Neurostimulation for traumatic brain injury

A review

Samuel S. Shin M.D., Ph.D., C. Edward Dixon Ph.D., David O. Okonkwo M.D., Ph.D. and R. Mark Richardson M.D., Ph.D.
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  • Department of Neurological Surgery, University of Pittsburgh, Pennsylvania
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Traumatic brain injury (TBI) remains a significant public health problem and is a leading cause of death and disability in many countries. Durable treatments for neurological function deficits following TBI have been elusive, as there are currently no FDA-approved therapeutic modalities for mitigating the consequences of TBI. Neurostimulation strategies using various forms of electrical stimulation have recently been applied to treat functional deficits in animal models and clinical stroke trials. The results from these studies suggest that neurostimulation may augment improvements in both motor and cognitive deficits after brain injury. Several studies have taken this approach in animal models of TBI, showing both behavioral enhancement and biological evidence of recovery. There have been only a few studies using deep brain stimulation (DBS) in human TBI patients, and future studies are warranted to validate the feasibility of this technique in the clinical treatment of TBI. In this review, the authors summarize insights from studies employing neurostimulation techniques in the setting of brain injury. Moreover, they relate these findings to the future prospect of using DBS to ameliorate motor and cognitive deficits following TBI.

Abbreviations used in this paper:ANT = anterior nucleus of the thalamus; cAMP = cyclic adenosine monophosphate; DARPA = Defense Advanced Research Projects Agency; DBS = deep brain stimulation; DLPFC = dorsolateral prefrontal cortex; GPi = globus pallidus internus; MCS = minimally conscious state; PD = Parkinson's disease; SCC = subgenual cingulate cortex; TBI = traumatic brain injury; tDCS = transcranial direct-current stimulation; TMS = transcranial magnetic stimulation; TRD = treatment-resistant depression; VIM = ventralis intermedius; VOA = ventralis oralis anterior; VOP = ventralis oralis posterior.

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Contributor Notes

Address correspondence to: Samuel S. Shin, M.D., Ph.D., Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop St., Ste. B400, Pittsburgh, PA 15213. email: shinss@upmc.edu.

Please include this information when citing this paper: published online August 29, 2014; DOI: 10.3171/2014.7.JNS131826.

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