A pilot treatment study for mild traumatic brain injury: Neuroimaging changes detected by MEG after low-intensity pulse-based transcranial electrical stimulation

Huang, Mingxiong; Swan, Ashley Robb; Quinto, Annemarie Angeles; Matthews, Scott C.; Harrington, Deborah L.; Nichols, Sharon L.; Bruder, Barry J; Snook, Corey C; Huang, Charles; Baker, Dewleen G.; Lee, Roland R.

doi:10.1080/02699052.2017.1363409

Cited by 15 publications

(21 citation statements)

References 67 publications

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“…Since this is an emerging area of research, limited studies met the inclusion criteria for review. Additionally, of the 14 studies included, only six were rated as having a low risk of bias (Leung et al, 2016b(Leung et al, , 2018Wilke et al, 2017;Choi et al, 2018;Moussavi et al, 2019;Stilling et al, 2019b), and the other eight studies had several methodological limitations (Walker et al, 2002;Fitzgerald et al, 2011;Koski et al, 2015;Leung et al, 2016a;Huang et al, 2017;Paxman et al, 2018;Ansado et al, 2019;Stilling et al, 2019a). At face value, all but one of the studies demonstrated that neuromodulation had a positive effect on the various symptoms measured and sometimes neurophysiological functioning following mTBI, as detailed in Supplementary Table 6B.…”

Section: Discussionmentioning

confidence: 99%

“…Neurofeedback was effective for reducing excessive delta wave EEG activity (Huang et al, 2017) as well as post-concussion symptom scores (Walker et al, 2002;Huang et al, 2017) and sleep disturbance (Huang et al, 2017). Improved rates of return to work were also seen with both rTMS and neurofeedback (Walker et al, 2002;Stilling et al, 2019b).…”

Section: Risk Of Bias and Quality Of Evidencementioning

confidence: 94%

“…It has been suggested that the reasons for limited treatment success to date, is the fact that the interventions do not address the pathophysiological cascade responsible for the persisting symptoms (Hadanny and Efrati, 2016). Indeed, it is likely that we do not yet have a comprehensive understanding of the pathophysiology underlying mTBI and PPCS (Huang et al, 2017). Other factors that influence recovery include individual factors such as preand post-injury characteristics as well as injury characteristics (Polinder et al, 2018), and motivations for secondary gain (Patrick and Horner, 2014).…”

Section: Rehabilitation: Current Trendsmentioning

confidence: 99%

“…Across the 14 studies, several neurophysiological changes were observed following mTBI, including microstructural damage in the corpus callosum (Ansado et al, 2019), reduced haemodynamic activation in the DLPFC (Stilling et al, 2019a), altered working memory network activation patterns (Koski et al, 2015;Ansado et al, 2019) and excess delta frequency EEG (Huang et al, 2017). The integrity of the spinothalamocortical pathway was also altered in participants with mTBI and chronic pain (Choi et al, 2018).…”

Section: Risk Of Bias and Quality Of Evidencementioning

confidence: 99%

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Neuromodulation for Mild Traumatic Brain Injury Rehabilitation: A Systematic Review

Buhagiar

Fitzgerald

Bell

et al. 2020

Front. Hum. Neurosci.

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Background: Mild traumatic brain injury (mTBI) results from an external force to the head or body causing neurophysiological changes within the brain. The number and severity of symptoms can vary, with some individuals experiencing rapid recovery, and others having persistent symptoms for months to years, impacting their quality of life. Current rehabilitation is limited in its ability to treat persistent symptoms and novel approaches are being sought to improve outcomes following mTBI. Neuromodulation is one technique used to encourage adaptive neuroplasticity within the brain.Objective: To systematically review the literature on the efficacy of neuromodulation in the mTBI population.Method: A systematic review was conducted using Medline, Embase, PsycINFO, PsycARTICLES and EBM Review. Preferred Reporting Items for Systematic Reviews and the Synthesis Without Meta-analysis reporting guidelines were used and a narrative review of the selected studies was completed. Fourteen articles fulfilled the inclusion criteria which were published in English, investigating an adult sample and using a pre- and post-intervention design. Studies were excluded if they included non-mild TBI severities, pediatric or older adult populations.Results: Thirteen of fourteen studies reported positive reductions in mTBI symptomatology following neuromodulation. Specifically, improvements were reported in post-concussion symptom ratings, headaches, dizziness, depression, anxiety, sleep disturbance, general disability, cognition, return to work and quality of life. Normalization of working memory activation patterns, vestibular field potentials, hemodynamics of the dorsolateral prefrontal cortex and excessive delta wave activity were also seen. The studies reviewed had several methodological limitations including small, heterogenous samples and varied intervention protocols, limiting generalisability. Further research is required to understand the context in which neuromodulation may be beneficial.Conclusions: While these positive effects are observed, limitations included unequal representation of neuromodulation modalities in the literature, and lack of literature describing the efficacy of neuromodulation on the development or duration of persistent mTBI symptoms. Better clarity regarding neuromodulation efficacy could have a significant impact on mTBI patients, researchers, clinicians, and policy makers, facilitating a more productive post-mTBI population. Despite the limitations, the literature indicates that neuromodulation warrants further investigation. PROSPERO registration number: CRD42020161279.

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Section: Discussionmentioning

confidence: 99%

Section: Risk Of Bias and Quality Of Evidencementioning

confidence: 94%

Section: Rehabilitation: Current Trendsmentioning

confidence: 99%

Section: Risk Of Bias and Quality Of Evidencementioning

confidence: 99%

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Neuromodulation for Mild Traumatic Brain Injury Rehabilitation: A Systematic Review

Buhagiar

Fitzgerald

Bell

et al. 2020

Front. Hum. Neurosci.

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“…Previous clinical studies have reported that electrical stimulation (ES) can be used to treat TBI, and its complications effectively. [17–19] However, no systematic review has explored the effect and safety of ES for the treatment of children with limbs spasticity (LS) after traumatic brain injury (TBI). Thus, this systematic review will aim to assess the effect and safety of ES for the treatment of LS following TBI among children population.…”

Section: Introductionmentioning

confidence: 99%

Electrical stimulation for limb spasticity in children with traumatic brain injury

et al. 2019

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Background: Previous clinical studies have reported that electrical stimulation (ES) can be utilized to treat children with limbs spasticity (LS) after traumatic brain injury (TBI). Currently, no systematic review has addressed the effect of ES in children with LS following TBI. Thus, this systematic review will assess the effect and safety of ES for the children with LS after TBI. Methods: We will conduct the present systematic review of randomized controlled trials that will be retrieved from searches of PubMed, PsycINFO, WOS, Scopus, OpenGrey, Google Scholar, Cochrane Central Register of Controlled Trials, Embase, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, and Chinese Biomedical Literature Database from the inception to the date of the literature searched. In addition, the clinical register websites, and reference lists of relevant studies will also be searched. Two independent reviewers will evaluate the eligibility criteria for all papers, extract the data and determine the methodology quality by using Cochrane risk of bias tool. Results: The results of this systematic review will pool the latest available data, and are expected to provide the summary of present evidence of ES for children with LS following TBI. Timeline: This systematic review will start on January 10, 2019 and expected to complete by June 1, 2019. Ethics and dissemination: No research ethic approval is needed in this study, because the data of this systematic review will not base on the individual data level. The results will be disseminated to publish at peer-reviewed journals or will present at relevant conferences. PROSPERO registration number: CRD42019120037

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Metabolic features and regulation of the healing cycle—A new model for chronic disease pathogenesis and treatment

Naviaux

2019

Mitochondrion

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Without healing, multicellular life on Earth would not exist. Without healing, one injury predisposes to another, leading to disability, chronic disease, accelerated aging, and death. Over 60% of adults and 30% of children and teens in the United States now live with a chronic illness. Advances in mass spectrometry and metabolomics have given scientists a new lens for studying health and disease. This study defines the healing cycle in metabolic terms and reframes the pathophysiology of chronic illness as the result of metabolic signaling abnormalities that block healing and cause the normal stages of the cell danger response (CDR) to persist abnormally. Once an injury occurs, active progress through the stages of healing is driven by sequential changes in cellular bioenergetics and the disposition of oxygen and carbon skeletons used for fuel, signaling, defense, repair, and recovery. >100 chronic illnesses can be organized into three persistent stages of the CDR. One hundred and two targetable chemosensory G-protein coupled and ionotropic receptors are presented that regulate the CDR and healing. Metabokines are signaling molecules derived from metabolism that regulate these receptors. Reframing the pathogenesis of chronic illness in this way, as a systems problem that maintains disease, rather than focusing on remote trigger(s) that caused the initial injury, permits new research to focus on novel signaling therapies to unblock the healing cycle, and restore health when other approaches have failed.

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A pilot treatment study for mild traumatic brain injury: Neuroimaging changes detected by MEG after low-intensity pulse-based transcranial electrical stimulation

Abstract: The present study demonstrates, for the first time, the neuroimaging-based documentation of the effect of LIP-tES treatment on brain functioning in mTBI. The mechanisms of LIP-tES treatment are discussed, with an emphasis on LIP-tES's potentiation of the mTBI healing process.

Cited by 15 publications

References 67 publications

Neuromodulation for Mild Traumatic Brain Injury Rehabilitation: A Systematic Review

Neuromodulation for Mild Traumatic Brain Injury Rehabilitation: A Systematic Review

Electrical stimulation for limb spasticity in children with traumatic brain injury

Metabolic features and regulation of the healing cycle—A new model for chronic disease pathogenesis and treatment

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