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

BackgroundStudies 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.ObjectiveThe present study provides an aggregate symptom assessment utilizing pre- and post-DBS narratives from subjects and their family members.MethodsDrawing 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.ResultsSubjects 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.ConclusionsSecondary 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.