Abstract
Transcranial magnetic stimulation (TMS) is one of rehabilitation approaches for patients with chronic disorders of consciousness (DOC). The aim of our study was to assess neurotrophic factors and the changes of those after TMS course in patients with chronic DOC. We enrolled 26 patients with chronic DOC of various etiology and 21 heathy volunteers. Blood serum and cerebrospinal fluid (CSF) were collected from all patients before and after the TMS course, the levels of BDNF, NSE, NGF, РDGF, GDNF and NT3 were assessed in the biomaterial. The blood BDNF, NSE, PDGF, GDNF and NT3 in patients with chronic DOC were higher compared to healthy volunteers (p < 0.05). We found no correlations between the type of DOC and neurotrophic factors concentrations in blood and CSF. The CSF level of BDNF in patients after traumatic brain injury (TBI) was higher compared to patients with non-traumatic chronic DOC (p < 0.05). We also found the increase of CSF BDNF after the TMS course in patients after TBI (p < 0.05). No other significant differences between groups and another blood and cerebrospinal fluid biomarker levels were detected. Thus, the serum BDNF, NSE, PDGF, GDNF and NT3 levels in patients with chronic DOC were higher compared to healthy volunteers. The BDNF level in CSF was higher in patients with traumatic DOC, and it also increased after the course of high-frequency TMS in this group. This fact may indicate the long-term neuronal plasticity processes in patients after TBI, as well as more favorable rehabilitation prognosis.
Highlights
Transcranial magnetic stimulation (TMS) is one of rehabilitation approaches for patients with chronic disorders of consciousness (DOC)
The levels of brain-derived neurotrophic factor (BDNF), neuron specific enolase (NSE), platelet derived growth factor (PDGF), glial cell derived neurotrophic factor (GDNF), and NT3 in serum were significantly higher in patients with chronic DOC, than in healthy volunteers, but there were no differences in nerve growth factor (NGF) levels
The only difference was in BDNF level: we saw the significant increase of cerebrospinal fluid (CSF) BDNF level after repetitive TMS (rTMS) course in patients with traumatic brain injury (TBI)
Summary
Transcranial magnetic stimulation (TMS) is one of rehabilitation approaches for patients with chronic disorders of consciousness (DOC). The blood BDNF, NSE, PDGF, GDNF and NT3 in patients with chronic DOC were higher compared to healthy volunteers (p < 0.05). The serum BDNF, NSE, PDGF, GDNF and NT3 levels in patients with chronic DOC were higher compared to healthy volunteers. The BDNF level in CSF was higher in patients with traumatic DOC, and it increased after the course of high-frequency TMS in this group This fact may indicate the long-term neuronal plasticity processes in patients after TBI, as well as more favorable rehabilitation prognosis. Что уровни BDNF, NSE, PDGF, GDNF, NT3 в крови у пациентов с ХНС выше, чем у здоровых добровольцев (p < 0,05). Уровни нейротрофических факторов BDNF, NSE, PDGF, GDNF, NT3 в сыворотке крови пациентов с ХНС выше, чем у здоровых добровольцев. Ключевые слова: хронические нарушения сознания, вегетативное состояние, синдром ареактивного бодрствования, состояние минимального сознания, BDNF, NSE, PDGF, NT3, нейротрофические факторы, транскраниальная магнитная стимуляция
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