Thalamic deep brain stimulation in traumatic brain injury: a phase 1, randomized feasibility study.

Publication Type	Academic Article
Authors	Schiff N, Giacino J, Butson C, Choi E, Baker J, O'Sullivan K, Janson A, Bergin M, Bronte-Stewart H, Chua J, DeGeorge L, Dikmen S, Fogarty A, Gerber L, Krel M, Maldonado J, Radovan M, Shah S, Su J, Temkin N, Tourdias T, Victor J, Waters A, Kolakowsky-Hayner S, Fins J, Machado A, Rutt B, Henderson J
Journal	Nat Med
Volume	29
Issue	12
Pagination	3162-3174
Date Published	12/04/2023
ISSN	1546-170X
Keywords	Brain Injuries, Traumatic, Deep Brain Stimulation
Abstract	Converging evidence indicates that impairments in executive function and information-processing speed limit quality of life and social reentry after moderate-to-severe traumatic brain injury (msTBI). These deficits reflect dysfunction of frontostriatal networks for which the central lateral (CL) nucleus of the thalamus is a critical node. The primary objective of this feasibility study was to test the safety and efficacy of deep brain stimulation within the CL and the associated medial dorsal tegmental (CL/DTTm) tract.Six participants with msTBI, who were between 3 and 18 years post-injury, underwent surgery with electrode placement guided by imaging and subject-specific biophysical modeling to predict activation of the CL/DTTm tract. The primary efficacy measure was improvement in executive control indexed by processing speed on part B of the trail-making test.All six participants were safely implanted. Five participants completed the study and one was withdrawn for protocol non-compliance. Processing speed on part B of the trail-making test improved 15% to 52% from baseline, exceeding the 10% benchmark for improvement in all five cases.CL/DTTm deep brain stimulation can be safely applied and may improve executive control in patients with msTBI who are in the chronic phase of recovery.ClinicalTrials.gov identifier: NCT02881151 .
DOI	10.1038/s41591-023-02638-4
PubMed ID	38049620
PubMed Central ID	PMC11087147