UCLA researchers are launching innovative clinical trials to treat chronic concussion symptoms and severe brain injury using personalized brain stimulation and ultrasound therapy. These groundbreaking approaches represent a significant shift from traditional recovery methods, offering new hope for patients whose symptoms persist long after their initial injury. What Is Personalized Brain Stimulation for Chronic Concussion? One of the most promising new treatments being tested at UCLA is called transcranial magnetic stimulation, or TMS. Unlike previous concussion therapies, this noninvasive approach directly targets the brain itself and is customized for each individual patient. The treatment uses magnetic pulses to stimulate specific brain regions, with the goal of improving how different areas of the brain communicate with each other. The clinical trial is enrolling people aged 18 to 65 who experience chronic symptoms after concussion or mild traumatic brain injury. These symptoms can include dizziness, headache, fatigue, brain fog, memory difficulty, sleep disruption, irritability, or anxiety that occurred or worsened after the injury. For many patients, these symptoms make it difficult to return to physical activity, work, or school. Participants in the study will make 14 visits to UCLA over several weeks. During these visits, they will undergo baseline assessments, receive 10 TMS treatment sessions, and complete follow-up evaluations with brain imaging. About two-thirds of participants will receive active TMS treatment, while the remaining third will receive sham, or inactive, TMS to serve as a comparison group. How Does This Treatment Actually Work? - Brain Connectivity: Researchers are investigating whether personalized TMS improves how different regions of the brain communicate with each other after a concussion. - Symptom Reduction: The treatment aims to reduce avoidance behaviors and the chronic symptoms that interfere with daily functioning, such as fatigue and memory problems. - Long-Term Effects: Scientists want to determine whether improvements from TMS treatment last for up to two months after the therapy ends. - Predictive Factors: Researchers are identifying which patients are most likely to respond well to the treatment, helping doctors personalize care in the future. What About Severe Brain Injury and Disorders of Consciousness? Beyond concussion treatment, UCLA is also testing ultrasound stimulation for patients with severe brain injuries who fail to fully recover. This multicenter clinical trial focuses on patients with prolonged disorders of consciousness, a condition where patients survive severe brain injury but remain unable to fully wake or respond to their surroundings. The ultrasound approach, called transcranial focused ultrasound or tFUS, targets the thalamus, a critical brain region involved in consciousness and awareness. The trial is enrolling eligible people aged 18 to 79 and aims to establish both the safety and effectiveness of this intervention compared to sham treatment. Researchers are also exploring which patients are most likely to benefit from the therapy and what biological markers might predict treatment response. How Are Doctors Optimizing Care for Severe Traumatic Brain Injury? Another major clinical trial at UCLA, called BOOST3, is comparing two different monitoring strategies for patients with severe traumatic brain injury, or TBI, in the intensive care unit. One approach monitors intracranial pressure, or ICP, which measures pressure inside the skull. The other approach monitors both ICP and brain tissue oxygen, or PbtO2, which measures how much oxygen is reaching the brain tissue itself. The study will determine whether adding brain tissue oxygen monitoring leads to better patient outcomes and safer treatment decisions. Both monitoring strategies are already used in standard care, but doctors don't yet know which approach is more effective. The results could help physicians make better decisions about medications, intravenous fluids, ventilator settings, and blood transfusions for critically injured patients. What Other Innovative Approaches Are Being Tested? UCLA researchers are also exploring whether a ketogenic diet, a high-fat, low-carbohydrate eating plan, might help children with acute brain injuries such as stroke, traumatic brain injury, and brain hemorrhage. The theory behind this approach is that after a brain injury, the brain's ability to use glucose as fuel becomes impaired. The ketogenic diet forces the body to burn fat for energy instead, producing ketones that the brain can use as an alternative fuel source. A pilot study is evaluating the safety and feasibility of providing ketogenic feeds to 5 to 10 children admitted to the pediatric intensive care unit with acute brain injuries for a two-week period. Researchers will measure ketone levels in the blood and brain using specialized imaging, and monitor for potential side effects such as kidney stones, excessive acidosis, and low blood sugar. Additionally, UCLA is testing telerehabilitation for patients recovering from stroke, traumatic brain injury, and spinal cord injury. This approach uses a sensor-based training system called HandyMotion that connects to a television in the hospital room, allowing patients to access rehabilitation exercises and games from their bedside during their inpatient recovery period. Why Should Patients Care About These Clinical Trials? For millions of people living with chronic concussion symptoms or severe brain injury, current treatment options are limited. These UCLA clinical trials represent a fundamental shift in how doctors approach brain injury recovery. Instead of waiting for the brain to heal on its own, researchers are now using advanced technologies like brain stimulation and ultrasound to actively promote recovery and improve function. The personalized approach is particularly important because it recognizes that every brain injury is different. By tailoring treatments to individual patients and identifying predictors of treatment response, doctors can eventually move away from one-size-fits-all approaches and toward precision medicine for brain injury. For eligible patients, participating in these trials offers access to cutting-edge treatments that are not yet available outside of research settings.
