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New approach for patients with brain trauma; participants needed

Currently, treatment options for people with brain injury from a trauma — such as a car crash, or bike accident — are limited. Some of these people remain impaired many years after the incident. They may return to work, but they struggle to concentrate or suffer from memory lapses. Even if life isn't awful, it isn't what it once was.

Stanford neurosurgeon Jaimie Henderson, MD, thinks that deep brain stimulation could help these patients improve. There's just one problem: It's never been done before in people with this condition. Henderson isn't averse to trying things that haven't been done before -- he's part of a team that is working to allow patients with impaired movement to control a cursor with their minds.

But convincing others to join him often requires some effort. Henderson and his colleagues have set up a clinical trial to test the safety, and get a glimpse at the efficacy, of deep brain stimulation for these patients, yet he's struggling to find people to enroll.

The procedure itself -- which involves implanting two tiny wires in the brain, connected to a pacemaker-like device in the chest -- isn't new. It's successfully used to treat symptoms of Parkinson's, epilepsy and other disorders.

For the attention problems caused by traumatic injuries, Henderson plans to target a different area of the brain than for Parkinson's treatments. Here, he's aiming for the central thalamus, which plays a key role in the ability to concentrate on tasks. Typically, attention problems after head injury occur because the central thalamus and frontal lobe regions supported by the central thalamus are impaired.

Previous studies have found that severely injured patients, who are minimally conscious, have been helped by the procedure. In addition, central thalamic stimulation has been shown to boost the concentration of monkeys on boring, repetitive tasks.

Henderson thinks once one person has been helped, others — for the total of six needed for the study -- will quickly join in. "We hope to see improvements, which should be evident fairly immediately," he said.

The challenge is finding that first person.

"We're looking for a pretty specific group of people, who have returned to employment or to school, but aren't able to function at a full-time level or to do the same things they were able to do before," Henderson said.

Study participants must be between 22 and 55 years old and have been injured at least two years -- additional details are available in the study description. Ideally, they would also live relatively close to Stanford.

Once implanted, the device would be tested for at least a year, a time period that can be extended if it is helping the patient, Henderson said.

The procedure does have risks, including bleeding or infection, although these are both rare. A variety of side effects, such as balance problems or tingling, are possible due to the stimulation, but these can usually be moderated by adjusting the device's programming or in the worst case removing, Henderson said.

Interested or have questions? Research coordinator Omar Rutledge is the person to contact: he's at orutledge@stanford.edu.

Previously: The story behind the development of a brain-computer interface, Pure brainpower directs onscreen cursor, letting paralyzed people type and Stanford conducts first U.S. implantation of deep-brain-stimulation device that monitors, records brain activity
Photo by Paul Sakuma

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