Brain stimulation in attention deficits after traumatic brain injury: a literature review and feasibility study.
Brain stimulation in attention deficits after traumatic brain injury: a literature review and feasibility study.
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DOI：
10.1186/s40814-021-00859-3
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发表时间：
2021-05-31
影响因子：
1.7
通讯作者：
H Dagher J
中科院分区：
文献类型：
--
作者：
Boissonnault È;Higgins J;LaGarde G;Barthélemy D;Lamarre C;H Dagher J
创伤性脑损伤后，注意力过程的紊乱对功能恢复和恢复复杂活动有直接的负面影响。到目前为止，还没有很好的注意力补救治疗。本综述和试点研究的主要目的是提供一个研究证据的概述，并评估实施tDCS协议的可行性，以改善在住院康复机构住院的轻度复杂至重度亚急性TBI患者的注意力障碍。我们的次要目标是提取参与者对治疗反应的初步数据和观察信息。参与者是从一个亚专科区域康复中心的TBI单位收治的连续系列患者中招募的。他们接受了20分钟的tDCS刺激，每周3次，持续3周。干预前后进行神经心理学评估。我们收集了参与者的社会人口统计学和临床特征以及有关满意度，耐受性和不良反应的信息。2018年9月至2020年1月期间收治了164例患者。158名患者被排除在外，6名疑似注意力缺陷的患者入组。没有人按预期完成方案。未发生重大副作用。非侵入性脑神经刺激有望改善TBI患者的注意力缺陷。在重症住院康复中心实施tDCS方案以实现这一目的有其局限性。我们提出了一些建议，以促进今后实施类似项目。ISRCTN，ISRCTN 55243064。2020年10月14日注册-追溯注册。
After a traumatic brain injury, disturbances in the attentional processes have a direct negative effect on functional recovery and on return to complex activities. To date, there is no good attention remediation treatment available. The primary objective of this review and pilot study is to provide an overview of the research evidence and to evaluate the feasibility of implementing a tDCS protocol to improve attention disorders in patients with mild complicated to severe subacute TBI, hospitalized in an inpatient rehabilitation facility. Our secondary objective is to extract preliminary data and observational information on participants’ response to treatment. Participants were recruited from a consecutive series of patients admitted to the TBI unit of a subspecialized regional rehabilitation center. They received a 20-min tDCS stimulation 3 times a week for 3 weeks. A neuropsychological evaluation was performed before and after the intervention. We collected participants’ sociodemographic and clinical characteristics as well as information about satisfaction, tolerability, and adverse effects. One hundred sixty-four patients were admitted between September 2018 and January 2020. One hundred fifty-eight were excluded, and 6 patients with presumed attentional deficits were enrolled. None completed the protocol as intended. No major side effects occurred. Non-invasive brain neurostimulation is promising to enhance attention deficits in patients with TBI. Implementation of a tDCS protocol to fulfill this purpose in an intensive inpatient rehabilitation center has its limitations. We made recommendations to facilitate the implementation of similar projects in the future. ISRCTN, ISRCTN55243064. Registered 14 October 2020—retrospectively registered.