Prefrontal Theta Burst Stimulation for Cognitive Improvement After ICU Delirium

This study focuses on older adults who have stayed in the intensive care unit (ICU) and experienced delirium, a sudden change in attention and awareness. Even after recovery, many survivors continue to face issues with memory, attention, and decision-making, which can affect daily activities. Currently, no specific treatments exist to improve these cognitive difficulties after ICU delirium. The study aims to test a noninvasive form of brain stimulation called intermittent theta burst stimulation (iTBS), which could potentially improve cognitive function in older ICU survivors who had delirium. The study targets the left dorsolateral prefrontal cortex, a brain region involved in attention and cognitive control, using a device cleared by the FDA for other conditions, like depression. The study involves up to 40 adults aged 50 to 75, approximately three months after an ICU stay with documented delirium. Participants will attend 11 visits over six weeks, including a baseline visit, 10 stimulation sessions over two weeks, and a one-month follow-up. Each stimulation session lasts about 15-20 minutes. Cognitive tests are conducted at baseline, immediately after the two-week stimulation period, and one month later. The primary outcome measure is the change in executive function, assessed using the Trail Making Test Part B. Additional tests evaluate attention, processing speed, language, and memory. The goals of this pilot study are to assess the feasibility, safety, and tolerability of the stimulation protocol and estimate the magnitude of cognitive changes. This research explores whether prefrontal neuromodulation could be a future strategy for cognitive recovery after ICU delirium.