Using a longitudinal case study design, we have tracked the recovery of motor function following severe traumatic brain injury (TBI) through a multimodal neuroimaging approach. In 2006, Canadian Soldier Captain (retired) Trevor Greene (TG) was attacked with an axe to the head while on tour in Afghanistan. TG continues intensive daily rehabilitation, which recently included the integration of physical therapy (PT) with neuromodulation using translingual neurostimulation (TLNS) to facilitate neuroplasticity. Recent findings with PT + TLNS demonstrated that recovery of motor function occurred beyond conventional time limits, currently extending past 14-years post-injury. To investigate whether PT + TLNS similarly resulted in associated cognitive function improvements, we examined event-related potentials (ERPs) with the brain vital signs framework. In parallel with motor function improvements, brain vital signs detected significant increases in basic attention (as measured by P300 response amplitude) and cognitive processing (as measured by contextual N400 response amplitude). These objective cognitive improvements corresponded with TG’s self-reported improvements, including a noteworthy and consistent reduction in ongoing symptoms of post-traumatic stress disorder (PTSD). The findings provide valuable insight into the potential importance of non-invasive neuromodulation in cognitive rehabilitation, in addition to initial indications for physical rehabilitation.

中文翻译：

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大脑生命体征检测到严重创伤性脑损伤康复过程中物理治疗和神经调节相结合的认知改善：病例报告

使用纵向案例研究设计，我们通过多模式神经影像学方法追踪了严重创伤性脑损伤（TBI）后运动功能的恢复情况。2006年，加拿大士兵上尉（退役）特雷弗·格林（TG）在阿富汗执行任务时头部遭到斧头袭击。TG 继续进行日常强化康复，最近包括将物理治疗 (PT) 与使用经舌神经刺激 (TLNS) 的神经调节相结合，以促进神经可塑性。PT + TLNS 的最新研究结果表明，运动功能的恢复超出了传统的时间限制，目前已延长到受伤后 14 年以上。为了研究 PT + TLNS 是否同样会导致相关的认知功能改善，我们使用大脑生命体征框架检查了事件相关电位 (ERP)。在运动功能改善的同时，大脑生命体征检测到基本注意力（通过 P300 反应幅度测量）和认知处理（通过情境 N400 反应幅度测量）显着增加。这些客观的认知改善与 TG 自我报告的改善相对应，包括显着且持续的创伤后应激障碍 (PTSD) 症状减少。除了身体康复的初步适应症之外，这些发现还为非侵入性神经调节在认知康复中的潜在重要性提供了宝贵的见解。