DEEP BRAIN STIMULATION TREATMENT

For the first time, researchers at The Ohio State University Wexner Medical Center have demonstrated the safety and effectiveness of using deep brain stimulation (DBS) in a new brain target to improve the quality of life and functioning of people with severe disability from traumatic brain injury (TBI).

“The results of this study show that DBS can significantly improve function in patients who have been impaired for up to 21 years from their initial TBI. We are excited about this study as it provides hope for future research to help patients and families affected by TBI,” said Dr. Ali Rezai, CEO of Ohio State’s Neurological Institute.

Rezai and John Corrigan, professor in the department of physical medicine and rehabilitation at Ohio State’s Wexner Medical Center, led this first-in-the-world study in which researchers investigated the use of DBS in the nucleus accumbens of four patients who had suffered severe disabling TBI from automobile crashes six to 21 years earlier. These patients had significant impairment in daily life functions, requiring continuous supervision. The goal of the study was to improve behavior and cognitive function.

“The fingerprint of TBI is damage to the frontal lobes of the brain; and a common consequence of injuring the frontal lobes is the loss of self-control,” said Corrigan, who also directs the Ohio Brain Injury Program. “We hoped to give these individuals a greater ability to regulate their own actions.”

Each year, 1.7 million Americans are treated in medical facilities as a result of TBI. While most of these injuries are mild, 25 percent are classified as moderate or severe TBI, resulting in more than 80,000 new cases of disability each year in the United Sates.

Severe TBI commonly damages the frontal lobe, resulting in a profound impairment in cognition and behavioral function with impairments in executive function and behavioral self-regulation, including impulsivity and poor decisionmaking. Despite the significant and long-lasting disabling motor, cognitive and behavioral effects of TBI, there are few treatment options for these patients. Many often live at home or institutions, requiring constant care and supervision, with limited hope for improvements of quality of life.

“The results showed that two years following DBS, three of the four participants demonstrated behavioral and emotional improvements and substantial gains in functional independence in self-care and activities of daily living,” said Rezai, who also is director of Ohio State’s Center for Neuromodulation.