CAN WE FACILITATE CONSCIOUSNESS AFTER SEVERE TRAUMATIC BRAIN INJURY?

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The standard medical treatment and rehabilitation provided to persons incurring a severe brain injury is based largely on case studies. There is no known treatment that facilitates recovery for persons who remain unconscious after severe traumatic brain injury. The purpose of this Phase I clinical trial is to examine the safety and efficacy of the experimental treatment, repetitive transcranial magnetic stimulation (rTMS), during coma recovery. The objectives are to: 1) Determine whether rTMS presented within parameters known to be safe on the healthy brain are also tolerated on the severely injured brain, and 2) Examine the potential of rTMS to induce a state conducive to neural plasticity, and 3) Identify the TMS parameters most effective in facillitating clinical recovery as well as the recovery of consciousness. The rationale for suggesting that rTMS will induce a state conducive to neural plasticity and/or induce neural adaptation is that pre-clinical evidence suggests that it influences brain plasticity and reorganization via neuronal excitation and inhibition.