Traumatic brain injuries (TBI) are brain dysfunctions caused by an outside force. While there are a variety of treatments currently being used for TBI, research has been conducted into the use of neuromodulatory methods as a treatment for TBI. Neuromodulation works by using chemical or electrical signals to target specific regions of the brain or nervous system to alter irregular nerve activity occurring there. It is typically used to treat conditions that cause symptoms such as chronic pain, movement disorders, epilepsy, and psychiatric disorders. Standard methods of invasive neuromodulation include deep brain stimulation (DBS), cortical stimulation, and peripheral nerve stimulation, while noninvasive methods include transcranial magnetic stimulation (TMS) and direct current stimulation (tDCS). Previous findings have shown that transcranial magnetic stimulation (TMS) can improve motor function and mood regulation, leading many researchers to believe that TMS could be a potential treatment for the symptoms of several neurological disorders, including traumatic brain injuries.
The article "Neuromodulatory Interventions for Traumatic Brain Injury" by Dr. Theresa Pape discusses how repetitive TMS (rTMS) can be used to treat traumatic brain injuries. As opposed to other noninvasive neuromodulation forms, rTMS can target multiple sites at varying levels of intensity, making it of great interest to researchers. In addition, rTMS can cause activations in other areas of the brain that aren't being targeted. In the article, Dr. Pape describes a study that was conducted on patients in states of disordered consciousness following a TBI in which participants were given either amantadine, a drug that has been shown to improve consciousness in coma patients, or rTMS before receiving both to observe whether they could alter the activity of separate regions that control dopamine production. They found that using the two treatments together had better outcomes on consciousness than using them individually.
Similar research is being conducted to determine how neuromodulatory interventions can impact other symptoms of TBI. The article "Biomarker-guided neuromodulation alleviates memory loss in traumatic brain injury patients" details how Dr. Michael Jacob Kahana at the University of Pennsylvania and his team placed electrodes in TBI patients experiencing memory loss to predict when they would experience memory lapses. Their technology uses machine learning to determine when participants need to receive stimulation. A previous study conducted by Dr. Kahana and his team, published in 2017, found that when participants received stimulation before incorrectly remembering something, memory improved, but when stimulation was received when memory was functioning well, memory worsened. Their new study published in 2023 delivered stimulation to participants only before memory failed, leading to a 15% increase in the probability participants would recall a word from a list.
Although these studies utilize different methods, both show significant evidence for the use of neuromodulation to treat TBI and display even more positive results when used in tandem with another form of treatment than when used alone. The benefits of neuromodulation in TBI patients are due to their capacity to improve neuroplasticity. However, these methods pose several risks to patients, including seizures, which aren't yet entirely understood. Thus, more research must be done to establish neuromodulation as a safe and effective treatment for TBI.
References
Bell, J. (2023, August 23). Biomarker-guided neuromodulation alleviates memory loss in traumatic brain injury patients. NeuroNews International. https://neuronewsinternational.com/biomarker-guided-neuromodulation-alleviates-memory-loss-in-traumatic-brain-injury-patients/
Bender Pape, T. L., Herrold, A. A., Guernon, A., Aaronson, A., & Rosenow, J. M. (2020). Neuromodulatory interventions for traumatic brain injury. Journal of Head Trauma Rehabilitation, 35(6), 365–370. https://doi.org/10.1097/htr.0000000000000643
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