Non-Invasive Brain Stimulation in Children With Unilateral Cerebral Palsy: A Protocol and Risk Mitigation Guide
Non-invasive brain stimulation has been increasingly investigated, mainly in adults, with the aims of influencing motor recovery after stroke. However, a consensus on safety and optimal study design has not been established in pediatrics. The low incidence of reported major adverse events in adults...
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doaj-8b08f7f72cb44dea9ba65e4fb61e6dfa2020-11-24T22:51:22ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602018-03-01610.3389/fped.2018.00056299499Non-Invasive Brain Stimulation in Children With Unilateral Cerebral Palsy: A Protocol and Risk Mitigation GuideBernadette T. Gillick0Andrew M. Gordon1Tim Feyma2Linda E. Krach3Jason Carmel4Tonya L. Rich5Yannick Bleyenheuft6Kathleen Friel7Physical Therapy Division, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, United StatesDepartment of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, United StatesGillette Children’s Specialty Healthcare, Pediatric Neurology, St. Paul, MN, United StatesCourage Kenny Rehabilitation Institute, Minneapolis, MN, United StatesWeill-Cornell Medical College, Blythedale Children’s Hospital, Burke Medical Research Institute, White Plains, NY, United StatesRehabilitation Science, University of Minnesota, Minneapolis, MN, United StatesInstitute of Neuroscience (IoNS), Universite catholique de Louvain, Brussels, BelgiumWeill-Cornell Medical College, Blythedale Children’s Hospital, Burke Medical Research Institute, White Plains, NY, United StatesNon-invasive brain stimulation has been increasingly investigated, mainly in adults, with the aims of influencing motor recovery after stroke. However, a consensus on safety and optimal study design has not been established in pediatrics. The low incidence of reported major adverse events in adults with and without clinical conditions has expedited the exploration of NIBS in children with paralleled purposes to influence motor skill development after neurological injury. Considering developmental variability in children, with or without a neurologic diagnosis, adult dosing and protocols may not be appropriate. The purpose of this paper is to present recommendations and tools for the prevention and mitigation of adverse events (AEs) during NIBS in children with unilateral cerebral palsy (UCP). Our recommendations provide a framework for pediatric NIBS study design. The key components of this report on NIBS AEs are (a) a summary of related literature to provide the background evidence and (b) tools for anticipating and managing AEs from four international pediatric laboratories. These recommendations provide a preliminary guide for the assessment of safety and risk mitigation of NIBS in children with UCP. Consistent reporting of safety, feasibility, and tolerability will refine NIBS practice guidelines contributing to future clinical translations of NIBS.http://journal.frontiersin.org/article/10.3389/fped.2018.00056/fullcerebral palsynon-invasive brain stimulationtranscranial magnetic stimulationtranscranial direct current stimulationrepetitive transcranial magnetic stimulationsafety |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Bernadette T. Gillick Andrew M. Gordon Tim Feyma Linda E. Krach Jason Carmel Tonya L. Rich Yannick Bleyenheuft Kathleen Friel |
spellingShingle |
Bernadette T. Gillick Andrew M. Gordon Tim Feyma Linda E. Krach Jason Carmel Tonya L. Rich Yannick Bleyenheuft Kathleen Friel Non-Invasive Brain Stimulation in Children With Unilateral Cerebral Palsy: A Protocol and Risk Mitigation Guide Frontiers in Pediatrics cerebral palsy non-invasive brain stimulation transcranial magnetic stimulation transcranial direct current stimulation repetitive transcranial magnetic stimulation safety |
author_facet |
Bernadette T. Gillick Andrew M. Gordon Tim Feyma Linda E. Krach Jason Carmel Tonya L. Rich Yannick Bleyenheuft Kathleen Friel |
author_sort |
Bernadette T. Gillick |
title |
Non-Invasive Brain Stimulation in Children With Unilateral Cerebral Palsy: A Protocol and Risk Mitigation Guide |
title_short |
Non-Invasive Brain Stimulation in Children With Unilateral Cerebral Palsy: A Protocol and Risk Mitigation Guide |
title_full |
Non-Invasive Brain Stimulation in Children With Unilateral Cerebral Palsy: A Protocol and Risk Mitigation Guide |
title_fullStr |
Non-Invasive Brain Stimulation in Children With Unilateral Cerebral Palsy: A Protocol and Risk Mitigation Guide |
title_full_unstemmed |
Non-Invasive Brain Stimulation in Children With Unilateral Cerebral Palsy: A Protocol and Risk Mitigation Guide |
title_sort |
non-invasive brain stimulation in children with unilateral cerebral palsy: a protocol and risk mitigation guide |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Pediatrics |
issn |
2296-2360 |
publishDate |
2018-03-01 |
description |
Non-invasive brain stimulation has been increasingly investigated, mainly in adults, with the aims of influencing motor recovery after stroke. However, a consensus on safety and optimal study design has not been established in pediatrics. The low incidence of reported major adverse events in adults with and without clinical conditions has expedited the exploration of NIBS in children with paralleled purposes to influence motor skill development after neurological injury. Considering developmental variability in children, with or without a neurologic diagnosis, adult dosing and protocols may not be appropriate. The purpose of this paper is to present recommendations and tools for the prevention and mitigation of adverse events (AEs) during NIBS in children with unilateral cerebral palsy (UCP). Our recommendations provide a framework for pediatric NIBS study design. The key components of this report on NIBS AEs are (a) a summary of related literature to provide the background evidence and (b) tools for anticipating and managing AEs from four international pediatric laboratories. These recommendations provide a preliminary guide for the assessment of safety and risk mitigation of NIBS in children with UCP. Consistent reporting of safety, feasibility, and tolerability will refine NIBS practice guidelines contributing to future clinical translations of NIBS. |
topic |
cerebral palsy non-invasive brain stimulation transcranial magnetic stimulation transcranial direct current stimulation repetitive transcranial magnetic stimulation safety |
url |
http://journal.frontiersin.org/article/10.3389/fped.2018.00056/full |
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