Deep Brain Stimulation for Cognitive Recovery After Traumatic Brain Injury: A Narrative Review
Author(s): Syed Owais Akhtar,Dushan Bosotov, Kerem Hiziroglu, Eiman zehra, Hiren Hisoriya, Ashish P.Balar, Diego Jiménez Royg, Saba Ahmed, Wahab Moustafa, Asmar Khan
Traumatic brain injury represents a significant public health concern, often leading to persistent cognitive impairments that profoundly impact an individual's ability to function in daily life. Traditional rehabilitation approaches, while beneficial, often yield limited success in restoring lost cognitive function. Deep brain stimulation, a neurosurgical technique involving the implantation of electrodes to modulate neuronal activity, has emerged as a potential therapeutic strategy for ameliorating cognitive deficits following TBI. This narrative review will provide a comprehensive overview of the current state of knowledge regarding the application of DBS for cognitive enhancement in individuals who have sustained TBI. We will begin by examining the theoretical rationale behind DBS, exploring its potential mechanisms of action in promoting neuroplasticity and restoring disrupted neural circuits. Subsequently, we will delve into the specific cognitive domains, such as attention, memory, and executive function, that have been targeted with DBS, discussing the rationale for selecting particular brain regions as stimulation targets. A critical analysis of preclinical and clinical studies will form the core of this review. We will highlight key findings, methodological considerations, and the efficacy of DBS in improving cognitive outcomes. Additionally, we will address the challenges and limitations associated with DBS, including surgical risks, device-related complications, and the identification of optimal stimulation parameters. Ethical considerations surrounding DBS, such as patient selection criteria and the potential for cognitive enhancement beyond pre-injury levels, will also be discussed. Finally, we will outline future directions for research and development in the field of DBS for TBI-related cognitive impairment. This will encompass the exploration of novel stimulation targets, advancements in DBS technology, and the integration of DBS with other rehabilitative interventions. By providing a balanced and insightful overview, this review aims to shed light on the potential of DBS as a valuable tool in the armamentarium of TBI rehabilitation, ultimately contributing to improved long-term outcomes for individuals living with cognitive impairments