Sep 29 2016
Deep brain stimulation (DBS), which sends electrical impulses to certain areas of the brain, may help people with chronic, disabling traumatic brain injury and problems of behavioral and emotional regulation.
The study was published in the journal Neurosurgery, and the abstract may be viewed here.
The study states that severe traumatic brain injury “damages the frontal lobes and connecting networks, which impairs executive functions, including the ability to self-regulate.” There are few treatment options available in the chronic phase after injury.
Ali Rezai, M.D., director of the Neurological Institute at The Ohio State University in Columbus, and colleagues studied the safety and potential effectiveness of DBS in four patients, who suffered severe traumatic brain injury in automobile crashes six to 21 years earlier.
The study participants did not have trouble staying awake or alert, but they needed help in other domains. Three needed help getting dressed, going to the bathroom, and grooming. All couldn’t be alone overnight and required daily supervision.
The DBS system contains an electrode, also known as a lead, the extension, and the pulse generator, essentially like the batteries. The lead was connected to the damaged areas of the brain. The extension is implanted under the skin and travels through the head down the neck to the pulse generator, which is implanted in the collarbone area.
After two years of treatment with the DBS system, all four of the patients showed improvements in alertness and engagement. Three of the four patients showed substantial improvements in behavioral and emotional domains, and substantial gains in functional independence. Two needed less help with activities of daily living. Three of the four increased their activities outside of the home.
DBS is a well-established therapy for people with Parkinson’s disease. This is a small study, so larger controlled trials need to be done to confirm these findings for traumatic brain injury patients and to refine the treatment.
The safety of the treatment was confirmed, and the results suggest potential effectiveness of treatment for severe TBI patients, not just those in car accidents but also those injured in sports or combat. “The primary impact was on behavioral and emotional adjustment, which in turn improved functional independence,” the study authors write.
Future studies should be larger and test the treatment against a placebo group to confirm the findings.