In recent years, neuromodulation has been of increasing interest as a treatment regimen to increase brain activity after stroke. However, few studies have focused on its effects after traumatic brain injury (TBI). This animal study assessed the effects of epidural electrical stimulation (EES) and repetitive transcranial magnetic stimulation (rTMS) on recovery of motor function and brain activity after TBI.

This trial included 30, male Sprague Dawley rats which were initially trained in a single pellet reaching task (SPRT) and the rotarod task (RRT). The animals were then subjected to a cortical impact and a fluid percussion brain injury. They were then randomly assigned to receive EES, rTMS or sham treatment for 14 days after injury. The animals were then retested with the SPRT and the RRT. At two weeks, the animals were euthanized for histopathologic examination.

The success rates on the SPRT and the RRT were significant higher in the EES group than in the sham group (P<0.05 for both comparisons). In the EES group, SPRT success was significantly higher than in the sham group on postoperative days eight through 12 (P<0.05). In the rTMS group, the improvement in the SPRT success rate was significantly higher between postoperative days four and 14 (P<0.05). Performance on the RRT did not differ significantly between the three groups on postoperative day 14. Immunohistochemical staining revealed that the expression of C-Fos (a measure of plasticity) was lower in the sham group than in either treatment group, as well as in the non-stimulated side of the EES group as compared with the stimulated side.

This animal study found that transcranial magnetic stimulation, as well as epidural electrical stimulation, can be used to enhance motor recovery and brain activity after brain injury.