Rapid and sustained improvement in Visuospatial/Executive function following perispinal etanercept documented by the Montreal Cognitive Assessment. The top panel depicts the first three tasks from the Montreal Cognitive Assessment completed by the patient one day prior to perispinal etanercept administration. The middle panel depicts the patient's results two hours after perispinal etanercept administration, showing correct completion of the alternating trail making task documenting improved executive function, and improvement in depiction of a clock face. The bottom panel depicts the patient's results at seven weeks, fourteen days after receiving his previous dose of perispinal etanercept, showing further improvement in his drawing of the clock face, with numerals added, and persistence in improvement in completion of the trail making task. (The instruction for completion of the alternating trail making task are as follows: Please draw a line, going from a number to a letter in ascending order. Begin here [point to (1)] and draw a line from 1 then to A then to 2 and so on. End here [point to (E)]).