Article

Transcranial magnetic stimulation has generated extensive interest within the
traumatic brain injury (TBI) rehabilitation community, but little work has been
done with repetitive protocols, which can produce prolonged changes in behavior.
This is partly because of concerns about the safety of repetitive transcranial
magnetic stimulation (rTMS) in subjects with TBI, particularly the risk of
seizures. These risks can be minimized by careful selection of the rTMS protocol
and exclusion criteria. In this article, we identify guidelines for safe use of
rTMS in subjects with TBI based on a review of the literature and illustrate
their application with a case study. Our subject is a 48-year-old man who
sustained a severe TBI 5 years prior to beginning rTMS for the treatment of
post-TBI depression. After a 4-week baseline period, we administered daily
sessions of low-frequency stimulation to the right dorsolateral prefrontal cortex
for 6 weeks. After stimulation, we performed monthly assessments for 3 months.
The Hamilton Depression Rating Scale (HAMD) was our primary outcome measure. The
stimulation was well tolerated and the patient reported no side effects. After 6
weeks of stimulation, the patient's depression was slightly improved, and these
improvements continued through follow-up. At the end of follow-up, the patient's
HAMD score was 49% of the average baseline score.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS