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dc.contributor.authorPoologaindran, Anujan
dc.contributor.authorProfyris, Christos
dc.contributor.authorYoung, Isabella M
dc.contributor.authorDadario, Nicholas B
dc.contributor.authorAhsan, Syed A
dc.contributor.authorChendeb, Kassem
dc.contributor.authorBriggs, Robert G
dc.contributor.authorTeo, Charles
dc.contributor.authorRomero-Garcia, Rafael
dc.contributor.authorSuckling, John
dc.contributor.authorSughrue, Michael E
dc.date.accessioned2022-02-23T17:01:39Z
dc.date.available2022-02-23T17:01:39Z
dc.date.issued2022-02-23
dc.date.submitted2021-03-17
dc.identifier.issn2045-2322
dc.identifier.others41598-022-06766-8
dc.identifier.other6766
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/334379
dc.descriptionFunder: Alan Turing Institute; doi: http://dx.doi.org/10.13039/100012338
dc.descriptionFunder: Guarantors of Brain; doi: http://dx.doi.org/10.13039/501100000627
dc.description.abstractThe 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.
dc.languageen
dc.publisherSpringer Science and Business Media LLC
dc.subjectArticle
dc.subject/692/4028/546
dc.subject/692/617/375/1922
dc.subjectarticle
dc.titleInterventional neurorehabilitation for promoting functional recovery post-craniotomy: a proof-of-concept.
dc.typeArticle
dc.date.updated2022-02-23T17:01:39Z
prism.issueIdentifier1
prism.publicationNameSci Rep
prism.volume12
dc.identifier.doi10.17863/CAM.81795
dcterms.dateAccepted2022-02-02
rioxxterms.versionofrecord10.1038/s41598-022-06766-8
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
dc.contributor.orcidSuckling, John [0000-0002-5098-1527]
dc.identifier.eissn2045-2322
cam.issuedOnline2022-02-23


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