Research Reports - TMS-EEG responses in recovered and symptomatic mild traumatic brain injury

J Neurotrauma. 2013 Feb 5

Tallus J, Lioumis P, Hämäläinen H, Kähkönen S, Tenovuo O

Mild traumatic brain injury (mTBI) may cause diffuse damage to the brain,
especially to the frontal areas, that may lead to persistent symptoms. We studied
participants with past mTBI by means of navigated transcranial magnetic
stimulation (nTMS) combined with electroencephalography (EEG). Eleven symptomatic
and eight recovered participants with a history of single mTBI and nine healthy
controls participated. Average time from injury to testing was five years. The
participants did not have abnormalities or signs of injury on brain MRIs and they
did not use any centrally acting medication. Left primary motor cortex (M1) and
dorsolateral prefrontal cortex (DLPFC) were stimulated with nTMS, and evoked
potentials measured from the corresponding areas of both hemispheres. Delayed
ipsilateral P30 and contralateral N45 peak latencies to left DLPFC nTMS were
found in the symptomatic group, along with higher DLPFC N100 amplitudes as
compared to the control or recovered group. The recovered group had shorter P200
latencies in left DLPFC nTMS compared to the other groups. Both mTBI groups had
higher motor thresholds compared to the control group. In left M1 nTMS the mTBI
groups showed less P30 amplitude increase, and the symptomatic group showed
longer P60 interhemispheric latency difference with higher stimulation
intensities. The results suggest altered brain reactivity and connectivity in
mTBI. Some of the observed differences may be related to compensatory mechanisms
of recovery. nTMS-EEG is a potentially useful tool for studying the effects of

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