CAN WE FACILITATE CONSCIOUSNESS AFTER SEVERE TRAUMATIC BRAIN INJURY?

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 向遭受严重脑损伤的人提供的标准医疗和康复主要是基于个案研究。 对于严重创伤性脑损伤后仍然昏迷的人，没有已知的治疗方法可以促进恢复。 这项I期临床试验的目的是检查实验性治疗的安全性和有效性，重复经颅磁刺激（rTMS），在昏迷恢复期间。 其目标是： 1)确定在已知对健康大脑安全的参数范围内呈现的rTMS是否在严重损伤的大脑上也是耐受的，以及 2)检查rTMS诱导有利于神经可塑性的状态的潜力， 3)确定促进临床恢复以及意识恢复最有效的TMS参数。 提示rTMS将诱导有利于神经可塑性和/或诱导神经适应的状态的基本原理是，临床前证据表明，它通过神经元兴奋和抑制影响大脑可塑性和重组。

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.