Design of an early intervention for persistent post-concussion symptoms in adolescents and young adults: A feasibility study.

Background: About 5-15 % of patients with concussion experience persistent post-concussion symptoms (PCS) longer than 3 months post-injury.

Objective: To explore the feasibility of a new intervention for young patients with persistent PCS and long-term changes after intervention.

Methods: Thirty-two consecutive patients (15-30 years) with persistent PCS 2-4 months post-injury were recruited from a cohort study or referred to a non-randomized feasibility study of an individually tailored, 8-week, multidisciplinary intervention.

Abnormal corticospinal excitability in patients with disorders of consciousness.

Background: Transcranial magnetic stimulation (TMS) has been frequently used to explore changes in the human motor cortex in different conditions, while the extent of motor cortex reorganization in patients in vegetative state (VS) (now known as unresponsive wakefulness syndrome, UWS) and minimally conscious (MCS) states due to severe brain damage remains largely unknown.

Objective/hypothesis: It was hypothesized that cortical motor excitability would be decreased and would correlate to the level of consciousness in patients with disorders of consciousness.

Methods: Corticospinal excitability was assessed in 47 patients (24 VS/UWS and 23 MCS) and 14 healthy controls.

Corticospinal excitability in patients with anoxic, traumatic, and non-traumatic diffuse brain injury.

Background: Transcranial magnetic stimulation (TMS) have been frequently used to explore changes in motor cortex excitability in stroke and traumatic brain injury, while the extent of motor cortex reorganization in patients with diffuse non-traumatic brain injury remains largely unknown.

Objective/hypothesis: It was hypothesized that the motor cortex excitability would be decreased and would correlate to the severity of brain injury and level of functioning in patients with anoxic, traumatic, and non-traumatic diffuse brain injury.

Methods: TMS was applied to primary motor cortices of 19 patients with brain injury (5 traumatic and 14 non-traumatic causes; on average four months after insult), and 9 healthy controls.

Robotic gait training in patients with impaired consciousness due to severe traumatic brain injury.

Primary Objective: This prospective controlled non-randomized study investigated the effects of robotic gait training on electroencephalographic (EEG) brain activity in patients with impaired consciousness due to severe traumatic brain injury (TBI).

Methods: Twelve TBI patients and 14 healthy controls underwent a single training session on a computer-driven gait orthosis (Lokomat®). The sensory pathways were assessed using sensory evoked potentials (SEPs).

Disorders of consciousness: further pathophysiological insights using motor cortex transcranial magnetic stimulation.

Transcranial magnetic stimulation (TMS) is a noninvasive means of investigating the function, plasticity, and excitability of the human brain. TMS induces a brief intracranial electrical current, which produces action potentials in excitable cells. Stimulation applied over the motor cortex can be used to measure overall excitability of the corticospinal system, somatotopic representation of muscles, and subsequent plastic changes following injury.