PMID- 33165155
OWN - NLM
STAT- MEDLINE
DCOM- 20210910
LR  - 20220420
IS  - 1550-509X (Electronic)
IS  - 0885-9701 (Print)
IS  - 0885-9701 (Linking)
VI  - 35
IP  - 6
DP  - 2020 Nov-Dec
TI  - Safety Considerations for the Use of Transcranial Magnetic Stimulation as 
      Treatment for Coma Recovery in People With Severe Traumatic Brain Injury.
PG  - 430-438
LID - 10.1097/HTR.0000000000000636 [doi]
AB  - 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.
FAU - Kletzel, Sandra L
AU  - Kletzel SL
AD  - The Department of Veterans Affairs (VA), Research Service, Edward Hines Jr VA 
      Hospital, Hines, Illinois (Drs Kletzel, Aaronson, Guernon, Walsh, Patil, Steiner, 
      Pacheco, and Bender Pape and Mr Chaudhry); The Department of Veterans Affairs 
      Mental Health Service Line, Hines VA, Hines, Illinois (Dr Aaronson) Marianjoy 
      Rehabilitation Hospital/Northwestern Medicine, Wheaton, Illinois (Drs Guernon and 
      Bender Pape); Battle Creek VA Medical Center, Kalamazoo, Michigan (Dr Carbone); 
      Department of Physical Medicine and Rehabilitation, Northwestern University 
      Feinberg School of Medicine, Chicago, Illinois (Drs Roth, Rosenow, and Bender 
      Pape); Departments of Neurosurgery and Neurology, Northwestern University 
      Feinberg School of Medicine, Chicago, Illinois (Dr Rosenow); The Department of 
      Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of 
      Medicine Chicago, Illinois (Drs Aaronson and Pacheco); Chicago Medical School, 
      Rosalind Franklin University of Science and Medicine, North Chicago, Illinois, 
      (Dr Conneely); Loyola University Chicago, Stritch School of Medicine, Maywood, 
      Illinois (Drs Patil and Steiner); University of Illinois at Chicago, Chicago, 
      Illinois (Mr Chaudhry).
FAU - Aaronson, Alexandra L
AU  - Aaronson AL
FAU - Guernon, Ann
AU  - Guernon A
FAU - Carbone, Christina
AU  - Carbone C
FAU - Chaudhry, Noor
AU  - Chaudhry N
FAU - Walsh, Elyse
AU  - Walsh E
FAU - Conneely, Mark
AU  - Conneely M
FAU - Patil, Vijaya
AU  - Patil V
FAU - Roth, Elliott
AU  - Roth E
FAU - Steiner, Monica
AU  - Steiner M
FAU - Pacheco, Marilyn
AU  - Pacheco M
FAU - Rosenow, Joshua
AU  - Rosenow J
FAU - Bender Pape, Theresa L
AU  - Bender Pape TL
LA  - eng
GR  - IK1 RX001850/RX/RRD VA/United States
GR  - IK1 RX003082/RX/RRD VA/United States
GR  - IK2 RX002938/RX/RRD VA/United States
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - J Head Trauma Rehabil
JT  - The Journal of head trauma rehabilitation
JID - 8702552
SB  - IM
MH  - *Brain Injuries, Traumatic/diagnosis/therapy
MH  - *Coma/etiology/therapy
MH  - Humans
MH  - Prefrontal Cortex
MH  - Seizures
MH  - *Transcranial Magnetic Stimulation
MH  - Treatment Outcome
PMC - PMC8908773
MID - NIHMS1663301
COIS- The authors declare no conflicts of interest.
EDAT- 2020/11/10 06:00
MHDA- 2021/09/11 06:00
PMCR- 2022/03/10
CRDT- 2020/11/09 14:24
PHST- 2020/11/09 14:24 [entrez]
PHST- 2020/11/10 06:00 [pubmed]
PHST- 2021/09/11 06:00 [medline]
PHST- 2022/03/10 00:00 [pmc-release]
AID - 00001199-202011000-00006 [pii]
AID - 10.1097/HTR.0000000000000636 [doi]
PST - ppublish
SO  - J Head Trauma Rehabil. 2020 Nov-Dec;35(6):430-438. doi: 
      10.1097/HTR.0000000000000636.