A small study shows that deep brain stimulation may help improve cognition in people with traumatic brain injury. Catherine Falls Commercial/Getty Images
- As many as 69 million people around the world
have a traumatic brain injury (TBI) each year.
- People with moderate to severe TBI can
experience long-term issues that can impact their lives.
- Researchers from Stanford University have found
that deep brain stimulation may help improve cognition in people with
moderate to severe TBI.
Researchers estimate that as many as
There are three levels of TBI severity — mild,
moderate, and severe. Previous research shows between
In the case of moderate to severe TBI, people can
experience lifelong issues that can have a profound effect on their lives, such
as:
- cognitive
difficulties
- changes in
behavior
- sensory
sensitivity
- physical
disabilities
Over the past few years, researchers have studied deep brain stimulation as a potential
treatment for TBI.
Now, scientists from Stanford University have
published a study in the journal
Is there any treatment for
TBI?
According to Dr. Jaimie M.
Henderson, the John and Jene Blume–Robert and Ruth Halperin
Professor and professor of neurosurgery at Stanford University and co-lead
author of this study, it is important to develop new ways of improving
cognitive function in people with moderate to severe TBI because there are
currently no effective treatments for TBI.
“There are millions of people living with the
aftereffects of a brain injury,” Dr. Henderson told Medical News Today. “Anything that could improve
their condition even a bit would be a breakthrough.”
“Previous research has
For example, a study published in July 2022 found
using deep brain stimulation with a lower frequency was
Other research published in September 2022
How does deep
brain stimulation work?
For this study, Dr. Henderson and his team recruited five
study participants, all of whom had experienced a moderate to severe TBI at
least two years prior.
The scientists used deep brain stimulation to target
the brain’s
“In deep brain stimulation,
thin wires — called leads — are placed into the brain using precision targeting
techniques, usually to targets that are deep below the brain surface. These
wires are then connected by extensions to a pacemaker-like device placed in the
chest wall. The device provides pulses of electricity that can reverse some of
the symptoms of neurological disorders such as Parkinson’s disease, tremor,
depression, and now traumatic brain injury.”
— Dr. Jaimie M. Henderson,
lead study author
Dr.
Henderson said that in patients with moderate-to-severe TBI, the normal
interplay between different brain parts — the
“It’s a bit like turning down a dimmer switch, where
there isn’t enough activity to keep the cortex working properly,” he continued.
“The idea behind using deep brain stimulation to treat these patients is to
restore this activity — like turning that dimmer switch back up.”
During the study, each participant received personalized treatment approaches for deep brain stimulation.
Each study participant underwent surgery to implant
electrodes near the thalamus in the brain. Scientists used the implants to
apply an electric current at a frequency between 150 and 185 hertz for 12 hours
a day for a period of three months.
Additionally, each participant was given a cognitive
function test at the beginning and end of the study period.
At the
end of the three months, researchers found the study participants showed an
average improvement of 30.7% in their performance on the cognitive test. And
they improved the speed of completing the test by an average of 32%.
“Based on some prior studies, we were fairly confident
that we would see at least some response in some patients,” Dr. Henderson said.
“The surprising part was the fact that every patient
improved, some far beyond what was expected. The study was designed in such a
way that a 10% improvement would be declared a success. So an average of 30%
improvement was a very clear indicator that the stimulation was working as
expected and that the study was successful.”
“The goal is now to do a
larger study, using all the knowledge that we gained from this smaller study to
select patients and outcome measures that will give us even more confidence
that this could become a treatment for the millions of people whose lives have
been affected by TBI.”
— Dr. Jaimie M. Henderson,
lead study author
More research
on deep brain stimulation for TBI still needed
MNT also
spoke with Dr.
Walavan Sivakumar, a board certified neurosurgeon and director of
neurosurgery at Pacific Neuroscience Institute-South Bay in Torrance, CA, about
this study. Dr. Sivakumar was not involved in the research.
“Deep
brain stimulation represents an emerging technology at the forefront of
clinical neurosciences,” he said. “Its success in movement disorders makes me
cautiously optimistic about its utility in this realm.”
Dr. Sivakumar said new ways of improving cognitive
function in people with moderate to severe TBI are important because the
cognitive and psychosocial impact of traumatic brain injury is impossible to
fully quantify with current assessment techniques.
“Patients can ‘look fine’ on the outside but be
extremely functionally limited,” he explained.
“This impacts their ability to communicate, to work,
and assimilate into society. As the longevity of the population improves,
long-term brain health becomes increasingly important. Anything we can do to
improve the cognitive health of our patients will help get us closer to the
goal.”
“The study is a great first step but it needs to be
expanded to a larger trial across many centers in order to achieve
generalizability,” Dr. Sivakumar added.
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