Approach & Services
The Neurodiagnostic Institute (NDI) has designed an innovative approach to delivering the cognitive neurorehabilitative protocols developed by Dr. Lars Landers. These treatments were tested and refined in traditional facilities. While delivering services from a fixed location is easier on the provider, and we continue to offer this, it can prove logistically challenging for many potential patients who could significantly benefit from the treatments. It was with this realization that our team was inspired to shake up the industry with an innovative delivery mechanism as well.
In addition to practicing from NDI's fixed location, our system leverages specialized equipment that we pack and transport to facilitate accessible treatment sessions delivered in collaboration with a range of partner organizations. These 'off site' capabilities empower partner organizations to facilitate intensive two-week sessions that offer participants the opportunity to benefit from NDI's unique methodologies and experience, all without the burden of traveling to a distant clinic. An additional benefit is that these intensive sessions allow scheduling of up to 10 participants in each intensive program.
Our organizational partners can feel positive about their role in increasing accessibility of treatments to patients in need. For certain nonprofit partners they can also receive an anonymized summary report at the end of each session that can prove valuable when engaging with grantors and donors about the impact of their contributions.
Treatment Elements
Eve ry par ticipant goes through an intake and onboarding process that includes a range of subjective and objective outcome assessment tools that form a baseline clinical picture. This process provides guidance for the ideal treatment approach, specifically catered to individual needs. Additionally, these assessments form the baseline against which we compare future performance to understand improvement trends.
TREATMENT
NDI customizes treatment plans that address the needs of each Veteran
RECOVERY
Prioritizing Recovery from existing injuries, recent and long-standing
PERFORMANCE
Optimizing neurological function to accomplish specific cognitive goals
RESEARCH
Treating and tracking results with the intent of demonstrating effectiveness in the academic field
Subjective outcome Assessment Tools
Together, these subjective assessments provide a solid baseline against which we can track and compare change over time. Many of the symptoms on these scales are not present in the absence of either physical or neurodegenerative brain injur y, and all of them can be caused and exacerbated by neurological injur y.
POST CONCUSSION SYMPTOM SCALE (PCSS)
This tool is ve ry specific to neurological function changes that are typical after a head inju y, such as presence of headache, difficulty concentrating, changes in sleep patte ns, memo ry difficulty, and light/sound sensitivity. Each catego ry has a rating of 0 6 with 6 being considered severe. A person with no neurological inju ry should have a ver y low score, overall, and yet 88% our pa ticipants had moderate to severe ratings across multiple catego ies.
PITTSBURGH SLEEP QUALITY INDEX (PSQI)
This tool differentiates “poor ” from “good” sleep by assessing multiple components that come together to create good quality sleep, such as sleep duration, medications taken, snor ing, and incidents of bad dreams. This tends to be one of the most difficult assessment values to affect, but NDI does offer specific Sleep Reset Protocols which have been effective in improving sleep quality.
HAMILTON ANXIETY RATING SCALE (HAM-A)
This tool is used by the par ticipant to record their levels of anxiety in var ying situations. A score of 17 indicates mild sever ity, and 18 is considered moderate to severe. We find that a significant majority of our participants with a history of TBI have increased anxiety ratings.
PATIENT HEALTH QUESTIONNAIRE (PHQ-9)
This assessment of depression symptoms states that “moderate depression” star ts at a score of 10, and 40% of our par ticipants fall above that line. Again, brain injuries and even extreme stress often affect brain function, resulting in changes in emotional states and regulation.
DIZZINESS HANDICAP INVENTORY
This tool tracks physical stability in many different circumstances. Patients with a history of head injury typically have higher ratings in this category, however, this set of symptoms can reflect changes to neurological function without direct TBI, as well.
Objective Assessment Tools
Our team collects objective information about participants' brain performance and leverages it to precisely guide treatment protocols, exponentiating benefits.
INTERACTIVE METRONOME - lONG FORM ASSESSMENT
This test involves using a computer and a timing device to measure how quickly and accurately a person responds to different stimuli. It is a direct measure of brain health and quality of communication between functional brain areas, and between brain and body. Inability to accurately coordinate performance in these tasks can be indicative of functional change in the brain. After treatment this assessment will be repeated, and almost invar iably shows that improved per fo mance co rresponds to symptom reduction. This is simply a measure of a brain that per fo ms more optimally across multiple domains after treatment.
COMPUTERIZED STABILOMETRY (BALANCE) ASSESSMENT
Vestibular (balance coordination) health is almost always affected to some degree in the case of neurological inju y, and this was consistent in our pa ticipants. Using a computer to assess stability and balance is the best way to objectively capture this type of dysfunction after inju y, especially because most people can develop compensations to appear more stable. This provides another method of retraining the brain through stability challenges / therapies.
Treatment tools
We use neural timing as our fulcrum, getting the brain to increase neural connectivity through extreme intensity and repetition. Every action is a test with feedback and it’s also an opportunity to refine performance. Each 1-hour session aims to have participants perfom as many repetitions as possible.
INTERACTIVE METRONOME - TRAINING
Interactive Metronome serves as both an assesment tool, and a treatment tool. Treating with IM involves challenging the brain to perform tasks tens of thousands of times while providing feedback. This encourages the growth of neural connections.
PHOTOBIOMODULATION (PBM)
PBM transmits light on the near-infrared spectr um, in the fo rm of photons. When these photons are transmitted at specific wavelengths, they essentially become packets of energy that become deposited into the cells that make up brain tissue. This results in tissue healing that has been shown in research to be 50%-60% faster than normal healing rates.
TRANSLINGUAL NEURAL STIMULATION (TLNS)
This neuro modulation technique involves stimulating through the t rigeminal ner ve, which can be accessed via the tongue. It is used to stimulate the brainstem, as opposed to TDCS, which accesses the outer layer of the brain, or the co rtex. TLNS is excellent for modulating the behavior of vestibular neurons, and many other vital functions housed in the brainstem.
COMPUTERIZED STABILOMETRY (BALANCE) TREATMENT
Balance training involves correcting the brain's interpretation of where the body is in space, and how to stabilize. This is accomplished using a balance plate that constantly provides feedback about the body's ability to stay upright, which the participant can then use to improve the quality of their balance.
NEUROMODULATION TO BOOST NEUROPLASTICITY
Transcranial Direct Cu rrent Stimulation (TDCS) increases plasticity, which offers a quicker timeline to results. It amounts to additional exercise, and it increases neurotransmitter pr ior ity in the regions where the stimulation is focused.
VESTIBULAR REHABILITATION
The vestibular system is one way our brains dete rmine our or ientation in space, if we are moving, and in what planes. It involves fluid-filled str uctures of the inner ear and the brain’s interpretation of the activity within those st ructures. It is ve ry common for brain injur ies to be accompanied by damage to these systems, and rehabilitation involves assessing where the system has been damaged and training it to restore function. Ver tigo (feeling like the room is spinning) is a ve ry typical example of vestibular dysfunction.
Treatment Benefits
The benefits of Neurodiagnostic Institute's treatments are best told through the words of our patients, however the below points are important components of what inspires the strong testimonials. Our innovative services have a significant impact on the lives of the Veterans we help.
ENHANCED COGNITIVE FUNCTION
Improved brain connectivity and cognitive performance through intensive neuroplastic proliferation and neuromodulation.
INCREASED NEUROPLASTICITY
Accelerated recovery and adaptability of the brain with TDCS.
REDUCED PTSD & TBI SYMPTOMS
Effective management and reduction of symptoms related to PTSD and TBI through increased brain function.
INCREASED ACCESS TO CARE
More accessible treatment solutions delivered directly where Veterans are, reducing barriers to care.
IMPROVED QUALITY OF LIFE
Better overall mental and emotional well-being for Veterans, First Responders, and Elderly patients.
Partnership & session planning
NDI provides specialty solutions for organizations serving specific populations. We seek out other organizations who share our passion for serving those in need, increasing accessibility to essential services, and we collaborate on outreach, event planning, and location selection to successfully deliver treatment sessions where and when they are needed most.
SITE SELECTION
Our best partnerships are with organizations who have the capability to host our intensive sessions onsite, but we also assist partners in selecting suitable offsite locations.
DATE SELECTION & OUTREACH
We align scheduling to ensure the best timing for session delivery, with adequate lead time to allow for outreach efforts. Although our partners are responsible for selection of participants, NDI can assist.
SESSION LOGISTICS
NDI ensures that arrangements are made so each session runs smoothly. From preparing the site to maintaining clear lines of communication.
TREATMENT DELIVERY
NDI provides the highest quality of treatment for patients we serve. Our team is dedicated to producing significant, lasting improvements for each individual.
COLLABORATION WITH FUNDRAISING TEAMS
Many of our partners are non-profits and public organizations who depend on grant funding. NDI can collaborate with in-house development or external grant writing teams to provide supporting documentation for grant applications.
DATA GATHERING & SESSION REPORTING
NDI prioritizes patient privacy, but recognizes the importance of reporting impact to grantors, donors, and sponsors. Our team anonymizes and aggregates outcomes, generating session reports to ensure that partners are confident in communicating success.