Subject and Family Perspectives from the Central Thalamic Deep Brain Stimulation Trial for Traumatic Brain Injury:...

Area of Science:

• Neurology
• Neurosurgery
• Rehabilitation Medicine

Background:

• Moderate to severe traumatic brain injury (msTBI) often results in persistent cognitive and emotional deficits.
• Current treatment options for msTBI have limited efficacy in restoring cognitive function.
• Deep brain stimulation (DBS) is an emerging therapeutic strategy for neurological disorders.

Purpose of the Study:

• To evaluate subject and family perspectives following a first-in-human trial of CENtral Thalamic Deep Brain Stimulation (DBS) for Traumatic Brain InjURY-Safety (CENTURY-S) in msTBI patients.
• To assess the impact of DBS on cognitive restoration and emotional regulation.
• To identify challenges and needs related to social reintegration and long-term device management.

Main Methods:

• Post-operative interviews were conducted with five msTBI subjects and their families after a trial of thalamic DBS.
• Subjects underwent assessment of decision-making capacity and cognitive function, including Trail-Making-Test Part B.
• Qualitative data from interviews were analyzed to understand patient and family experiences.

Main Results:

• All five msTBI subjects achieved a primary endpoint of at least a 10% improvement in Trail-Making-Test Part B completion time, indicating enhanced executive function.
• Interviews revealed challenges in adapting to cognitive and emotional improvements, alongside altered family dynamics.
• Subjects and families reported concerns regarding post-trial device access, maintenance, and the need for ongoing supportive counseling.

Conclusions:

• Thalamic DBS shows promise for cognitive restoration in msTBI, meeting primary efficacy endpoints.
• Successful cognitive recovery presents unique challenges for social reintegration and requires comprehensive support systems.
• Long-term management strategies, including device maintenance and psychological support, are crucial for patients undergoing DBS for msTBI.