Patient and Provider Perspective of Cranioelectrical Stimulation for the Management of Persistent Mild Traumatic Brain Injury Symptoms in Veterans and Service Members.

INTRODUCTION: Mild traumatic brain injury (mTBI) is a significant public health concern. Individuals with persistent symptoms following mTBI can experience long-term disability. Non-pharmacological interventions such as cranial electrical stimulation (CES) are needed to address chronic symptoms. The purpose of this study is to explore the perspectives of both patients and clinicians on the use of CES for managing persistent mTBI symptoms, evaluate participants' perceptions and usage patterns, identify indications driving use, and assess self-efficacy.

MATERIALS AND METHODS: A qualitative, convergent parallel mixed methods design was employed within an inpatient rehabilitation program in a Veterans Affairs (VA) polytrauma rehabilitation center. Interviews were conducted with 81 patients with mTBI post-discharge, and surveys were collected from 23 clinicians. Data were analyzed using thematic analysis and descriptive phenomenology, guided by the Diffusion of Innovation Model.

RESULTS: Three major themes emerged: (1) Preparation and Comprehension, (2) Perceived Value and Effectiveness, and (3) Tailored Utilization. Patients used CES to manage anxiety, depression, pain, headache, and sleep disturbances, reporting broad symptom improvements. Seventy-one percent of participants continued device usage post-discharge. Similarly, clinicians prescribed CES for insomnia, anxiety, and headache and non-headache pain. Both groups reported a desire for advanced device use training/education to optimize treatment outcomes for complex symptoms.

CONCLUSION: CES should be considered for nonpharmacologic intervention for managing chronic mTBI symptoms. Enhanced patient education and comprehensive clinician training could improve its effectiveness and adoption. Further research and structured guidance are necessary to maximize the benefits of CES in mTBI care.