当前位置： SCI文献检索 > JOURNAL OF NEUROTRAUMA期刊下所有文献 > Noninvasive brain stimulation for persistent postconcussion symptoms in mild traumatic brain injury.

Noninvasive brain stimulation for persistent postconcussion symptoms in mild traumatic brain injury.

Abstract：

:Mild traumatic brain injury (mTBI) is typically followed by various postconcussive symptoms (PCS), including headache, depression, and cognitive deficits. In 15-25% of cases, PCS persists beyond the usual 3-month recovery period, interfering with activities of daily living and responding poorly to pharmacotherapy. We tested the safety, tolerability, and efficacy of repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) for alleviating PCS. Fifteen eligible patients with mTBI and PCS > 3 months postinjury consented to 20 sessions of rTMS (20 × 5-sec trains; 10 Hz at 110% threshold), with clinical and functional magnetic resonance imaging (fMRI) assessments before and after intervention and clinical assessment at 3-month follow-up. Primary outcomes were tolerability, safety, and efficacy, as measured with the PCS Scale. Secondary outcomes included the Cognitive Symptoms Questionnaire, neuropsychological test performance, and working memory task-associated activity as assessed with fMRI. Twelve patients completed all sessions. Three withdrew because of worsening symptoms or for an unrelated event. Stimulation intensity was increased gradually across sessions, and all subjects tolerated the protocol by the sixth session. Commonly reported side effects among completers were increased headache (n = 3) and greater sleep disturbance (n = 3). Participants also reported positive outcomes such as less sleep disturbance (n = 3), and better mental focus (n = 3). On average, PCS scores declined by 14.6 points (p = 0.009) and fMRI task-related activation peaks in the DLPFC increased after rTMS. rTMS is safe, tolerated by most patients with mTBI, and associated with both a reduction in severity of PCS and an increase in task-related activations in DLPFC. Assessment of this intervention in a randomized, control trial is warranted.

journal_name

J Neurotrauma

journal_title

Journal of neurotrauma

authors

Koski L,Kolivakis T,Yu C,Chen JK,Delaney S,Ptito A

doi

10.1089/neu.2014.3449

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

38-44

issue

eissn

0897-7151

issn

1557-9042

journal_volume

pub_type

杂志文章

在线工具

Noninvasive brain stimulation for persistent postconcussion symptoms in mild traumatic brain injury.