Qualitative Analysis of Symptoms from the Central Thalamic Deep Brain Stimulation Trial for Traumatic Brain Injury

Abstract

Background

Studies of moderate-to-severe traumatic brain injury (TBI) report persistent clinical impairment post-injury. In the CENTURY-S study of deep brain stimulation (DBS) in chronic TBI, Schiff et al.‘s paper, “Thalamic deep brain stimulation in traumatic brain injury: a phase 1, randomized feasibility study” demonstrated improvements in executive control. A companion narrative analysis by Fins et al., “Subject and Family Perspectives from the Central Thalamic Deep Brain Stimulation Trial for Traumatic Brain Injury” Parts I and II described improvements in cognitive, behavioral, and emotional capabilities.

Objective

The present study provides an aggregate symptom assessment utilizing pre- and post-DBS narratives from subjects and their family members.

Methods

Drawing upon participants from the CENTURY-S study, Fins et al. conducted semi-structured interviews with five subjects with moderate-to-severe TBI and their family members. Transcripts were subsequently coded deductively and inductively in Dedoose by two independent investigators.

Results

Subjects and families frequently volunteered memory and cognitive symptoms as well as difficulties with self-regulation, frustration, and irritability pre-DBS. Following stimulation, four subjects and four families noted improvement in memory and attention and focus, while three subjects and five families volunteered improvements in self-regulation. Fatigue improved in three subjects who previously reported this symptom and in one who did not.

Conclusions

Secondary qualitative analysis of narrative data of DBS trial participants supports the incorporation of qualitative data as additional outcome measures in studies of DBS in TBI.

Keywords

traumatic brain injury deep brain stimulation symptom reporting qualitative research narrative analysis neuroethics neuromodulation

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