Traumatic Brain Injury (TBI) is a major cause of death and disability in the US (Whiteneck, Cuthbert, Corrigan & Bogner, 2016; Capizzi, Woo, Verduzco-Gutierrez, 2020;) and worldwide (Iaccarino, Carretta, Nicolosi, Morselli, 2018). Outcomes after a head injury are heterogeneous depending on the type and severity of focal brain damage, diffuse axonal injury and a secondary cascade of multidimensional neurometabolic events (Madikians & Giza, 2006; Werner & Engelhard, 2007; Pearn, M. L., et al. (2016). It has also been increasingly recognized that biopsychosocial, contextual and temporal pre-injury, injury and post-injury factors have an impact in the long-term outcomes of TBI (Forslund, 2019) with a more significant impact in mild TBI patients (Marshall et al, 2018). In fact, TBI underlies cognitive deficits, behavioral impairments and physical symptoms which have a significant negative impact on independent living skills, employment, interpersonal and social interactions (Ponsford, 2013). These symptoms persist years (deGuise, 2008) and decades post-injury, defining TBI as a chronic condition (Wilson, 2017). Although patients with a severe TBI show a relatively good physical and functional recovery, emotional and cognitive outcome is poor (deGuise, 2008) and a considerable clinical and neuropsychological variability prevail across individuals (Ponsford, 2013).
Although more evidence is needed, neuroregulation tools (neurofeedback,
photobiomodulation and tDCS among others) may be the most promising approaches to improve the functional recovery of TBI patients, comprehensively.
In this workshop, an overview of TBI’s pathophysiology and the multiple factors that influence recovery will be provided. The assessment of sequelae and brain dysfunction through EEG, QEEG, neuropsychological assessment and validated scales and questionnaires, will be described and common findings will be discussed. The importance of a comprehensive assessment will be highlighted considering it leads to an individualized treatment plan, a more accurate monitoring of functional improvements and a pre- and post-intervention objective comparison. The personalized intervention includes the implementation of one or more neuroregulation tools, cognitive neurorehabilitation and lifestyle recommendations for an improved outcome. Among these interventions, a more detailed review of the current evidence for different neurofeedback modalities and photobiomodulation will be provided and illustrated through clinical examples.
Presented by: Tanya Morosoli