Impact of right median nerve stimulation on neuroplasticity markers and motor relearning in individuals with traumatic brain injury

Abstract

Background: Traumatic brain injury (TBI) frequently results in disorders of consciousness and impaired functional responsiveness, particularly during the early stages of recovery. Enhancing arousal and facilitating neuroplastic mechanisms are critical goals of neurorehabilitation. Peripheral sensory stimulation, specifically right median nerve stimulation, has been proposed as a non- invasive neuromodulatory approach capable of activating cortical and subcortical networks involved in consciousness and motor relearning. Objective: To investigate the effect of right median nerve electrical stimulation on level of consciousness and functional recovery in individuals with traumatic brain injury. Methods: Thirty individuals with traumatic brain injury classified as Rancho Los Amigos Level I or II participated in a quasi-experimental study. Participants received right median nerve electrical stimulation for four weeks, administered six days per week. Level of consciousness was assessed using the Glasgow Coma Scale (GCS), and functional outcomes were measured using the Disability Rating Scale (DRS). Pre- and post-intervention scores were statistically analysed. Results: Participants demonstrated significant improvement in both consciousness level and functional outcomes following the intervention. GCS scores increased significantly, indicating enhanced arousal and responsiveness. DRS scores showed a corresponding reduction, reflecting improved functional status. Statistical analysis revealed highly significant changes (p