Transcranial electrical stimulation (TES) for mood, cognitive, sleep, and pain disorders after traumatic brain injury (TBI)

James Malec, PhD (PI, RHI), Aaron Cohen-Gadol, MD; Leisha Osborn (Clarian Neuroscience Institute, Indianapolis Neurosurgical Group, IU Neurosurgery), Shashank Davé, MD (IU PM&R), Ken Yoshida, PhD (IUPUI Biomedical Engineering)

 

The majority of patients with traumatic brain injury (TBI) become depressed and disorders of sleep and pain are common after TBI. Cognitive impairment characterizes the vast majority of individuals with a history of significant brain trauma. Cognitive impairment, specifically of executive function, has also been identified as a characteristic of depression. Furthermore, there is mounting evidence that depression and associated executive cognitive dysfunction find a common underpinning in the genetic regulation of serotonin and other neurotransmitters. Transcranial electrical stimulation (TES) is a treatment in which low amperage electrical current is passed through the skull and brain using external electrodes. Prior studies of TES provide evidence of improvement of brain metabolism. Thus, TES may be an appropriate treatment for individuals living with TBI and cognitive impairment who experience symptoms of depression.

There is some evidence that TES may also be beneficial in the treatment of common co-morbidities of depression following TBI, such as, anxiety, sleep disturbance, and pain. The Nexalin company has developed a device that provides TES treatment using a standardized alternating current and specified waveforms. The Nexalin device has been approved by the FDA as safe for the treatment of depression, anxiety, and insomnia. The purpose of this study is to find out if a very low level of electrical current delivered by the Nexalin device can have a good effect in reducing depression after brain injury. We are also interested in learning whether this same treatment will improve other problems that sometimes go along with depression and brain injury such as  anxiety, sleep problems, pain, thinking  problems (such as, problems with attention and memory) and other disabilities.