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Safety Considerations for the Use of Transcranial Magnetic Stimulation as Treatment for Coma Recovery in People With Severe Traumatic Brain Injury
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 stu...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8908773/ https://www.ncbi.nlm.nih.gov/pubmed/33165155 http://dx.doi.org/10.1097/HTR.0000000000000636 |
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author | Kletzel, Sandra L. Aaronson, Alexandra L. Guernon, Ann Carbone, Christina Chaudhry, Noor Walsh, Elyse Conneely, Mark Patil, Vijaya Roth, Elliott Steiner, Monica Pacheco, Marilyn Rosenow, Joshua Bender Pape, Theresa L. |
author_facet | Kletzel, Sandra L. Aaronson, Alexandra L. Guernon, Ann Carbone, Christina Chaudhry, Noor Walsh, Elyse Conneely, Mark Patil, Vijaya Roth, Elliott Steiner, Monica Pacheco, Marilyn Rosenow, Joshua Bender Pape, Theresa L. |
author_sort | Kletzel, Sandra L. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8908773 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
record_format | MEDLINE/PubMed |
spelling | pubmed-89087732022-03-10 Safety Considerations for the Use of Transcranial Magnetic Stimulation as Treatment for Coma Recovery in People With Severe Traumatic Brain Injury Kletzel, Sandra L. Aaronson, Alexandra L. Guernon, Ann Carbone, Christina Chaudhry, Noor Walsh, Elyse Conneely, Mark Patil, Vijaya Roth, Elliott Steiner, Monica Pacheco, Marilyn Rosenow, Joshua Bender Pape, Theresa L. J Head Trauma Rehabil Article 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. 2020 /pmc/articles/PMC8908773/ /pubmed/33165155 http://dx.doi.org/10.1097/HTR.0000000000000636 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Article Kletzel, Sandra L. Aaronson, Alexandra L. Guernon, Ann Carbone, Christina Chaudhry, Noor Walsh, Elyse Conneely, Mark Patil, Vijaya Roth, Elliott Steiner, Monica Pacheco, Marilyn Rosenow, Joshua Bender Pape, Theresa L. Safety Considerations for the Use of Transcranial Magnetic Stimulation as Treatment for Coma Recovery in People With Severe Traumatic Brain Injury |
title | Safety Considerations for the Use of Transcranial Magnetic Stimulation as Treatment for Coma Recovery in People With Severe Traumatic Brain Injury |
title_full | Safety Considerations for the Use of Transcranial Magnetic Stimulation as Treatment for Coma Recovery in People With Severe Traumatic Brain Injury |
title_fullStr | Safety Considerations for the Use of Transcranial Magnetic Stimulation as Treatment for Coma Recovery in People With Severe Traumatic Brain Injury |
title_full_unstemmed | Safety Considerations for the Use of Transcranial Magnetic Stimulation as Treatment for Coma Recovery in People With Severe Traumatic Brain Injury |
title_short | Safety Considerations for the Use of Transcranial Magnetic Stimulation as Treatment for Coma Recovery in People With Severe Traumatic Brain Injury |
title_sort | safety considerations for the use of transcranial magnetic stimulation as treatment for coma recovery in people with severe traumatic brain injury |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8908773/ https://www.ncbi.nlm.nih.gov/pubmed/33165155 http://dx.doi.org/10.1097/HTR.0000000000000636 |
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