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Is mental 'boot camp' the answer for concussion victims?
October 5, 2015

PROVO — A clinic in Provo is claiming remarkable success in treating people — including some NFL football players — who suffer long-term consequences from concussions.

"I had personality changes, I had severe fatigue, it affected my personal relationships, my family relationships, my grades even," said college student Lisie Cornish describing her symptoms after suffering a concussion in a car accident.

But her treatment at Cognitive FX has made a dramatic improvement. "Yes, yes, yes. I would recommend it to anybody," she said.

The claims of a breakthrough are still awaiting formal scientific confirmation, but the clinic does expect to submit its data for peer-review by the end of the year. "We know how to target exactly what to work on," said Rett Lam, one of the partners in Cognitive FX.

Think of it as one-stop shopping for a damaged brain. Cognitive FX is a small clinic, but it has its own dedicated MRI scanner. There is a wide variety of machines, devices, games and challenging mental exercises that are designed to straighten out brains — like Rand Kerr's — that were hammered by a concussion. Kerr is overjoyed at how it's unscrambled his scrambled life.

"It has made a profound change." he said. "If you could have seen me before, the difference is night and day."

The standard treatment at Cognitive FX puts concussion victims through a full-time, five-day mental boot camp.

"Even by the end of the first session of that first day, they are significantly improved," said Lindsey Holbrook, lead psychometrist at Cognitive FX.

The clinic has treated about 300 patients so far. When asked if the treatment works, co-inventor Dr. Alina Fong said, "I hate when people ask me this question because it doesn't seem real. But there has not been one of those patients, not one, that has not reported significant improvement. Most of them would say they're between 80 and 100 percent fixed."

From Kerr's perspective, it all seems a bit like a miracle. He's better qualified than most concussion victims to evaluate treatment because he actually runs a hospital. As CEO of Lakeview Hospital in Bountiful, he had access to the best doctors and therapists.

"I saw many medical professionals," Kerr said, "and I was told over and over again that only time can heal me and that there's not a whole lot that I can do. The predominant belief is that there's nothing that you can really do to escalate the healing of a concussion."

His own brain injury resulted from a freak accident. His hobby is making long-bows that are used in archery. Disastrously, he decided to watch a football game while doing a routine task, stretching a new bow on a notched board known as a tillering board. As he watched the game on TV, with the tillering board standing unsecured on a coffee table, he placed his head between the bow and the bowstring. When the tillering board suddenly slipped off the coffee table, the powerful bow snapped the back of his head with tremendous force.

"Honestly, I'm lucky to be alive to have that kind of power hit me in the head like it did," Kerr said.

But the concussion turned his life upside down.

"When it was at its worst," Kerr said, "the first few months, I was completely defunct."

Routine background sounds at the hospital became unbearable. He couldn't stay focused in meetings. He had trouble processing conversation.

"I was extremely depressed, I was extremely frustrated," Kerr said. "I didn't know if I was going to be able to continue fulfilling my job. I didn't know if I was going to be able to continue being a father and a husband."

He went to Cognitive FX in desperation because he couldn't get help elsewhere.

"I felt helpless, hopeless. Came here. This place seemed too good to be true," Kerr said while seated next to the MRI scanner at Cognitive FX. "And in three days, they re-set my brain."

"He is one of our success stories," said Fong as she watched Kerr engage in a therapy session that involved catching repeated tosses of a football while balancing on an unstable, rocking platform. "We're working on his processing speed, his reaction speed, his gross motorability and his balance, all at the same time."

Cognitive FX in Provo is a small clinic that treats people with brain injuries. The standard treatment puts concussion victims through a full-time, five-day mental boot camp. There is a wide variety of machines, devices, games and challenging mental exercises that are designed to straighten out brains. (Photo: Ken Fall, Deseret News )

Fong said a number of current and former NFL players have been treated at Cognitive FX, among them former BYU star Austin Collie. He suffered concussions in the NFL and now plays for the BC Lions in Vancouver.

In a text message from Canada, Collie told KSL News that his treatment has been "very effective."

"Alina and Cognitive FX have been awesome for me," he said. "It gave me more confidence when I step on the field knowing that my head is OK."

If Cognitive FX has a "secret sauce" it may be the way in which a 20-year-old technology — a functional MRI — has been adapted for therapeutic use. While the MRI scan is underway, the concussion victim performs certain mental tasks. As questions or images appear on a TV screen, the patient responds by pushing buttons. Meanwhile, the MRI is examining the patient's brain activity.

"We use functional neuro-cognitive imaging to actually image what's going on in a person's brain while they're doing these tasks," said Rett Lam, a partner at Cognitive FX.

The MRI-scan zeroes in on 57 separate regions of the brain, "looking at points where there's too much activation, where there are structures showing too little activation," said partner Dr. Mark Allen.

In the company's startup phase, Cognitive FX invested large sums of money to scan the brains of hundreds of normal people. That provides a baseline of data so that their system can determine — for each region of the brain — what activity levels are normal and what levels are abnormal. That gives them the information they need to plan a week of intensive therapy.

"Treatment is based specifically on what parts of the brain are either working too hard or not working hard enough," said Fong.

As Holbrook monitored Cornish during a therapy session, she said, "As she's doing the different tests, it's working these different areas of her brain to really kind of enhance the different areas that are kind of weaker and need strengthening."

Kerr believes his own targeted therapy made all the difference and restored his life to near normal. His wife noticed the difference almost immediately when he came home from Cognitive FX. "I was home for about an hour. She just broke into tears and she said, 'I had forgotten you.' That was how profound of a difference it was."

The one-week treatment program ranges in cost from $6,900 to $9,500, depending on the patient's specific circumstance. So far, the treatment is not covered by most insurance policies.

The originators of Cognitive FX have solid academic credentials and they've published their protocols in peer-reviewed journals. But they've been open less than two years and their success claims have not been peer-reviewed.

An outside expert who asked not to be identified by name said, "This is based in science" and "it could be" a breakthrough. But the expert said Cognitive still needs to prove that the healing is permanent instead of temporary.

"Obviously," the expert said, "we need some research on it."

Fong said patients are showing long-term relief and she expects to submit Cognitive's data for peer review by the end of the year.