Safety Considerations for the Use of Transcranial Magnetic Stimulation as Treatment for Coma Recovery in People With Severe Traumatic Brain Injury.
J Head Trauma Rehabil
; 35(6): 430-438, 2020.
Article
en En
| MEDLINE
| ID: mdl-33165155
ABSTRACT
OBJECTIVE:
For persons in states of disordered consciousness (DoC) after severe traumatic brain injury (sTBI), we report cumulative findings from safety examinations, including serious adverse events (AEs) of a repetitive transcranial magnetic stimulation (rTMS) parameter protocol in 2 different studies.PARTICIPANTS:
Seven persons in states of DoC after sTBI with widespread neuropathology, but no large lesions in proximity to the site of rTMS. One participant had a ventriculoperitoneal shunt with programmable valve.METHODS:
Two clinical trials each providing 30 rTMS sessions to the right or left dorsolateral prefrontal cortex, involving 300 to 600 pulses over 1 or 2 sessions daily. One study provided concomitant amantadine. Safety indicators monitored related to sleep, temperature, blood pressure, skin integrity, sweating, weight loss, infections, and seizure.RESULTS:
Average changes for monitored indicators were of mild severity, with 75 nonserious AEs and 1 serious AE (seizure). The participant incurring a seizure resumed rTMS while taking antieplieptics without further seizure activity.CONCLUSIONS:
Considering elevated risks for this patient population and conservative patient selection, findings indicate a relatively safe profile for the specified rTMS protocols; however, potential for seizure induction must be monitored. Future research for this population can be broadened to include patients previously excluded on the basis of profiles raising safety concerns.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Coma
/
Estimulación Magnética Transcraneal
/
Lesiones Traumáticas del Encéfalo
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Guideline
Límite:
Humans
Idioma:
En
Revista:
J Head Trauma Rehabil
Asunto de la revista:
REABILITACAO
/
TRAUMATOLOGIA
Año:
2020
Tipo del documento:
Article