The Clinical And Mechanism Research Of Rehabilitation Treatment On Disturbance Of Consciousness And Cognitive Disorderafter Traumatic Brain Injury

Objective:To investigate arousal effect of median nerve electrical stimulation(MNS) on traumatic brain injury(TBI) induced coma in patients.Methods:60 patients with coma after TBI were randomly divided into two groups :the experimental group(n = 30) and the control group(n = 30),the two groups were given conventional awakening promoted treatment, but the experimental group with an extra MNS treatment. Glasgow coma scale(GCS), and Electroencephalo-graph(EEG),Single photon emission computed tomography(SPECT)were performed to evaluate the two groups patients, before and after treatment respectively.Results:(1) After 4 weeks, average score of GCS,in the experimental group is better than average score of the control group, the difference was statistically significant(P < 0.05);(2) EEG showδ/θwave and α wave amplitude decreases in injured side of patients in the experimental group;(3) SPECT visual analysis indicate that ischemia area blood flow increased significantly compared with before treatment, SPECT semi-quantitative analysis display ischemia area(rightROI-leftROI)/rightROI% increased by 12.34±0.36% compared with before treatment, the difference was statistically significant(P < 0.05).Conclusion:MNS treatment play predominant role to promote awakening in patients with TBI induced coma.,its mechanism may be related to the ischemia area blood flow increased.Objectives(1) To investigate the effects of high frequency repetitive transcranial magnetic stimulation(r TMS) on traumatic brain injury patients with unilateral spatial neglect(USN)(2) To explore the functional neuroimaging mechanisms following r TMS intervention;Methods(1)30 traumatic brain injury patients with USN voluntarily participated in the present study, and they were randomly divided into the control group(CG) and experimental group(EG);(2)Both the CG and the EG received regular rehabilitation intervention, while the EG was treated with additional high frequency r TMS which was performed twice a day and 10 minutes each day for 10 days; The r TMS was conducted with 10 Hz stimulation frequency and 95% intensity of the stimulation threshold; The stimulation position was located on the right parietal cortex(the position P5 or P6 according to the 10-20 EEG system);(3)All the patients received a series of neuropsychological tests and a resting-state f MRI scanning at baseline and 10 days after the r TMS treatment.Results(1)Compared to the CG, significant improvements were found in EG on tests of line cancellation(p=0.038), graph deletion(p=0.034) and Catherine Bergego Scale(p<0.05);(2)Besides, the regional homogeneity(activity) of the right superior temporal gyrus, middle frontal gyrus, superior parietal lobule, precuneus and anterior cerebellum lobe were enhanced significantly after the r TMS intervention compared to the baseline.ConclusionsHigh frequency r TMS significantly improved the symptoms of USN and counterbalanced the activity between the left and right hemisphere.