Continuous electroencephalography (cEEG) is potentially useful in determining prognosis in patients with traumatic brain injuries (TBI). The objective of this prospective, observational cohort study was to determine if the percent alpha variability (PAV) on cEEG was predictive of outcome following TBI. Injury characteristics were indexed to assess whether lesions in specific cerebral loci were correlated with PAV and patient recovery. Fifty-three TBI patients were studied using cEEG recording and serial neuroimaging. Clinical recovery was assessed at regular intervals in hospital and following discharge. The principal outcome measures included the mean 3-day PAV score, the 7-day PAV pattern, delineation of the anatomical sites of brain injury, and the 6-month clinical outcome, as measured by the Glasgow Outcome Scale (GOS). Significant univariate (p = 0.030) and multivariate (p = 0.008) relations were identified between PAV and GOS scores. PAV offered good discrimination between favorable and unfavorable 6-month outcomes (AUC 0.76) and, with a cutpoint of 0.20, had a sensitivity of 87% and negative predictive value of 82%. Multivariate modeling revealed that injuries of the thalamus (p = 0.009) and basal ganglia (p = 0.016), and the presence of diffuse edema (p = 0.009), were the key anatomical predictors of PAV. Brainstem injuries (p = 0.020) and indicators of diffuse cerebral trauma, such as deep white matter shearing (p = 0.036) and multiple subcortical lesions (p = 0.033), were the principal determinants of 6-month recovery. Inclusion of PAV enhanced the accuracy of prediction models that encompassed a selective combination of clinical and anatomical variables (adjusted R(2) = 0.458, p < 0.001). The two main results of this study are (1) PAV is a sensitive predictor of 6-month clinical outcomes following TBI, and (2) injury to the thalamus is related to impaired PAV. PAV appears best utilized as a functional adjunct to traditional clinical and anatomical predictors.

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The clinical benefits of DBS observed in this HD patient were comparable to those reported in other hyperkinetic disorders and demonstrate that pallidal stimulation can provide long-term alleviation of HD-associated choreathetosis.

Glioblastoma (GBM) is the leading cause of high fatality cancer arising within the adult brain. Electrotherapeutic approaches offer new promise for GBM treatment by exploiting innate vulnerabilities of cancer cells to low intensity electric fields. This report describes the preclinical outcomes of a novel electrotherapeutic strategy called Intratumoral Modulation Therapy (IMT) that uses an implanted stimulation system to deliver sustained, titratable, low intensity electric fields directly across GBM-affected brain regions. This pilot technology was applied to in vitro and animal models demonstrating significant and marked reduction in tumor cell viability and a cumulative impact of concurrent IMT and chemotherapy in GBM. No off target neurological effects were observed in treated subjects. Computational modeling predicted IMT field optimization as a means to further bolster treatment efficacy. This sentinel study provides new support for defining the potential of IMT strategies as part of a more effective multimodality treatment platform for GBM.