Diagnostics & Pre-Treatment Testing



Videonystagmography ( VNG )  technology measures and records eye movements.  Eye movements are controlled by different parts of the brain and give us a way to evaluate the function of those areas.  We will assess your ability to focus, track, and change targets rapidly.  

Difficulty performing these movements is associated with: concussion , traumatic brain injury , stroke, cerebral palsy, developmental disorders, neurodegenerative disorders (Alzheimer’s, Dementia, Parkinson’s & etc …), anxiety , vertigo, and more.

The results will be thoroughly discussed with you.  It is important that you have an understanding of how your eye movements are impacting your symptoms and function.  

Following your treatment, you will be retested to evaluate progress.  The results will be used to create a program you will perform at home.  


Research
   

Impaired eye movements in post-concussion syndrome indicate suboptimal brain  function   beyond  the influence of depression, malingering or intellectual ability.

Diagnosing Extraocular Muscle Dysfunction in Clinic: Comparing Computerized Hess Analysis, Park’s 3-Step Test and a Novel 3-Step Test 

     
Computerized assessment of postural stability (CAPS)
measures balance.  The patient will perform screening on a flat and perturbed surface with eyes open or closed.  Balance is the result of proper communication between eyes, ears, joints, and muscles.  Each of these areas must be able to compensate for the other in situations such as at night, elevator, driving, 3D movie, and walking on an uneven surface.  

The ears allow for interacting with the environment through sound and movement.  In the inner ear is a system for reflexogenic balance called the vestibular system .  The vestibular system is stimulated by any motion.  Improper function of the vestibular system will impact balance, walking, and eye movements.   
 
Information sent from the joints and muscles of the leg and feet are sent to the brain.  Damage to the joints, muscles, or part of the brain that receives the information can occur from injuries, neuropathy, diabetes, stroke, traumatic brain injury, cerebral palsy, or concussions will impact balance.  The lack of information from the joints and muscles is one reason you will see patients will neuropathy use a wide-based stance.   


The visual system is dominant for most people and usually, compensates for decreased function of the others.  Problems arise though when it is dark or the visual system is no longer able to process environment as quickly.  There are many causes for a disturbance in the visual system, but here are a few: concussion, multiple sclerosis , diabetes, Parkinson's, cerebral palsy , vertigo, dizziness, migraines, traumatic brain injury, and stroke .  



Research

     

   

Cognitrax is powered by CNS Vital Signs neurocognitive assessment technologies; the leader in clinical use with over 7000 clinical users and over 2000 clinical investigators and researchers in 52 countries. Cognitrax enables an objective longitudinal assessment of a patient's "CORE" neurocognitive function using computerized neuropsychological tests. It can assist in the recognition and evaluation of Neurodegenerative Disorders.

Cognitrax automates the precise psychometric (speed and accuracy of responses with no rater bias) measurement of
apatients neurocognitive function. Cognitrax domain scores are presented as Subject (raw) Scores, Standard Scores, and Percentile Ranks computed from calculations using the data values of individual subtests and are simply the number of correct responses, incorrect responses, and reaction times. Cognitrax grades the severity of impairment based on an age-matched normative comparison database with lifespan norms from ages 8 to 90.

Research

The value of neurocognitive testing for acute outcomes after mild traumatic brain injury.





ImPACT is a computerized neurocognitive assessment tool to help licensed healthcare providers evaluate and manage a suspected concussion.  Test results are compared to baseline scores and normative data scores as part of a healthcare provider's assessment of the injury.
 
Trusted by sports teams, schools, corporations, hospitals, and clinics,  ImPACT is the most widely used computerized neurocognitive test to help evaluate and manage concussions.



Research

Computerized neurocognitive testing for the management of sport-related concussions.

UTILIZATION OF ImPACT TESTING TO MEASURE INJURY RISK IN ALPINE SKI AND SNOWBOARD ATHLETES.

Validity of the Immediate Post Concussion Assessment and Cognitive Testing (ImPACT)

Sensitivity and specificity of subacute computerized neurocognitive testing and symptom evaluation in predicting outcomes after sports-related concussion.



Functional Movement & Physical Exam- There are specific observational tests that can help your doctor figure out what is causing your neurological disturbance. A functional neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine where the nervous system is impaired.


Research



A core physical exam for medical students: results of a national survey.


Services & Diagnostic Imaging- We offer in-house electrodiagnostic services such as EMG , SSEP , and NCV . Revive is also partnered with several imaging facilities within the Denver area to ensure the most advanced imaging at the best cost. Revive in always seeking out the latest advancements in the brain and spinal cord imaging. We work with several facilities to help develop and implement new breakthroughs in Neuroimaging.


Research

A day in the EMG laboratory: case studies of 10 patients with different clinical problems


Story  of electromyography equipment.


   
Lab Testing & Blood work - Often we will need thorough lab work to identify underlying causes or comorbidities to neurologic impairment.  This could include one or some of the following:  comprehensive blood panel (Including specific food allergy testing, detailed hormone panels, or in-depth thyroid panels) genetic test, a saliva sample, stool sample.


Research

Estrogens, inflammation and cognition 

Estrogens as neuroprotectants: Estrogenic actions in the context of cognitive aging and brain injury 

Brain sex matters: Estrogen in cognition and Alzheimer’s disease 

Metal toxicity at the synapse: presynaptic, postsynaptic, and long-term effects.

Pathophysiological Consequences of Homocysteine Excess