Trauma in the Brain Series: TBI and Stroke
- Katya Bownas RN, PMH-BC
- Feb 5
- 1 min read
Damage to the brain via physical trauma such as stroke and traumatic brain injury (TBI) can lead to long lasting neuropsychiatric symptoms as well as physical impairment. Neuropsychiatric disorders affect up to 88% of TBI patients, manifesting with symptoms such as impulsivity, irritability, depression, and anxiety. For patients who experience stroke, motor as well as nonmotor impairments can be debilitating to patients, decreasing their quality of life and, in some cases, leading to depression as a result.
The traditional methods in which we treat neuropsychiatric symptoms of traumatic brain injury include psychopharmacology and therapies such as CBT. However, many patients are refractory to medication, meaning their symptoms are not relieved by antidepressants or other psychiatric drugs. This has led researchers to explore alternative treatment options, including transcranial magnetic stimulation (TMS), in both TBI and stroke patients. Not only has TMS shown to improve the neuropsychiatric impacts of brain injury on patients such as depression and impaired executive function, it is also showing promise in motor recovery, gait, and balance.
For a time, TBI was thought to be a contraindication for repetitive TMS (rTMS) treatment due to the increased seizure risk associated with brain injury, but most studies of rTMS in TBI patients showed that it was well-tolerated with minor, if any, side effects. Because of this possible risk factor, low-frequency rTMS as opposed to high-frequency may be a safer option for individuals with a history of TBI as it is less associated with seizure risk in patients. Based on studies, rTMS appears to work equally as well on depression as a result of TBI as it does in
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