   
                   
                 Headache 
                   
                   
                   
                   
                   
                 of Memory 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 (immediate/delayed), 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Language, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Visuospatial/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Constructional 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 deficits, Object 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 identification/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Semantic Fluency. 
               
               
                 7 
                 15.00 
                 F 
                 Post- 
                 Depression, 
                 87 
                 108 
                 18 
                 22 
                 Post-Concussion 
               
               
                 months 
                   
                   
                 Concussive 
                 Dyslexia, 
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                 Syndrome, 
                 Anxiety 
                   
                   
                   
                   
                 Significant increase 
               
               
                   
                   
                   
                 Chronic Post- 
                   
                   
                   
                   
                   
                 in functions 
               
               
                   
                   
                   
                 concussion 
                   
                   
                   
                   
                   
                 of Memory 
               
               
                   
                   
                   
                 Headache 
                   
                   
                   
                   
                   
                 (immediate/delayed), 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Visuospatial/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Constructional 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 deficits, Object 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 identification/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Semantic Fluency/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Attention. 
               
               
                 9 
                 30.00 
                 M 
                 Concussion 
                 Depression, 
                 54 
                 92 
                 21 
                 30 
                 Resolved 
               
               
                 months 
                   
                   
                 with LOC 
                 Anxiety, Panic 
                   
                   
                   
                   
                 depression and 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 anxiety (panic) 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 via significant 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 increase in 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 functions of Memory 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 (immediate/delayed), 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Visuospatial/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Constructional 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 deficits, Object 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 identification/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Semantic Fluency/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Attention. 
               
               
                 6 
                 64.00 
                 F 
                 Anxiety 
                 Depression 
                 80 
                 90 
                 6 
                 17 
                 Significant 
               
               
                 months 
                   
                   
                   
                   
                   
                   
                   
                   
                 reduction in 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 anxiety/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 depression via 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 increase in 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 functions of 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Memory 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 (immediate/delayed), 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Visuospatial/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Constructional 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 deficits, Object 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 identification/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Semantic Fluency/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Attention. 
               
               
                 3 
                 25.00 
                 M 
                 Concussion 
                 Sleep 
                 94 
                 101 
                 6 
                 5 
                 Post-Concussion 
               
               
                 months 
                   
                   
                 w/o LOC 
                 Disturbance 
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Resolved sleep 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 disturbance, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 increased functions 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 of Memory 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 (immediate) and 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Visuospatial/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Constructional abilities. 
               
               
                 7 
                 57.00 
                 M 
                 Concussion 
                 Depression, 
                 108 
                 111 
                 16 
                 27 
                 Post-Concussion 
               
               
                 months 
                   
                   
                 w/o LOC 
                 Anxiety, Sleep 
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                   
                 Disturbance 
                   
                   
                   
                   
                 Resolved sleep disturbance, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 depression/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 anxiety, tinnitus. 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Significantly 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 increased functions 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 of Memory 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 (immediate/delayed), 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Attention and 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Visuospatial/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Constructional abilities. 
               
               
                 5 
                 76.00 
                 F 
                 Concussion 
                 Diabetes 
                 63 
                   
                 18 
                 30 
                 Post-Concussion 
               
               
                 months 
                   
                   
                 with LOC 
                   
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Increased functions 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 of memory, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 eliminated headaches, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 sleep disturbance, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 increased irritability, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 depression and 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 anxiety. 
               
               
                 5.5 
                 18.00 
                 M 
                 Concussion 
                 N/A 
                 93 
                 95 
                 15 
                 22 
                 Post-Concussion 
               
               
                 months 
                   
                   
                 w/o LOC 
                   
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Increased functions 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 of Visuospatial/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Constructional 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 abilities and 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Language 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 (Semantic Fluency/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Attention). 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Greatly improved 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 symptoms of depression, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 anxiety, social 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 avoidance and 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 positive future 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 orientation. 
               
               
                 5 
                 34.00 
                 M 
                 Autism 
                 Post Chronic 
                 72 
                 85 
                 12 
                 45 
                 Post-Concussion 
               
               
                 months 
                   
                   
                   
                 Concussion 
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Significant improvement 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 with Immediate/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Delayed Memory, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Visuospatial/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Constructional, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 and Attention 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 abilities. 
               
               
                 9 
                 38.00 
                 M 
                 PTSD and 
                 Sleep 
                 63 
                 79 
                 26 
                 38 
                 Post-Concussion 
               
               
                 months 
                   
                   
                 Depression 
                 Disturbance 
                   
                   
                   
                   
                 Treatment: 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Increased functions 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 of Memory 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 (immediate/delayed), 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Visuospatial/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Constructional 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 deficits, Object 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 identification/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Semantic Fluency/ 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Attention. 
               
               
                   
                 17.00 
                 M 
                 Schizophrenia 
                 Post 
                   
                   
                   
                   
                 Eliminated psychotic 
               
               
                   
                   
                   
                   
                 Concussive 
                   
                   
                   
                   
                 symptoms, 
               
               
                   
                   
                   
                   
                 Syndrome 
                   
                   
                   
                   
                 increased 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 socialization, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 stopped 4 meds 
               
               
                   
                 21.00 
                 F 
                 Post 
                 Type I 
                   
                   
                   
                   
                 Insulin p blood 
               
               
                   
                   
                   
                 Concussion 
                 Diabetes 
                   
                   
                   
                   
                 sugar lowered 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 to low 100&#39;s 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 (100-110) on a 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 consistent basis. 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Less activation 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 of insulin p 
               
               
                   
                 56.00 
                 M 
                 Post 
                 Type II 
                   
                   
                   
                   
                 Blood Sugar 
               
               
                   
                   
                   
                 Concussion 
                 Diabetes and 
                   
                   
                   
                   
                 reduced from 
               
               
                   
                   
                   
                   
                 Chronic Pain 
                   
                   
                   
                   
                 250 to 120-130 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 consistently 
               
               
                   
                 15.00 
                 M 
                 Concussion 
                 Schizophrenia 
                   
                   
                   
                   
                 Eliminated 
               
               
                   
                   
                   
                 with LOC 
                   
                   
                   
                   
                   
                 psychotic 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 symptoms - 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 discontinued 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 antipsychotics 
               
               
                   
                 42.00 
                 M 
                 Autism 
                 Post 
                   
                   
                   
                   
                 RBANS 2-4 SD 
               
               
                   
                   
                   
                   
                 Concussive 
                   
                   
                   
                   
                 increase from 
               
               
                   
                   
                   
                   
                 Syndrome 
                   
                   
                   
                   
                 pre to post testing; 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 employed new; 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 increased since 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 interaction. 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 Has not completed 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 post RBANS 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 significantly 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 increased since 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 interaction. 
               
               
                   
                 21.00 
                 M 
                 Autism 
                 Post 
               
               
                   
                   
                   
                   
                 Concussive 
               
               
                   
                   
                   
                   
                 Syndrome 
               
               
                   
                 5.00 
                 M 
                 Autism 
                   
                   
                   
                   
                   
                 Reduced anxiety, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 eliminated 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 classroom problems, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 eliminated outbursts 
               
               
                   
                 3.00 
                 M 
                 Autism 
                   
                   
                   
                   
                   
                 Improved speech, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 decreased anxiety, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 reduced emotional 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 outbursts 
               
               
                   
                 19.00 
                 F 
                 Autism 
                   
                   
                   
                   
                   
                 Increased social 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 interaction, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 reduced anxiety, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 improved speech 
               
               
                   
                 63.00 
                 M 
                 Autism 
                   
                   
                   
                   
                   
                 Increased 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 socialization, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 improved memory, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 improved marriage 
               
               
                   
                 29.00 
                 M 
                 Compulsive 
                   
                   
                   
                   
                   
                 Eliminated use 
               
               
                   
                   
                   
                 Sexual 
                   
                   
                   
                   
                   
                 of pornography, 
               
               
                   
                   
                   
                 Behavior, 
                   
                   
                   
                   
                   
                 eliminated 
               
               
                   
                   
                   
                 Childhood 
                   
                   
                   
                   
                   
                 sexual acting 
               
               
                   
                   
                   
                 Sexual Abuse, 
                   
                   
                   
                   
                   
                 out 
               
               
                   
                   
                   
                 PTSD 
               
               
                   
                 18.00 
                 F 
                 Dissociative 
                   
                   
                   
                   
                   
                 Eliminated 
               
               
                   
                   
                   
                 Disorder, 
                   
                   
                   
                   
                   
                 dissociative 
               
               
                   
                   
                   
                 PTSD 
                   
                   
                   
                   
                   
                 episodes, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 eliminated 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 nightmares, 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 eliminated 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 PTSD symptoms 
               
               
                   
                 57.00 
                 M 
                 Migraine 
                   
                   
                   
                   
                   
                 Eliminated 
               
               
                   
                   
                   
                 Headaches 
                   
                   
                   
                   
                   
                 migraine 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 headaches 
               
               
                   
                 38.00 
                 F 
                 Migraine 
                   
                   
                   
                   
                   
                 Eliminated 
               
               
                   
                   
                   
                 Headaches 
                   
                   
                   
                   
                   
                 migraine 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 headaches 
               
               
                   
                 14.00 
                 M 
                 Migraine 
                   
                   
                   
                   
                   
                 Eliminated 
               
               
                   
                   
                   
                 Headaches 
                   
                   
                   
                   
                   
                 migraine 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 headaches 
               
               
                   
                 56.00 
                 F 
                 Migraine 
                   
                   
                   
                   
                   
                 Eliminated 
               
               
                   
                   
                   
                 Headaches 
                   
                   
                   
                   
                   
                 migraine 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 headaches 
               
               
                   
                 27.00 
                 M 
                 Migraine 
                   
                   
                   
                   
                   
                 Eliminated 
               
               
                   
                   
                   
                 Headaches 
                   
                   
                   
                   
                   
                 migraine 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 headaches