title: Novel integrative virtual rehabilitation reduces symptomatology of primary progressive aphasia--a case report.
abstract: OBJECTIVE
  BrightBrainer™ integrative cognitive rehabilitation system evaluation in an Adult Day Program by a subject with Primary Progressive Aphasia (PPA) assumed to be of the mixed nonfluent/logopenic variant, and for determination of potential benefits.
  
  
  METHODS
  The subject was a 51-year-old Caucasian male diagnosed with PPA who had attended an Adult Day Program for 18 months prior to BrightBrainer training. The subject interacted with therapeutic games using a controller that measured 3D hand movements and flexion of both index fingers. The computer simulations adapted difficulty level based on task performance; results were stored on a remote server. The clinical trial consisted of 16 sessions, twice/week for 8 weeks. The subject was evaluated through neuropsychological measures, therapy notes and caregiver feedback forms.
  
  
  RESULTS
  Neuropsychological testing indicated no depression (BDI 0) and severe dementia (BIMS 1 and MMSE 3). The 6.5 h of therapy consisted of games targeting Language comprehension; Executive functions; Focusing; Short-term memory; and Immediate/working memory. The subject attained the highest difficulty level in all-but-one game, while averaging 1300-arm task-oriented active movement repetitions and 320 index finger flexion movements per session. While neuropsychological testing showed no benefits, the caregiver reported strong improvements in verbal responses, vocabulary use, speaking in complete sentences, following one-step directions and participating in daily activities. This corroborated well with therapy notes.
  
  
  CONCLUSIONS
  Preliminary findings demonstrate a meaningful reduction of PPA symptoms for the subject, suggesting follow-up imaging studies to detail neuronal changes induced by BrightBrainer system and controlled studies with a sufficiently large number of PPA subjects.
authors.affiliation: a Bright Cloud International Corp , Highland Park, NJ, USA.
authors.forename: Grigore C
authors.initials: GC
authors.lastname: Burdea
authors.affiliation: a Bright Cloud International Corp , Highland Park, NJ, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Polistico
authors.affiliation: a Bright Cloud International Corp , Highland Park, NJ, USA.
authors.forename: Gregory P
authors.initials: GP
authors.lastname: House
authors.affiliation: a Bright Cloud International Corp , Highland Park, NJ, USA.
authors.forename: Richard R
authors.initials: RR
authors.lastname: Liu
authors.affiliation: b Francis E. Parker Memorial Home, Inc. , Piscataway, NJ, USA.
authors.forename: Roberto
authors.initials: R
authors.lastname: Muñiz
authors.affiliation: b Francis E. Parker Memorial Home, Inc. , Piscataway, NJ, USA.
authors.forename: Natalie A
authors.initials: NA
authors.lastname: Macaro
authors.affiliation: b Francis E. Parker Memorial Home, Inc. , Piscataway, NJ, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Slater
mesh_terms: D018888:Aphasia, Primary Progressive / Q000503:physiopathology* / Q000534:rehabilitation*; D056344:Executive Function; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D000069350:Telerehabilitation / Q000379:methods*; D016896:Treatment Outcome
keywords: BrightBrainer; bimanual game controller; caregiver feedback; primary progressive aphasia; virtual rehabilitation