Journal
JOURNAL OF HEAD TRAUMA REHABILITATION
Volume 27, Issue 4, Pages 274-292Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HTR.0b013e318217df55
Keywords
DAI; diffuse axonal injury; LLLT; low-level laser therapy; rTMS; TBI; TBS; TCD; tDCS; theta burst stimulation; TMS; transcranial direct current stimulation; transcranial Doppler sonography; transcranial magnetic stimulation; traumatic brain injury
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Funding
- BBVA Translational Research Chair in Biomedicine
- International Brain Research Foundation (IBRF)
- National Institutes of Health [K 24 RR018875]
- Instituto de Salud Carlos III [PI082004]
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Objective: To review novel techniques of noninvasive brain stimulation (NBS), which may have value in assessment and treatment of traumatic brain injury (TBI). Methods: Review of the following techniques: transcranial magnetic stimulation, transcranial direct current stimulation, low-level laser therapy, and transcranial Doppler sonography. Furthermore, we provide a brief overview of TMS studies to date. Main findings: We describe the rationale for the use of these techniques in TBI, discuss their possible mechanisms of action, and raise a number of considerations relevant to translation of these methods to clinical use. Depending on the stimulation parameters, NBS may enable suppression of the acute glutamatergic hyperexcitability following TBI and/or counter the excessive GABAergic effects in the subacute stage. In the chronic stage, brain stimulation coupled to rehabilitation may enhance behavioral recovery, learning of new skills, and cortical plasticity. Correlative animal models and comprehensive safety trials seem critical to establish the use of these modalities in TBI. Conclusions: Different forms of NBS techniques harbor the promise of diagnostic and therapeutic utility, particularly to guide processes of cortical reorganization and enable functional restoration in TBI. Future lines of safety research and well-designed clinical trials in TBI are warranted to determine the capability of NBS to promote recovery and minimize disability.
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