rTMS: A Treatment to Restore Function after Severe TBI

Traumatic brain injury (TBI) alters the lives of the patient, their family and society.Severe TBI is particurlarly devastating with only two-thirds of survivors recovering full consciousness within the first year of injury. The other one-third will live in prolonged states of seriously impaired consciousness for an average of 12 years. Regardless of recovery rates, severe TBI causes significant cognitive and physical impairments and while advanced technology will sustain life, functional recovery is unlikely without further treatment. Despite a known need for treatments and a growing body of evidence indicating that this devastating injury is modifiable, there are few to no treatments that induce or accelerate functional recovery for survivors of severe TBI. The proposed study addresses the need for robust treatments. The purpose of the proposed study is to determine the safety and behavioral effect of repetitive Transcranial Magnetic Stimulation (rTMS) as an intervention for persons living in vegetative (VS) or minimally conscious (MCS) states 3 to 12 months after severe TBI. The immediate study objectives are to (1) Determine safety of a rTMS protocol, (2) Determine neurobehavioral effect of rTMS, (3) Characterize rTMS effect on functional neural activation, and (4) Characterize rTMS effect on structural changes in the brain.