Interventional neurorehabilitation for promoting functional recovery post-craniotomy: a proof-of-concept.
Authors
Poologaindran, Anujan
Profyris, Christos
Young, Isabella M
Dadario, Nicholas B
Ahsan, Syed A
Chendeb, Kassem
Briggs, Robert G
Teo, Charles
Romero-Garcia, Rafael
Sughrue, Michael E
Publication Date
2022-02-23Journal Title
Sci Rep
ISSN
2045-2322
Publisher
Springer Science and Business Media LLC
Volume
12
Issue
1
Language
en
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Poologaindran, A., Profyris, C., Young, I. M., Dadario, N. B., Ahsan, S. A., Chendeb, K., Briggs, R. G., et al. (2022). Interventional neurorehabilitation for promoting functional recovery post-craniotomy: a proof-of-concept.. Sci Rep, 12 (1) https://doi.org/10.1038/s41598-022-06766-8
Description
Funder: Alan Turing Institute; doi: http://dx.doi.org/10.13039/100012338
Funder: Guarantors of Brain; doi: http://dx.doi.org/10.13039/501100000627
Abstract
The human brain is a highly plastic 'complex' network-it is highly resilient to damage and capable of self-reorganisation after a large perturbation. Clinically, neurological deficits secondary to iatrogenic injury have very few active treatments. New imaging and stimulation technologies, though, offer promising therapeutic avenues to accelerate post-operative recovery trajectories. In this study, we sought to establish the safety profile for 'interventional neurorehabilitation': connectome-based therapeutic brain stimulation to drive cortical reorganisation and promote functional recovery post-craniotomy. In n = 34 glioma patients who experienced post-operative motor or language deficits, we used connectomics to construct single-subject cortical networks. Based on their clinical and connectivity deficit, patients underwent network-specific transcranial magnetic stimulation (TMS) sessions daily over five consecutive days. Patients were then assessed for TMS-related side effects and improvements. 31/34 (91%) patients were successfully recruited and enrolled for TMS treatment within two weeks of glioma surgery. No seizures or serious complications occurred during TMS rehabilitation and 1-week post-stimulation. Transient headaches were reported in 4/31 patients but improved after a single session. No neurological worsening was observed while a clinically and statistically significant benefit was noted in 28/31 patients post-TMS. We present two clinical vignettes and a video demonstration of interventional neurorehabilitation. For the first time, we demonstrate the safety profile and ability to recruit, enroll, and complete TMS acutely post-craniotomy in a high seizure risk population. Given the lack of randomisation and controls in this study, prospective randomised sham-controlled stimulation trials are now warranted to establish the efficacy of interventional neurorehabilitation following craniotomy.
Keywords
Article, /692/4028/546, /692/617/375/1922, article
Identifiers
s41598-022-06766-8, 6766
External DOI: https://doi.org/10.1038/s41598-022-06766-8
This record's URL: https://www.repository.cam.ac.uk/handle/1810/334379
Rights
Licence:
http://creativecommons.org/licenses/by/4.0/
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