Traumatic Brain Injury (TBI) following accidents can lead to a variety of neurological impairments in perception, language, motor performance or other higher cognitive functions. Frequently, impairments affect especially the attention domain which is a basic mechanism involved in information processing for all other functions. The neuropsychological therapy of attention problems is very time consuming and can often not prevent the development of chronic residual impairments.
The electrical brain-stimulation will be carried out in two consecutive weeks, once a day, while simultaneous derivation of surface-EEG (electroencephalography) (total ten applications). Each time after stimulation a standardized training of the attention functions will be ensued and adjusted to the psychometrical data that is collected. Before and after the stimulation period the subject group will be neuropsychological examined explicitly. The acquisition of target figures will be standardized involving computerized diagnostic procedures for assessing the attention deficit disorders.
During a sub-acute phase of TBI patients were treated either with alternating current stimulation (ACS) (n=10) or with a placebo condition (n=10). Following each daily ACS session patients received a one-hour attention training. Primary endpoint were "alertness", "sustained Attention", "devided Attention", "Go-Nogo" and visual scanning taken from the TAP test battery.
Sustained attention improved in both groups significantly. Divided attention in response to auditory stimuli improved in both groups, with not significant differences between both groups. Contrary to our hypothesis, in the alertness test the sham group improved significantly more than the ACS group. With respect to the functions "concentration (Go/Nogo)" no significant improvements were noted in either of the both groups.
To summarize: because of the non-specific results it was not possible to come to a clear conclusion with regard to the efficacy of ACS in the rehabilitation of attention disorders following TBI. We suspect that this null-finding is mostly due to the heterogeneous patient sample and the heterogeneous nature of the attention deficit.
Relevance for the accident insurance provider resp. transfer of the results into clinical practice:
From the trial we learned that ACS is safe and practical and can be integrated into a rehabilitation setting. In addition, based on the experience of this trial we are now in a better position to plan (including power-calculations) and carry out future studies on ACS and/or attention, which, if possible, should be carried out with a larger sample size.
-cross sectoral-Type of hazard:
rehabilitationDescription, key words:
electrical synchronization, cerebric, attention deficit disorders, brain injury, trauma