Efficacy of Repetitive Transcranial Magnetic Stimulation Combined With Visual Scanning Treatment on Cognitive-Behavioral Symptoms of Unilateral Spatial Neglect in Patients With Traumatic Brain Injury: Study Protocol for a Randomized Controlled Trial

Abstract

Left hemispatial neglect (LHSN) is a frequent and disabling condition affecting patients who suffered from traumatic brain injury (TBI). LHSN is a neuropsychological syndrome characterized clinically by difficulties in attending, responding, and consciously representing the right side of space. Despite its frequency, scientific evidence on effective treatments for this condition in TBI patients is still low. According to existing literature, we hypothesize that in TBI, LHSN is caused by an imbalance in inter-hemispheric activity due to hyperactivity of the left hemisphere, as observed in LHSN after right strokes. Thus, by inhibiting this left hyperactivity, repetitive Transcranial Magnetic Stimulation (rTMS) would have a rebalancing effect, reducing LHSN symptoms in TBI patients. We plan to test this hypothesis within a single-blind, randomized SHAM controlled trial in which TBI patients will receive inhibitory i-rTMS followed by cognitive treatment for 15 days. Neurophysiological and clinical measures will be collected before, afterward, and in the follow-up. This study will give the first empirical evidence about the efficacy of a novel approach to treating LHSN in TBI patients.Clinical Trial Registration:https://www.clinicaltrials.gov/ct2/show/NCT04573413?cond=Neglect%2C+Hemispatial&cntry=IT&city=Bologna&draw=2&rank=2, identifier: NCT04573413.

Accuracy of EEG Biomarkers in the Detection of Clinical Outcome in Disorders of Consciousness after Severe Acquired Brain Injury: Preliminary Results of a Pilot Study Using a Machine Learning Approach

“…A preliminary Shapiro–Wilk test for normality distribution was performed for all measures [ 65 ]. For similar statistical procedures, see also [ 66 , 67 , 68 , 69 , 70 ].…”

Advances in EEG-based functional connectivity approaches to the study of the central nervous system in health and disease

“…3 These evidence-based approaches highlight neural mechanisms of brain plasticity and connectivity in healthy individuals, 54,55 but more importantly, they could also lead to adequate prediction and evaluation of clinical symptoms or treatment improvements. 10,20,30,36,[56][57][58][59][60] In particular, a recent study compared different measures to predict clinical outcomes in patients with traumatic or nontraumatic acquired brain injuries. 20 While the PLI connectivity may reflect the typical diffuse axonal damage in trauma patients, the MI and PC predicted long-term clinical outcomes in all patients.…”