Traumatic Brain Injury (TBI)
A fall, a traffic accident, a sports injury, or a hard blow to the head can disrupt brain function. This is known as traumatic brain injury (TBI).
Sometimes the consequences are immediately visible. For others, initial examinations may seem reassuring, yet persistent symptoms still develop.
Concentration is no longer what it used to be.
Processing information takes more time.
You may forget appointments, have trouble finding the right words, or become exhausted more quickly by everyday activities.
Headaches, dizziness, sleep problems, and increased sensitivity to light or sound can also occur.
Traumatic brain injury can disrupt the communication between brain regions, leading to cognitive, physical, and emotional symptoms.
At BRAI3N, we investigate how these brain networks are involved in persistent symptoms and whether neuromodulation can provide additional support during the rehabilitation process.
What is it?
What happens in the brain during a traumatic brain injury?
A traumatic brain injury occurs when an external force damages or disrupts the function or structure of the brain.
This can happen due to a direct impact to the head, but also through forceful acceleration, deceleration, or rotational movements.
During these movements, the brain and its nerve connections are subjected to mechanical forces.
Depending on the nature and severity of the trauma, various injuries can occur:
- Brain contusions:damage to brain tissue caused by the impact.
- Brain hemorrhages:bleeding in or around the brain.
- Diffuse axonal injury:damage to nerve fibers that connect different areas of the brain.
- Changes in brain function:disruptions in the functioning of nerve cells and brain networks, even when no clear abnormalities are visible on conventional imaging.
In a so-calledcoup-contrecoup injurybrain tissue can be damaged at the site of the impact and on the opposite side. This is just one of the possible injury mechanisms.
Severe acceleration or deceleration of the head without a direct impact can also cause brain injury under certain circumstances.
AnWhiplashand traumatic brain injury can occur simultaneously, but they are not the same thing.
Why aren't all effects visible on a scan?
In cases of severe traumatic brain injury, a CT or MRI scan can reveal bleeding, bruising, and other structural abnormalities.
However, with a concussion or mild traumatic brain injury, conventional imaging may appear normal.
A normal CT or MRI scan therefore does not automatically mean that brain function remains unchanged after the trauma.
Our brains function as an extensive network of nerve cells. Different brain regions constantly exchange information to enable us to think, move, speak, remember, and respond to our environment.
When this communication is disrupted, daily activities can suddenly require much more effort.
For example, someone might still know exactly what they want to say but struggle to find the right word. Or they might be able to perform a simple task individually but get stuck as soon as multiple actions need to be combined.
This helps explain why some patients experience clear functional limitations without conventional imaging being able to fully explain the cause.
What symptoms can arise after a traumatic brain injury?
The effects of TBI vary greatly from person to person. They depend on factors such as the severity and location of the injury and the brain functions that are affected.
1. Attention and concentration disorders
After a brain injury, patients may have difficulty maintaining their attention.
Reading, following conversations, or working in a busy environment requires more effort than before.
Performing multiple tasks simultaneously can also become difficult.
The brain sometimes needs more time to process information and organize appropriate responses.
Read more aboutattention and concentration disorders.
2. Memory problems and word-finding difficulties
Memory problems are among the frequently occurring cognitive consequences of TBI.
Some patients forget recent events, have trouble remembering new information, or find it harder to recall memories.
Word-finding difficulties also occur.
You know what you want to say, but you cannot find the right word. Sometimes speaking is slower, or it takes more effort to put your thoughts into words.
These symptoms can arise when the areas of the brain involved in language, memory, and information processing do not work together efficiently enough.
Read more aboutmemory disorders.
3. Problems with executive functions
Executive functions are the brain processes that help us organize daily activities and carry them out in a goal-oriented way.
They are important for, among other things:
- Planning and organizing.
- Making decisions.
- Controlling impulses.
- Switching between different tasks.
- Solving problems.
- Maintaining an overview in complex situations.
After a traumatic brain injury, these functions can become impaired.
A task that used to be automatic can suddenly require a lot of mental effort.
This often has a significant impact on independence, work, and social functioning.
4. Mental fatigue and sensory sensitivity
After a TBI, some patients experience pronounced mental fatigue.
The brain seems to become exhausted more quickly when it has to process a lot of information.
Even ordinary stimuli, such as conversations, background noise, bright light, or a busy environment, can become overwhelming.
As a result, someone may feel the need to rest after only limited cognitive effort.
This fatigue can be accompanied by sleep problems and a reduced capacity for daily activities.
5. Headaches, dizziness, and balance problems
Traumatic brain injury can also cause physical symptoms.
Post-traumatic headache is a common consequence. The symptoms can resemble migraines or tension headaches and may persist for a long time in some patients.
Scientific research points to the potential involvement of inflammatory processes, altered pain processing, and disruptions in brain networks involved in pain regulation.
In addition,dizziness and balance disorderscan occur due to disruptions in vestibular, visual, or central information processing.
6. Emotional and behavioral changes
The regulation of emotions and behavior can also change after a brain injury.
Some patients notice that they are more irritable, react more emotionally, or have more difficulty coping with stress.
In addition,anxietyanddepressive symptomsdevelop or increase.
These changes can be related to the brain injury itself, but also to the impact of long-term limitations on daily life.
What happens to brain networks after TBI?
The brain does not function as separate, independent areas.
For almost every cognitive function, multiple brain areas must work together precisely.
With traumatic brain injury, nerve connections can be damaged or the functional communication between brain areas can change.
This is also known as a disruption of functional connectivity.
Networks involved in attention, memory, motor control, and executive functions are particularly relevant.
An important area is the prefrontal cortex, which helps with planning, concentration, and controlling thoughts and behavior, among other things.
Thepre-supplementary motor area(pre-SMA) and thedorsal anterior cingulate cortex(dACC) also play a role in cognitive control, selecting responses, and retrieving information.
Scientific research shows that these networks can remain adaptable even in people with chronic traumatic brain injury.
That is important because the brain possessesneuroplasticity: the ability to adapt the function and interconnections of nerve cells.
This serves as an important foundation for modern neurorehabilitation and research into neuromodulation.
How to treat
Neurorehabilitation: supporting the functioning of brain networks
Recovery after a traumatic brain injury is a complex and individual process.
Depending on the symptoms, various forms of rehabilitation may be indicated, such as cognitive rehabilitation, occupational therapy, physical therapy, speech therapy, vestibular rehabilitation, and psychological counseling.
These treatments help patients restore functions, redevelop skills, or learn compensatory strategies.
However, some patients continue to experience cognitive, neurological, or physical limitations, even long after the initial trauma.
Neuromodulation offers an additional treatment approach where we aim to specifically influence the activity of brain networks involved in these functions.
Neuromodulation as an adjunctive therapy for TBI
With non-invasive neuromodulation, we use electrical or magnetic stimulation to influence the activity of specific brain regions and their communication with one another.
The goal is to support brain processes involved in cognitive or neurological functions.
Scientific research focuses on areas including:
- Attention and concentration.
- Memory and word retrieval.
- Executive functions and cognitive control.
- Motor functions.
- Pain processing and post-traumatic headache.
This treatment approach investigates methods including transcranial electrical stimulation (tES), such as high-definition tDCS (HD-tDCS), and transcranial magnetic stimulation (TMS).
Neuromodulation is not viewed here as a replacement for neurorehabilitation, but as a potential supplement that can support specific recovery and learning processes.
What does scientific research show?
Researchers includingProf. Dr. Sven Vannestehave published various studies on the influence of targeted electrical brain stimulation in patients with chronic traumatic brain injury.
In these studies, particular attention was paid to brain networks involved in word retrieval, memory, and executive functions.
Improvement in word retrieval and cognitive control
In a controlled clinical study, Motes and colleagues investigated the effect of targeted HD-tDCS in patients with chronic TBI and word-finding difficulties.
After multiple stimulation sessions, improvements were found in certain cognitive tests, including verbal memory, cognitive control, and word retrieval.
For one component of word retrieval, the improvements were still detectable eight weeks after treatment.
Changes in electrical brain activity
In follow-up research, Chiang, Vanneste, and colleagues studied how brain activity changed following HD-tDCS.
They found changes in theta activity and in the functional connectivity between frontal and other brain regions.
Theta activity is a form of electrical brain activity involved in processes such as attention, memory, and cognitive control.
The findings show that neuromodulation can cause measurable changes in these brain processes.
Possibilities for motor recovery
Interesting results have also been described in patients with motor impairments following TBI.
For example, researchers reported improvements in fine motor skills of the hand in a patient with chronic brain injury following targeted electrical stimulation.
This concerns an individual clinical case and therefore cannot be automatically generalized to all patients with TBI.
Together, these studies show that targeted neuromodulation offers possibilities for influencing certain brain networks, even in the chronic phase of traumatic brain injury.
The results are promising, but the magnitude and durability of the effect vary by cognitive function and patient group. Larger studies are needed to further determine the role of neuromodulation within standard neurorehabilitation.
The BRAI3N treatment process
1. Assessment
During the initial evaluation, we examine which symptoms are present following the traumatic brain injury and how they affect your daily functioning.
We focus on areas including attention, memory, word-finding, executive functions, mental fatigue, dizziness, pain, and emotional functioning.
Previous neurological examinations and rehabilitation treatments are also taken into account.
AnqEEG measurement and analysisprovides additional information about electrical brain activity and can help investigate certain neurophysiological processes, but it does not replace a neurological diagnosis or neuropsychological evaluation.
2. Targeted treatment
Based on the clinical assessment, we determine which treatment goals are relevant.
When neuromodulation appears indicated, we investigate which brain networks could potentially be influenced to support specific symptoms.
The treatment can be combined with existing forms of cognitive or motor rehabilitation.
3. Stabilization
During the treatment process, we monitor how your symptoms and daily functioning evolve.
For example, we look at whether there are changes in concentration, memory, mental stamina, or other predetermined treatment goals.
The treatment plan is adjusted as necessary.
4. Maintenance
When improvement occurs, we look at how it can be maintained as effectively as possible.
Further neurorehabilitation, cognitive training, adapted activities, or medical follow-up can continue to play an important role in this.
Not every patient requires neuromodulation or follows the same path.
Are your symptoms persisting after a traumatic brain injury?
Are you still struggling with concentration, memory, word-finding, mental fatigue, or other neurological functions following an accident or brain injury?
At BRAI3N, we investigate how the involved brain networks are functioning and whether neuromodulation could be a valuable addition to your current rehabilitation.
During an initial evaluation, we will discuss your symptoms, previous examinations, and the possibilities for a personalized treatment plan.
Contact us for a no-obligation consultation or to schedule an appointment
Scientific Background
Motes MA, Spence JS, Yeatman K, et al.Journal of Neurotrauma. 2020;37(1):170–177.
Chiang HS, Motes M, Kraut M, Vanneste S, Hart J.Clinical Neurophysiology. 2022;143:36–47.
Chiang HS, Motes M, O'Hair R, Vanneste S, Kraut M, Hart J Jr.Neuroscience Letters. 2021;764:136204.
Chiang HS, Shakal S, Vanneste S, Kraut M, Hart J Jr.Frontiers in Neurology. 2021;12:678518.
Chiang HS, Shakal S, Strain JF, et al.Brain Stimulation. 2022;15:283–285.
Begemann MJ, Brand BA, Ćurčić-Blake B, Aleman A, Sommer IE.Psychological Medicine. 2020;50:2465–2486.
Inflammation, Brain Connectivity, and Neuromodulation in Post-Traumatic Headache
da Silva Fiorin F, do Espírito Santo CC, Da Silva JT, Chung MK.Brain, Behavior, & Immunity – Health. 2024;35:100723.
Non-Invasive Brain Stimulation in Rehabilitation
Kesikburun S.Turkish Journal of Physical Medicine and Rehabilitation. 2022;68(1):1–8.
Authored by Prof. Dr. Sven Vanneste, Prof. Dr. Dirk De Ridder and Jan Ost - 10/22/2026
Other conditions that we treat
Auditory and vestibular disorders
These disorders are related to hearing and balance and can have a major impact on your daily life.
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Neurological and cognitive disorders
These disorders affect brain function, which can lead to problems with attention, memory, and motor skills.
Mental and emotional disorders
Mental illness can be deeply rooted in neurobiological dysfunctions.
Chronic Pain and Fatigue Syndromes
Chronic pain and fatigue are often difficult to treat with conventional methods, especially when there is no obvious physical cause.
Fatigue syndromes and sleep disorders
Sleep and energy management are essential for brain function. Problems in these areas can lead to severe tiredness and difficulty concentrating.
Headache and facial pain disorders
Headaches and facial pain can result from complex neurological processes.
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Our specialists are here to help you. Find out what treatments are possible or schedule a consultation.