scholarly journals The Effect of Non-Invasive Brain Stimulation (NIBS) on Executive Functioning, Attention and Memory in Rehabilitation Patients with Traumatic Brain Injury: A Systematic Review

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 627
Author(s):  
Takatoshi Hara ◽  
Aturan Shanmugalingam ◽  
Amanda McIntyre ◽  
Amer M. Burhan
Keyword(s):  
Systematic Review ◽  
Traumatic Brain Injury ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Brain Injury ◽  
Brain Stimulation ◽  
Control Group ◽  
Attention And Memory ◽  
Stimulation Site ◽  
Non Invasive

In recent years, the potential of non-invasive brain stimulation (NIBS) for therapeutic effects on cognitive functions has been explored for populations with traumatic brain injury (TBI). However, there is no systematic NIBS review of TBI cognitive impairment with a focus on stimulation sites and stimulation parameters. The purpose of this study was to conduct a systematic review examining the effectiveness and safety of NIBS for cognitive impairment after a TBI. This study was prospectively registered with the PROSPERO database of systematic reviews (CRD42020183298). All English articles from the following databases were searched from inception up to 31 December 2020: Pubmed/MEDLINE, Scopus, CINAHL, Embase, PsycINFO and CENTRAL. Randomized and prospective controlled trials, including cross-over studies, were included for analysis. Studies with at least five individuals with TBI, whereby at least five sessions of NIBS were provided and used standardized neuropsychological measurement of cognition, were included. A total of five studies met eligibility criteria. Two studies used repetitive transcranial magnetic stimulation (rTMS) and three studies used transcranial direct current stimulation (tDCS). The pooled sample size was 44 individuals for rTMS and 91 for tDCS. Three of five studies combined cognitive training or additional therapy (computer assisted) with NIBS. Regarding rTMS, target symptoms included attention (n = 2), memory (n = 1), and executive function (n = 2); only one study showing significant improvement compared than control group with respect to attention. In tDCS studies, target symptoms included cognition (n = 2), attention (n = 3), memory (n = 3), working memory (WM) (n = 3), and executive function (n = 1); two of three studies showed significant improvement compared to the control group with respect to attention and memory. The evidence for NIBS effectiveness in rehabilitation of cognitive function in TBI is still in its infancy, more studies are needed. In all studies, dorsolateral prefrontal cortex (DLPFC) was selected as the stimulation site, along with the stimulation pattern promoting the activation of the left DLPFC. In some studies, there was a significant improvement compared to the control group, but neither rTMS nor tDCS had sufficient evidence of effectiveness. To the establishment of evidence we need the evaluation of brain activity at the stimulation site and related areas using neuroimaging on how NIBS acts on the neural network.

scholarly journals Deep brain stimulation for the treatment of disorders of consciousness and cognition in traumatic brain injury patients: a review

2018 ◽  
Vol 45 (2) ◽  
pp. E14 ◽  
Author(s):  
Bornali Kundu ◽  
Andrea A. Brock ◽  
Dario J. Englot ◽  
Christopher R. Butson ◽  
John D. Rolston
Keyword(s):  
Traumatic Brain Injury ◽  
Executive Function ◽  
Deep Brain Stimulation ◽  
Brain Injury ◽  
Brain Stimulation ◽  
Minimally Conscious State ◽  
Disorders Of Consciousness ◽  
Future Research ◽  
Attention And Memory ◽  
Deep Brain

Traumatic brain injury (TBI) is a looming epidemic, growing most rapidly in the elderly population. Some of the most devastating sequelae of TBI are related to depressed levels of consciousness (e.g., coma, minimally conscious state) or deficits in executive function. To date, pharmacological and rehabilitative therapies to treat these sequelae are limited. Deep brain stimulation (DBS) has been used to treat a number of pathologies, including Parkinson disease, essential tremor, and epilepsy. Animal and clinical research shows that targets addressing depressed levels of consciousness include components of the ascending reticular activating system and areas of the thalamus. Targets for improving executive function are more varied and include areas that modulate attention and memory, such as the frontal and prefrontal cortex, fornix, nucleus accumbens, internal capsule, thalamus, and some brainstem nuclei. The authors review the literature addressing the use of DBS to treat higher-order cognitive dysfunction and disorders of consciousness in TBI patients, while also offering suggestions on directions for future research.

scholarly journals Intervention Effect of Non-Invasive Brain Stimulation on Cognitive Functions among People with Traumatic Brain Injury: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 (7) ◽  
pp. 840
Author(s):  
Daniel Kwasi Ahorsu ◽  
Emma Sethina Adjaottor ◽  
Bess Yin-Hung Lam
Keyword(s):  
Systematic Review ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Stimulation ◽  
Cognitive Functions ◽  
Traditional Approach ◽  
Meta Analysis ◽  
Adjunct Treatment ◽  
Non Invasive ◽  
Randomized Control

This systematic review and meta-analysis aggregated and examined the treatment effect of non-invasive brain stimulation (NIBS) (transcranial direct current stimulation and transcranial magnetic stimulation) on cognitive functions in people with traumatic brain injury (TBI). A systematic search was conducted using databases (PubMed, Web of Science, Scopus, PsycINFO, EMBASE) for studies with keywords related to non-randomized and randomized control trials of NIBS among people with TBI. Nine out of 1790 NIBS studies with 197 TBI participants (103 active vs. 94 sham) that met the inclusion and exclusion criteria of the present study were finally selected for meta-analysis using Comprehensive Meta-Analysis software (version 3). Results showed that the overall effect of NIBS on cognition in people with TBI was moderately significant (g = 0.304, 95% CI = 0.055 to 0.553) with very low heterogeneity across studies (I2 = 0.000, Tau = 0.000). Specifically, significant and marginally significant moderate effect sizes were found for cognitive sub-domains including attention, memory, and executive function. The present findings suggest that NIBS is moderately effective in improving cognitive functions among people with TBI. In particular, NIBS may be used as an alternative and/or an adjunct treatment to the traditional approach in rehabilitating cognitive functions in people with TBI.

scholarly journals The Effect of Non-Invasive Brain Stimulation (NIBS) on Attention and Memory Function in Stroke Rehabilitation Patients: A Systematic Review and Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 227
Author(s):  
Takatoshi Hara ◽  
Aturan Shanmugalingam ◽  
Amanda McIntyre ◽  
Amer M. Burhan
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Brain Stimulation ◽  
Meta Analysis ◽  
Attention And Memory ◽  
Post Stroke ◽  
Non Invasive ◽  
Stimulation Parameters ◽  
Global Cognition ◽  
Attention Memory

Background: In recent years, the potential of non-invasive brain stimulation (NIBS) for therapeutic effects on cognitive functions has been explored for populations with stroke. There are various NIBS methods depending on the stimulation site and stimulation parameters. However, there is no systematic NIBS review of post-stroke cognitive impairment with a focus on stimulation sites and stimulation parameters. The purpose of this study is to conduct a systematic review and meta-analysis on effectiveness and safety of NIBS for cognitive impairment after a stroke to obtain new insights. This study was prospectively registered with the PROSPERO database of systematic reviews (CRD42020183298). Methods: All English articles from MEDLINE, Scopus, CINAHL, Embase, PsycINFO, and CENTRAL were searched from inception up to 31 December 2020. Randomized and prospective controlled trials were included for the analysis. Studies with at least five individuals post-stroke, whereby at least five sessions of NIBS were provided and using standardized neuropsychological measurement of cognition, were included. We assessed the methodological quality of selected studies as described in the Physiotherapy Evidence Database (PEDro) scoring system. Results: A total of 10 studies met eligibility criteria. Six studies used repetitive transcranial magnetic stimulation (rTMS) and four studies used transcranial direct current stimulation (tDCS). The pooled sample size was 221 and 196 individuals who received rTMS and tDCS respectively. Eight studies combined general rehabilitation, cognitive training, or additional therapy with NIBS. In rTMS studies, target symptoms included global cognition (n = 4), attention (n = 3), memory (n = 4), working memory (WM) (n = 3), and executive function (n = 2). Five studies selected the left dorsolateral prefrontal cortex (DPLFC) as the stimulation target. One rTMS study selected the right DLPFC as the inhibitory stimulation target. Four of six studies showed significant improvement. In tDCS studies, target symptoms included global cognition (n = 2), attention (n = 4), memory (n = 2) and WM (n = 2). Three studies selected the frontal area as the stimulation target. All studies showed significant improvement. In the meta-analysis, rTMS showed a significant effect on attention, memory, WM and global cognition classified by neuropsychological tests. On the other hand, tDCS had no significant effect. Conclusions: In post-stroke patients with deficits in cognitive function, including attention, memory, and WM, NIBS shows promising positive effects. However, this effect is limited, suggesting that further studies are needed with more precision in stimulation sites and stimulation parameters. Future studies using advanced neurophysiological and neuroimaging tools to allow for a network-based approach to treat cognitive symptoms post-stroke with NIBS are warranted.

scholarly journals A Systematic Review of effect of Non-Invasive Brain Stimulation on Cognition Impairment after a Stroke and Traumatic Brain Injury

2020 ◽  
Author(s):  
Takatoshi Hara ◽  
Aturan Shanmugalingam ◽  
Amanda McIntyre ◽  
Amer M. Burhan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Intervention Group ◽  
Spatial Neglect ◽  
Attention And Memory ◽  
Therapeutic Effects ◽  
Post Stroke ◽  
Non Invasive

ABSTRACTBackgroundIn recent years, the potential of non-invasive brain stimulation (NIBS) for therapeutic effects on cognitive functions has been explored for stroke and traumatic brain injury (TBI) populations.MethodsAll English articles from the following sources were searched from inception up to December 31, 2018: PubMed, Scopus, CINAHL, Embase, PsycINFO and CENTRAL. Randomized and prospective controlled trials, including cross-over studies, were included for analysis. Studies with at least five individuals post stroke or TBI, whereby at least five sessions of NIBS were provided and used standardized neuropsychological measurement of cognition, were included.ResultsA total of 17 studies met eligibility criteria which included 546 patients receiving either repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS). Sample sizes ranged 5-25 subjects per group. Seven studies used rTMS and ten studies used tDCS. Target symptoms included global cognition (n=8), memory (n=1), attention (n=1), and unilateral spatial neglect (USN) (n=7). Nine studies combined rehabilitation or additional therapy with NIBS. Six of ten studies showed significant improvement in attention, memory, working memory, and executive function. In the USN study, five of the seven studies had a significant improvement in the intervention group.ConclusionsThe effect of NIBS on executive functions including attention and memory post stroke or TBI yielded mixed results with variable stimulation parameters. A significant, consistent improvement was observed for USN post stroke or TBI. Future studies using advanced neurophysiological and neuroimaging tools to allow network-based approach to NIBS for cognitive symptoms post stroke or TBI are warranted.

Profiles of Executive Function Across Children with Distinct Brain Disorders: Traumatic Brain Injury, Stroke, and Brain Tumor

2017 ◽  
Vol 23 (7) ◽  
pp. 529-538 ◽  
Author(s):  
Gabriel C. Araujo ◽  
Tanya N. Antonini ◽  
Vicki Anderson ◽  
Kathryn A. Vannatta ◽  
Christina G. Salley ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Tumor ◽  
Executive Function ◽  
Brain Injury ◽  
Executive Functions ◽  
Control Group ◽  
Medical Illness ◽  
Brain Disorders ◽  
Brain Disorder ◽  
Orthopedic Injury

AbstractObjectives:This study examined whether children with distinct brain disorders show different profiles of strengths and weaknesses in executive functions, and differ from children without brain disorder.Methods:Participants were children with traumatic brain injury (N=82; 8–13 years of age), arterial ischemic stroke (N=36; 6–16 years of age), and brain tumor (N=74; 9–18 years of age), each with a corresponding matched comparison group consisting of children with orthopedic injury (N=61), asthma (N=15), and classmates without medical illness (N=68), respectively. Shifting, inhibition, and working memory were assessed, respectively, using three Test of Everyday Attention: Children’s Version (TEA-Ch) subtests: Creature Counting, Walk-Don’t-Walk, and Code Transmission. Comparison groups did not differ in TEA-Ch performance and were merged into a single control group. Profile analysis was used to examine group differences in TEA-Ch subtest scaled scores after controlling for maternal education and age.Results:As a whole, children with brain disorder performed more poorly than controls on measures of executive function. Relative to controls, the three brain injury groups showed significantly different profiles of executive functions. Importantly, post hoc tests revealed that performance on TEA-Ch subtests differed among the brain disorder groups.Conclusions:Results suggest that different childhood brain disorders result in distinct patterns of executive function deficits that differ from children without brain disorder. Implications for clinical practice and future research are discussed. (JINS, 2017,23, 529–538)

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