Neurorehabilitation After Traumatic Brain Injury: Functional Magnetic Resonance Imaging Study (RemCog-TC)

Cognitive Rehabilitation Combined to Transcranial Direct Current Stimulation Following Traumatic Brain Injury: Functional Magnetic Resonance Imaging Study

The current study aims to better understand cerebral plasticity mechanisms to optimize non-pharmacological rehabilitation approaches for patients with traumatic brain injury.

Cognitive impairment following moderate to severe traumatic brain injury are usual. To date, cognitive rehabilitation effects on cerebral plasticity and quality of life remain unproven essentially because of methodological biases. Transcranial Direct Current Stimulation is an innovative technique of noninvasive brain stimulation that showed efficacy in literature. The current study want to better understand cerebral plasticity mechanisms to optimize non-pharmacological rehabilitation approaches for patients with traumatic brain injury. The aim in the present study is to assess the effect of rehabilitation combined with Transcranial Direct Current Stimulation provided to traumatic brain injury patients with cognitive impairment on cerebral plasticity using functional magnetic resonance imaging. Effects of rehabilitation and Transcranial Direct Current Stimulation will be observed on functional magnetic resonance imaging activation maps acquired. Relationship between attentional outcomes measured in the neuropsychological assessment and activation extend will be explored.

nonspecific cognitive rehabilitation (placebo rehab) combined to transcranial direct current stimulation

nonspecific cognitive rehabilitation (placebo rehab) combined to transcranial direct current stimulation sham

intensity provided will be 2 milliampere during 20 minutes using 2 electrodes (7x5cm). Anode electrode will be located on the right prefrontal dorsolateral area; cathode electrode will be located on the left supraorbital area.

Specific cognitive rehabilitation will be personalized regarding the cognitive complaint and will include a training part and an ecological part.

the n-back cognitive task was developed : 3 runs will be provided (0-back, 1-back and 2-back), each will be composed of 8 activation blocks and 8 resting blocks alternatively presented.

intergroup difference on cerebral map activation in functional magnetic resonance imaging (N-back task).

Inclusion Criteria: Moderate to severe traumatic brain injury more than 3 months since the onset Attentional disorders (PASAT test (score ≤ centile 10) and/or CANTAB test (≤ -2 standard deviation) Women having contraceptive treatment (for the magnetic resonance imaging exam) Exclusion Criteria: inability to undergo magnetic resonance imaging scan No attentional impairment (PASAT ≥ centile10) Severe depression Neurological disease Major cognitive impairment (aphasia, neglect) Drugs addiction Pregnant women and women having no contraceptive treatment