Transcranial Pulsed-Current Stimulation versus Transcranial Direct Current Stimulation in Patients with Disorders of Consciousness: A Pilot, Sham-Controlled Cross-Over Double-Blind Study

被引:14
|
作者
Barra, Alice [1 ,2 ,3 ]
Rosenfelder, Martin [4 ,5 ]
Mortaheb, Sepehr [1 ,6 ]
Carriere, Manon [1 ,2 ]
Martens, Geraldine [1 ,2 ,3 ]
Bodien, Yelena G. [3 ,7 ]
Morales-Quezada, Leon [3 ,8 ]
Bender, Andreas [9 ]
Laureys, Steven [1 ,2 ,10 ]
Thibaut, Aurore [1 ,2 ,8 ]
Fregni, Felipe [8 ]
机构
[1] Univ Liege, GIGA Consciousness GIGA Res, Coma Sci Grp, B-4000 Liege, Belgium
[2] Univ Hosp Liege, Ctr Cerveau, B-4000 Liege, Belgium
[3] Harvard Med Sch, Dept Phys Med & Rehabil, Spaulding Rehabil Hosp, Boston, MA 02114 USA
[4] Therapiezentrum Burgau, Dept Neurol, Kapuziner Str 34, D-89331 Burgau, Germany
[5] Univ Ulm, Inst Psychol & Educ, Clin & Biol Psychol, D-89081 Ulm, Germany
[6] Univ Liege, GIGA Consciousness, Physiol Cognit Lab, B-4000 Liege, Belgium
[7] Harvard Med Sch, Massachusetts Gen Hosp, Ctr Neurotechnol & Neurorecovery, Dept Neurol, Boston, MA 02114 USA
[8] Harvard Med Sch, Spaulding Rehabil Hosp, Neuromodulat Ctr, Boston, MA 02114 USA
[9] Ludwig Maximilians Univ LMU, Dept Neurol, D-81377 Munich, Germany
[10] Univ Laval, CERVO Brain Res Ctr CIUSS, Joint Int Res Unit Consciousness, Quebec City, PQ G1E1T2, Canada
基金
欧盟地平线“2020”; 美国国家科学基金会;
关键词
minimally conscious state; coma; non-invasive brain stimulation; electrophysiology; neuromodulation; randomized controlled trial; BRAIN-STIMULATION; TDCS; CORTEX; CONNECTIVITY; DEFINITION; RESPONSES; TRIAL; STATE; TPCS; QEEG;
D O I
10.3390/brainsci12040429
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Transcranial direct-current stimulation (tDCS) over the prefrontal cortex can improve signs of consciousness in patients in a minimally conscious state. Transcranial pulsed-current stimulation (tPCS) over the mastoids can modulate brain activity and connectivity in healthy controls. This study investigated the feasibility of tPCS as a therapeutic tool in patients with disorders of consciousness (DoC) and compared its neurophysiological and behavioral effects with prefrontal tDCS. This pilot study was a randomized, double-blind sham-controlled clinical trial with three sessions: bi-mastoid tPCS, prefrontal tDCS, and sham. Electroencephalography (EEG) and behavioral assessments were collected before and after each stimulation session. Post minus pre differences were compared using Kruskal-Wallis and Wilcoxon signed-rank tests. Twelve patients with DoC were included in the study (eight females, four traumatic brain injury, 50.3 +/- 14 y.o., 8.8 +/- 10.5 months post-injury). We did not observe any side-effects following tPCS, nor tDCS, and confirmed their feasibility and safety. We did not find a significant effect of the stimulation on EEG nor behavioral outcomes for tPCS. However, consistent with prior findings, our exploratory analyses suggest that tDCS induces behavioral improvements and an increase in theta frontal functional connectivity.
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收藏
页数:16
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