Brain injury : [BI]
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Brain injury : [BI] · Jan 2021
Accelerated repetitive transcranial magnetic stimulation in the treatment of post-concussion symptoms due to mild traumatic brain injury: a pilot study.
Objective: To investigate the feasibility, tolerability, and efficacy of twice-daily, low frequency (LF) repetitive transcranial magnetic stimulation (rTMS) over the right dorsolateral prefrontal cortex (DLPFC) in the reduction of chronic post-concussion symptoms (PCS) in patients who have suffered a mild traumatic brain injury (mTBI). Methods: 15 patients with mTBI received 30 sessions of twice-daily LF rTMS (1 Hz) over the right DLPFC. Post-concussion symptoms, pain, disability, fatigue, apathy, agitation, and mood were assessed by a psychiatrist pre- and post-treatment. ⋯ Cognitive testing revealed improvements in verbal fluency, working memory, selective attention, and cognitive processing speed. Conclusions: This small-sample pilot study suggests that twice-daily, LF rTMS over the right DLPFC can be safely and tolerably applied and has the potential to improve post-concussion symptoms as well as elements of mood and cognition in patients with mTBI. Larger, sham-controlled studies will be important to confirm these observations.
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Brain injury : [BI] · Jan 2021
Dilation velocity is associated with Glasgow Coma Scale scores in patients with brain injury.
Background: Pupillary light reflex (PLR) is informative about patients with neurological injury. Automated pupillometry provides discrete variables such as dilation velocity (DV). The objective of this study is to determine association between DV and Glasgow Coma Score (GCS), for patients with acquired brain injury. ⋯ PLR may provide a biomarker of injury when a neurological exam is limited. Trial Registration: NCT02804438 (June 17, 2016). ABBREVIATIONS: GCS: Glasgow Coma Scale; PLR: Pupillary Light Reflex; DV: Dilation velocity; ICP: Intracranial pressure; NPi: Neurological pupil index; mRS: Modified Rankin Score; PCT: Percent change in size (pre and post constriction); Lat: Latency; CV: Constriction velocity; GLMM: Generalized Linear Mixed Model.