Vol. 13 nº 2 - Apr/May/Jun de 2019
Original Article Páginas: 172 a 179

Transcranial direct current stimulation (tDCS) effects on traumatic brain injury (TBI) recovery: a systematic review

Authors Ana Luiza Zaninotto1; Mirret M. El-Hagrassy2; Jordan R. Green1; Maíra Babo3; Vanessa Maria Paglioni3; Glaucia Guerra Benute4; Wellingson Silva Paiva3


keywords: traumatic brain injury; neuronal plasticity; rehabilitation; non-invasive brain stimulation; transcranial direct current stimulation.

Traumatic brain injury (TBI) is a major cause of chronic disability. Less than a quarter of moderate and severe TBI patients improved in their cognition within 5 years. Non-invasive brain stimulation, including transcranial direct current stimulation (tDCS), may help neurorehabilitation by boosting adaptive neuroplasticity and reducing pathological sequelae following TBI.
METHODS: we searched MEDLINE/PubMed and Web of Science databases. We used Jadad scale to assess methodological assumptions.
RESULTS: the 14 papers included reported different study designs; 2 studies were open-label, 9 were crossover randomized clinical trials (RCTs), and 3 were parallel group RCTs. Most studies used anodal tDCS of the left dorsolateral prefrontal cortex, but montages and stimulation parameters varied. Multiple studies showed improved coma recovery scales in disorders of consciousness, and improved cognition on neuropsychological assessments. Some studies showed changes in neurophysiologic measures (electroencephalography (EEG) and transcranial magnetic stimulation (TMS), correlating with clinical findings. The main methodological biases were lack of blinding and randomization reports.
CONCLUSION: tDCS is a safe, non-invasive neuromodulatory technique that can be given as monotherapy but may be best combined with other therapeutic strategies (such as cognitive rehabilitation and physical therapy) to further improve clinical cognitive and motor outcomes. EEG and TMS may help guide research due to their roles as biomarkers for neuroplasticity.


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