Transcranial direct current stimulation (tDCS) effects on traumatic brain injury (TBI) recovery: A systematic review

Zaninotto, Ana Luiza; El-Hagrassy, Mirret M.; Green, Jordan R.; Babo, Maíra; Paglioni, Vanessa Maria; Benute, Gláucia Rosana Guerra; Paiva, Wellingson Silva

doi:10.1590/1980-57642018dn13-020005

Cited by 39 publications

(29 citation statements)

References 48 publications

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“…To in uence neuronal plasticity, non-invasive brain neurostimulation (NIBS) uses an extrinsic-induced electrical stimulus to modulate neuronal excitability, synaptic strength and dendritic connections. Long-term potentiation (LTP) increases synaptic transmission between two neurons by modulating GABAergic and glutamatergic synapses, while long-term depression (LTD) decreases it and reduces glutamate excitotoxicity and GABA-mediated inhibition (4,11,12). The two most studied modalities are transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS).…”

Section: Transcranial Neurostimulationmentioning

confidence: 99%

“…High-frequency stimulation facilitates neuronal e ciency, while low-frequency rTMS reduces it (3,12). Depending on the frequency of stimulation (rTMS) or the polarity of the direct current (tDCS), these techniques can induce LTP-like or LTD-like effects that last beyond the stimulation time frame (3,4,11,12).…”

Section: Transcranial Neurostimulationmentioning

confidence: 99%

“…Two systematic reviews highlight the use of NIBS for improvement of motor function, memory, tinnitus, alteration of consciousness and depression (11,13). The most recent concluded that tDCS is a safe and non-invasive neuromodulatory technique that may be best combined with other therapeutics to improve cognitive and motor outcomes (11). Out of the 14 studies reviewed, 7 used tDCS to improve responsiveness in patients with disorders of consciousness, 6 in cognition and one in motor outcomes.…”

Section: Neurostimulation and Cognitive Impairmentmentioning

confidence: 99%

“…Out of the 14 studies reviewed, 7 used tDCS to improve responsiveness in patients with disorders of consciousness, 6 in cognition and one in motor outcomes. They underline the challenge in clinical trials due to the heterogeneous procedures in rehabilitation and the di culty to target a cognitive function as it do not correspond to delineated network as compared to motor function (11).…”

Section: Neurostimulation and Cognitive Impairmentmentioning

confidence: 99%

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Brain Stimulation in Attention Deficits after Traumatic Brain Injury: A Literature Review and Feasibility Study

Boissonnault

Higgins

LaGarde³

et al. 2020

Preprint

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Background: After a traumatic brain injury, disturbances in the attentional processes have a direct negative effect on functional recovery and on return to complex activities. To date, there is no good attention remediation treatment available. The primary objective of this review and pilot study is to get a comprehensive analysis and to evaluate the feasibility of implementing a tDCS protocol to improve attention disorders in patients with mild complicated to severe subacute TBI, hospitalized in an inpatient rehabilitation facility. Our secondary objective is to extract preliminary data and observational information on participants’ response to treatment. Methods: Participants were recruited from a consecutive series of patients admitted to the TBI unit of a subspecialized regional rehabilitation center. They received a 20-minute tDCS stimulation 3 times a week for 3 weeks. A neuropsychological evaluation was performed before and after the intervention. We collected participants’ socio-demographic and clinical characteristics as well as information about satisfaction, tolerability and adverse effects.Results: 164 patients were admitted between September 2018 and January 2020. 158 were excluded and 6 patients with presumed attentional deficits were enrolled. None completed the protocol as intended. No major side effects occurred. Conclusion: Non-invasive brain neurostimulation is promising to enhance attention deficits in patients with TBI. Implementation of a tDCS protocol to fulfill this purpose in an intensive inpatient rehabilitation center has its limitations. We made recommendations to facilitate the implementation of similar projects in the future. Trial registration: ISRCTN, ISRCTN55243064. Registered 14 October 2020 - Retrospectively registered, http://www.isrctn.com/ISRCTN55243064.

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Section: Transcranial Neurostimulationmentioning

confidence: 99%

Section: Transcranial Neurostimulationmentioning

confidence: 99%

Section: Neurostimulation and Cognitive Impairmentmentioning

confidence: 99%

Section: Neurostimulation and Cognitive Impairmentmentioning

confidence: 99%

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Brain Stimulation in Attention Deficits after Traumatic Brain Injury: A Literature Review and Feasibility Study

Boissonnault

Higgins

LaGarde³

et al. 2020

Preprint

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“…NIBS could be a promising complementary treatment when used in combination with conventional cognitive rehabilitation to enhance rehabilitation in patients with brain injury; however, there is currently, no systematic review examining its effects on cognitive impairment after TBI. There are reviews of rTMS and tDCS in TBI [ 18 , 19 , 20 ]. Some reviews focused on depression, dizziness, central pain, and visual neglect [ 18 , 19 ], while others were not specifically focused on current paradigms of NIBS therapeutic application [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Non-Invasive Brain Stimulation (NIBS) on Executive Functioning, Attention and Memory in Rehabilitation Patients with Traumatic Brain Injury: A Systematic Review

et al. 2021

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In recent years, the potential of non-invasive brain stimulation (NIBS) for therapeutic effects on cognitive functions has been explored for populations with traumatic brain injury (TBI). However, there is no systematic NIBS review of TBI cognitive impairment with a focus on stimulation sites and stimulation parameters. The purpose of this study was to conduct a systematic review examining the effectiveness and safety of NIBS for cognitive impairment after a TBI. This study was prospectively registered with the PROSPERO database of systematic reviews (CRD42020183298). All English articles from the following databases were searched from inception up to 31 December 2020: Pubmed/MEDLINE, Scopus, CINAHL, Embase, PsycINFO and CENTRAL. Randomized and prospective controlled trials, including cross-over studies, were included for analysis. Studies with at least five individuals with TBI, whereby at least five sessions of NIBS were provided and used standardized neuropsychological measurement of cognition, were included. A total of five studies met eligibility criteria. Two studies used repetitive transcranial magnetic stimulation (rTMS) and three studies used transcranial direct current stimulation (tDCS). The pooled sample size was 44 individuals for rTMS and 91 for tDCS. Three of five studies combined cognitive training or additional therapy (computer assisted) with NIBS. Regarding rTMS, target symptoms included attention (n = 2), memory (n = 1), and executive function (n = 2); only one study showing significant improvement compared than control group with respect to attention. In tDCS studies, target symptoms included cognition (n = 2), attention (n = 3), memory (n = 3), working memory (WM) (n = 3), and executive function (n = 1); two of three studies showed significant improvement compared to the control group with respect to attention and memory. The evidence for NIBS effectiveness in rehabilitation of cognitive function in TBI is still in its infancy, more studies are needed. In all studies, dorsolateral prefrontal cortex (DLPFC) was selected as the stimulation site, along with the stimulation pattern promoting the activation of the left DLPFC. In some studies, there was a significant improvement compared to the control group, but neither rTMS nor tDCS had sufficient evidence of effectiveness. To the establishment of evidence we need the evaluation of brain activity at the stimulation site and related areas using neuroimaging on how NIBS acts on the neural network.

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Traumatic Brain Injury

Mollayeva

2020

Encyclopedia of Life Sciences

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Traumatic brain injury, generally defined as an alteration in brain function, or other evidence of brain pathology as a result of an external force, has established itself as a significant threat to public health. It impacts survivors and their families, and demonstrates clear economic repercussions at the societal level, costing hundreds of billions of dollars annually worldwide. To detect, manage and prevent this complex and often lifelong disabling injury, it is essential to understand its distribution and patterns, and have comprehensive knowledge of persons at risk of injury and adverse outcomes. Key Concepts Traumatic brain injury (TBI) is on the rise worldwide. The lack of a universal definition of TBI presents a problem for quantification of true TBI burden. The baseline clinical severity measures for TBI are often based on symptomatology, loss of consciousness and post‐traumatic amnesia; discordance between clinical severity and evidence of injury based on neuroimaging is common; investment in biomarkers of neuronal and glial integrity is growing. Persons with similar injury severity and acute presentation can experience significantly different clinical course and functional outcomes. Certain groups of people are more vulnerable to TBI and adverse outcomes than others, owing to unique interactions between their biological, behavioural, social and cultural standing before and after the injury. Clinicians, researchers and policy leaders dealing with critical injuries with long‐lasting effects such as TBI cannot afford to leave its probability in the future to chance; greater investment in injury prevention is timely.

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Transcranial direct current stimulation (tDCS) effects on traumatic brain injury (TBI) recovery: A systematic review

Cited by 39 publications

References 48 publications

Brain Stimulation in Attention Deficits after Traumatic Brain Injury: A Literature Review and Feasibility Study

Brain Stimulation in Attention Deficits after Traumatic Brain Injury: A Literature Review and Feasibility Study

The Effect of Non-Invasive Brain Stimulation (NIBS) on Executive Functioning, Attention and Memory in Rehabilitation Patients with Traumatic Brain Injury: A Systematic Review

Traumatic Brain Injury

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