title: Transcranial magnetic stimulation facilitates neurorehabilitation after pediatric traumatic brain injury.
abstract: Traumatic brain injury (TBI) is the leading cause of death and disability among children in the United States. Affected children will often suffer from emotional, cognitive and neurological impairments throughout life. In the controlled cortical impact (CCI) animal model of pediatric TBI (postnatal day 16-17) it was demonstrated that injury results in abnormal neuronal hypoactivity in the non-injured primary somatosensory cortex (S1). It materializes that reshaping the abnormal post-injury neuronal activity may provide a suitable strategy to augment rehabilitation. We tested whether high-frequency, non-invasive transcranial magnetic stimulation (TMS) delivered twice a week over a four-week period can rescue the neuronal activity and improve the long-term functional neurophysiological and behavioral outcome in the pediatric CCI model. The results show that TBI rats subjected to TMS therapy showed significant increases in the evoked-fMRI cortical responses (189%), evoked synaptic activity (46%), evoked neuronal firing (200%) and increases expression of cellular markers of neuroplasticity in the non-injured S1 compared to TBI rats that did not receive therapy. Notably, these rats showed less hyperactivity in behavioral tests. These results implicate TMS as a promising approach for reversing the adverse neuronal mechanisms activated post-TBI. Importantly, this intervention could readily be translated to human studies.
authors.affiliation: F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA.|The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.|School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Hongyang
authors.initials: H
authors.lastname: Lu
authors.affiliation: F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA.|The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Tali
authors.initials: T
authors.lastname: Kobilo
authors.affiliation: Department of Anesthesiology/Critical Care Medicine and Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Courtney
authors.initials: C
authors.lastname: Robertson
authors.affiliation: School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Shanbao
authors.initials: S
authors.lastname: Tong
authors.affiliation: Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Pablo
authors.initials: P
authors.lastname: Celnik
authors.affiliation: F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA.|The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Galit
authors.initials: G
authors.lastname: Pelled
mesh_terms: D000818:Animals; D000070642:Brain Injuries, Traumatic / Q000503:physiopathology* / Q000628:therapy*; D054732:Calcium-Calmodulin-Dependent Protein Kinase Type 2 / Q000378:metabolism; D002540:Cerebral Cortex / Q000378:metabolism / Q000502:physiology; D004195:Disease Models, Animal; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D000066530:Neurological Rehabilitation; D009473:Neuronal Plasticity / Q000502:physiology; D010446:Peptide Fragments / Q000378:metabolism; D017207:Rats, Sprague-Dawley; D050781:Transcranial Magnetic Stimulation / Q000379:methods*
chemical_list: C583782:CN17beta peptide; D010446:Peptide Fragments; D054732:Calcium-Calmodulin-Dependent Protein Kinase Type 2