Transcranial Direct Current Stimulation for Post-Concussion Syndrome: Study Protocol for a Randomized Crossover Trial

Carregando...
Imagem de Miniatura
Citações na Scopus
9
Tipo de produção
article
Data de publicação
2017
Título da Revista
ISSN da Revista
Título do Volume
Editora
FRONTIERS MEDIA SA
Citação
FRONTIERS IN NEUROLOGY, v.8, article ID 164, 8p, 2017
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: Mild traumatic brain injury (MTBI) represents 70-80% of all treated brain injuries. A considerable proportion of MTBI patients experience post-concussion symptoms for a prolonged period after MTBI, and these symptoms are diagnosed as persistent post-concussion syndrome (PPCS). PPCS is defined as a range of physical, cognitive, and emotional symptoms. However, memory and executive dysfunction seems to be one of the most debilitating symptoms. Recently, non-invasive brain stimulation has been studied as a potential treatment method for traumatic brain injury (TBI) patients. Therefore, our primary goal is to verify the effects of transcranial direct current stimulation (tDCS) in patients with PPCS who demonstrate cognitive deficits in long-term episodic memory, working memory, and executive function following MTBI. Methods/design: This is a randomized crossover trial of patients with a history of MTBI with cognitive deficits in memory and executive function. Thirty adult patients will be randomized in a crossover manner to receive three weekly sessions of anodal tDCS (2mA) at left dorsolateral prefrontal cortex, left temporal cortex, and sham stimulation that will be performed at 7-day intervals (washout period). The clinical diagnosis of PPCS will be determined using the Rivermead Post-Concussion Symptoms Questionnaire. Patients who meet the inclusion criteria will be assessed with a neuropsychological evaluation. A new battery of computerized neuropsychological tests will be performed before and immediately after each stimulation. Statistical analysis will be performed to determine trends of cognitive improvement. Discussion: There is paucity of studies regarding the use of tDCS in TBI patients, and although recent results showed controversial data regarding the effects of tDCS in such patients, we will address specifically patients with PPCS and MTBI and no brain abnormalities on CT scan other than subarachnoid hemorrhage. Moreover, due to the missing information on literature regarding the best brain region to be studied, we will evaluate two different regions to find immediate effects of tDCS on memory and executive dysfunction.
Palavras-chave
brain injuries, post-concussion syndrome, transcranial direct current stimulation, non-invasive brain stimulation, crossover studies
Referências
  1. Ahman S, 2013, J REHABIL MED, V45, P758, DOI 10.2340/16501977-1182
  2. Angelakis E, 2014, ARCH PHYS MED REHAB, V95, P283, DOI 10.1016/j.apmr.2013.09.002
  3. Bajaj JS, 2008, GASTROENTEROLOGY, V135, P1591, DOI 10.1053/j.gastro.2008.07.021
  4. BECK AT, 1961, ARCH GEN PSYCHIAT, V4, P561
  5. Benedict RHB, 1998, CLIN NEUROPSYCHOL, V12, P43, DOI 10.1076/clin.12.1.43.1726
  6. Bigler ED, 2001, ARCH CLIN NEUROPSYCH, V16, P95
  7. Bigler ED, 2008, J INT NEUROPSYCH SOC, V14, P1, DOI 10.1017/S135561770808017X
  8. Boggio PS, 2009, J NEUROL NEUROSUR PS, V80, P444, DOI 10.1136/jnnp.2007.141853
  9. Boggio PS, 2007, J AFFECT DISORDERS, V101, P91, DOI 10.1016/j.jad.2006.10.026
  10. Boggio PS, 2006, J NEUROL SCI, V249, P31, DOI 10.1016/j.jns.2006.05.062
  11. Boggio PS, 2009, PLOS ONE, V4, DOI 10.1371/journal.pone.0004959
  12. Bolognini N, 2009, J NEUROENG REHABIL, V6, DOI 10.1186/1743-0003-6-8
  13. Bonni S, 2013, NEUROL SCI, V34, P2053, DOI 10.1007/s10072-013-1412-y
  14. Brandt J., 2001, HOPKINS VERBAL LEARN
  15. Brunoni AR, 2012, BRAIN STIMUL, V5, P175, DOI 10.1016/j.brs.2011.03.002
  16. Bueno VF, 2011, NEUROCASE, V17, P318, DOI 10.1080/13554794.2010.509319
  17. Cerruti C, 2009, J COGNITIVE NEUROSCI, V21, P1980, DOI 10.1162/jocn.2008.21143
  18. Cotelli M, 2014, FRONT AGING NEUROSCI, V6, DOI 10.3389/fnagi.2014.00038
  19. Datta SGS, 2009, NEUROL INDIA, V57, P594, DOI 10.4103/0028-3886.57810
  20. Lima DPD, 2008, INJURY, V39, P604, DOI 10.1016/j.injury.2007.11.008
  21. Demirtas-Tatlidede A, 2012, J HEAD TRAUMA REHAB, V27, P274, DOI 10.1097/HTR.0b013e318217df55
  22. Dockery CA, 2009, J NEUROSCI, V29, P7271, DOI 10.1523/JNEUROSCI.0065-09.2009
  23. Dresler M, 2013, NEUROPHARMACOLOGY, V64, P529, DOI 10.1016/j.neuropharm.2012.07.002
  24. Fecteau S, 2010, SUBST USE MISUSE, V45, P1766, DOI 10.3109/10826084.2010.482434
  25. Garavan H, 1999, P NATL ACAD SCI USA, V96, P8301, DOI 10.1073/pnas.96.14.8301
  26. Goldman RL, 2011, APPETITE, V56, P741, DOI 10.1016/j.appet.2011.02.013
  27. Gorenstein C, 1996, BRAZ J MED BIOL RES, V29, P453
  28. Harris PA, 2009, J BIOMED INFORM, V42, P377, DOI 10.1016/j.jbi.2008.08.010
  29. Howell D, 2013, MED SCI SPORT EXER, V45, P1030, DOI 10.1249/MSS.0b013e3182814595
  30. Iyer MB, 2005, NEUROLOGY, V64, P872
  31. Jo JM, 2009, AM J PHYS MED REHAB, V88, P404, DOI 10.1097/PHM.0b013e3181a0e4cb
  32. Jones KT, 2015, PLOS ONE, V10, DOI 10.1371/journal.pone.0121904
  33. Kang EK, 2009, RESTOR NEUROL NEUROS, V27, P645, DOI 10.3233/RNN-2009-0514
  34. Kang EK, 2012, J REHABIL MED, V44, P346, DOI 10.2340/16501977-0947
  35. King N, 1997, BRIT J CLIN PSYCHOL, V36, P161
  36. KING NS, 1995, J NEUROL, V242, P587, DOI 10.1007/BF00868811
  37. Koski L, 2015, J NEUROTRAUM, V32, P38, DOI 10.1089/neu.2014.3449
  38. Lesniak M, 2014, J HEAD TRAUMA REHAB, V29, pE20, DOI 10.1097/HTR.0b013e318292a4c2
  39. Lezak M. D., 2012, NEUROPSYCHOLOGICAL A
  40. Rosenow J, 2009, BRAIN STIMUL, V2, P22, DOI 10.1016/J.BRS.2008.09.004
  41. Lundin A, 2006, BRAIN INJURY, V20, P799, DOI 10.1080/02699050600744327
  42. McCauley SR, 2001, J CLIN EXP NEUROPSYC, V23, P792, DOI 10.1076/jcen.23.6.792.1016
  43. Naunheim RS, 2008, J HEAD TRAUMA REHAB, V23, P116, DOI 10.1097/01.HTR.0000314530.30401.70
  44. Nitsche MA, 2008, BRAIN STIMUL, V1, P206, DOI 10.1016/j.brs.2008.06.004
  45. Park SH, 2013, J KOREAN NEUROSURG S, V54, P484, DOI 10.3340/jkns.2013.54.6.484
  46. Pereira JB, 2013, BRAIN STIMUL, V6, P16, DOI 10.1016/j.brs.2012.01.006
  47. Prigatano GP, 2011, CURR OPIN PSYCHIATR, V24, P243, DOI 10.1097/YCO.0b013e328344698b
  48. Riggio S, 2009, MT SINAI J MED, V76, P163, DOI 10.1002/msj.20097
  49. Rossi S, 2009, CLIN NEUROPHYSIOL, V120, P2008, DOI 10.1016/j.clinph.2009.08.016
  50. Ruffolo CF, 1999, ARCH PHYS MED REHAB, V80, P392, DOI 10.1016/S0003-9993(99)90275-7
  51. Son AHPWV, 2007, CLIN REHABIL, V21, P1024, DOI 10.1177/0269215507077603
  52. Spreen O, 1998, COMPENDIUM NEUROPSYC
  53. Stuart B, 2012, J EMERG NURS, V38, P435, DOI 10.1016/j.jen.2011.04.006
  54. Ulam F, 2015, CLIN NEUROPHYSIOL, V126, P486, DOI 10.1016/j.clinph.2014.05.015
  55. Van den Eynde F, 2010, BIOL PSYCHIAT, V67, P793, DOI 10.1016/j.biopsych.2009.11.023
  56. Vanderhasselt MA, 2013, PLOS ONE, V8, DOI 10.1371/journal.pone.0062219
  57. Weschler D, 1997, WESCHLER ADULT INTEL
  58. Wu YJ, 2014, BRAIN COGNITION, V91, P87, DOI 10.1016/j.bandc.2014.09.002
  59. Yun GJ, 2015, J STROKE, V17, P354, DOI 10.5853/jos.2015.17.3.354