Traumatic Brain Injury and Neuromodulation Techniques in Rehabilitation: A Scoping Review

Abstract

Background and Objectives: Traumatic Brain Injury (TBI) is a condition in which an external force, usually a violent blow to the head, causes functional impairment in the brain. Neuromodulation techniques are thought to restore altered function in the brain, resulting in improved function and reduced symptoms. Brain stimulation can alter the firing of neurons, boost synaptic strength, alter neurotransmitters and excitotoxicity, and modify the connections in their neural networks. All these are potential effects on brain activity. Accordingly, this is a promising therapy for TBI. These techniques are flexible because they can target different brain areas and vary in frequency and amplitude. This review aims to investigate the recent literature about neuromodulation techniques used in the rehabilitation of TBI patients. Materials and Methods: The identification of studies was made possible by conducting online searches on PubMed, Web of Science, Cochrane, Embase, and Scopus databases. Studies published between 2013 and 2023 were selected. This review has been registered on OSF (JEP3S). Results: We have found that neuromodulation techniques can improve the rehabilitation process for TBI patients in several ways. Transcranial Magnetic Stimulation (TMS) can improve cognitive functions such as recall ability, neural substrates, and overall improved performance on neuropsychological tests. Repetitive TMS has the potential to increase neural connections in many TBI patients but not in all patients, such as those with chronic diffuse axonal damage.Conclusions: This review has demonstrated that neuromodulation techniques are promising instruments in the rehabilitation field, including those affected by TBI. The efficacy of neuromodulation can have a significant impact on their lives and improve functional outcomes for TBI patients.

Defining the concept of reserve in the motor domain: a systematic review

“…Interestingly, recent studies are also highlighting the possible role of non-invasive brain stimulation (NIBS) for the assessment and the potentiation of the cerebellar reserve ( Manto, 2023 ). NIBS has been promoted as a safe and reliable tool for causal validation of theoretical models and modulation of brain activity with extensive application in the motor domain in both healthy individuals and patients ( Matsuda et al, 2017 ; Giustiniani et al, 2019 , 2021 ; Learmonth et al, 2021 ; Calderone et al, 2024 ). Recently, transcranial magnetic stimulation (TMS) has been used to probe the bimodal balance recovery theory which suggests that, in case of stroke, contralesional influence changes based on the amount of ipsilesional reserve (i.e., it would be inhibitory when there is a high level of ipsilateral reserve and supportive in case of a low level) ( Li et al, 2022 ).…”