Centre for Neurology Studies, HealthTech Connex, 13737 96th ave, Suite 204, Vancouver, BC, V3V 0C6, Canada.
BrainNET, Health and Technology District, Vancouver, Canada.
J Neuroeng Rehabil. 2020 Dec 1;17(1):158. doi: 10.1186/s12984-020-00772-5.
In a recent high-profile case study, we used functional magnetic resonance imaging (fMRI) to monitor improvements in motor function related to neuroplasticity following rehabilitation for severe traumatic brain injury (TBI). The findings demonstrated that motor function improvements can occur years beyond current established limits. The current study extends the functional imaging investigation to characterize neuromodulation effects on neuroplasticity to further push the limits.
Canadian Soldier Captain (retired) Trevor Greene (TG) survived a severe open-TBI when attacked with an axe during a 2006 combat tour in Afghanistan. TG has since continued intensive daily rehabilitation to recover motor function, experiencing an extended plateau using conventional physical therapy. To overcome this plateau, we paired translingual neurostimulation (TLNS) with the continuing rehabilitation program.
Combining TLNS with rehabilitation resulted in demonstrable clinical improvements along with corresponding changes in movement evoked electro-encephalography (EEG) activity. High-density magneto-encephalography (MEG) characterized cortical activation changes in corresponding beta frequency range (27 Hz). MEG activation changes corresponded with reduced interhemispheric inhibition in the post-central gyri regions together with increased right superior/middle frontal activation suggesting large scale network level changes.
The findings provide valuable insight into the potential importance of non-invasive neuromodulation to enhance neuroplasticity mechanisms for recovery beyond the perceived limits of rehabilitation.
在最近的一项备受瞩目的案例研究中,我们使用功能磁共振成像(fMRI)监测严重创伤性脑损伤(TBI)康复后与神经可塑性相关的运动功能改善。研究结果表明,运动功能的改善可以在目前既定的时间限制之外持续多年。本研究将功能成像研究扩展到描述神经调节对神经可塑性的影响,以进一步突破极限。
加拿大退役上尉特雷弗·格林(Trevor Greene,TG)在 2006 年阿富汗的一次战斗任务中被斧头袭击,导致严重的开放性 TBI。此后,TG 继续进行密集的日常康复训练以恢复运动功能,在接受传统物理治疗时经历了长时间的平台期。为了克服这个平台期,我们将跨语言神经刺激(TLNS)与持续的康复计划相结合。
TLNS 与康复相结合,不仅在临床方面取得了显著的改善,而且运动诱发脑电图(EEG)活动也相应发生了变化。高密度磁脑电图(MEG)在相应的β频带(27 Hz)中描述了皮质激活的变化。MEG 激活的变化与后中央回区域的半球间抑制减少以及右侧额上/中回的激活增加有关,这表明了大规模网络水平的变化。
这些发现为非侵入性神经调节增强神经可塑性机制以促进康复提供了有价值的见解,这可能超出了康复的感知极限。