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微意识状态患者经颅直流电刺激反应的功能连接基质

Functional Connectivity Substrates for tDCS Response in Minimally Conscious State Patients.

作者信息

Cavaliere Carlo, Aiello Marco, Di Perri Carol, Amico Enrico, Martial Charlotte, Thibaut Aurore, Laureys Steven, Soddu Andrea

机构信息

Coma Science Group, GIGA-Research, University and University Hospital of LiegeLiege, Belgium; NAPLab, IRCCS SDN Istituto di Ricerca Diagnostica e NucleareNaples, Italy.

NAPLab, IRCCS SDN Istituto di Ricerca Diagnostica e Nucleare Naples, Italy.

出版信息

Front Cell Neurosci. 2016 Nov 3;10:257. doi: 10.3389/fncel.2016.00257. eCollection 2016.


DOI:10.3389/fncel.2016.00257
PMID:27857682
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5093112/
Abstract

Transcranial direct current stimulation (tDCS) is a non-invasive technique recently employed in disorders of consciousness, and determining a transitory recovery of signs of consciousness in almost half of minimally conscious state (MCS) patients. Although the rising evidences about its possible role in the treatment of many neurological and psychiatric conditions exist, no evidences exist about brain functional connectivity substrates underlying tDCS response. We retrospectively evaluated resting state functional Magnetic Resonance Imaging (fMRI) of 16 sub-acute and chronic MCS patients (6 tDCS responders) who successively received a single left dorsolateral prefrontal cortex (DLPFC) tDCS in a double-blind randomized cross-over trial. A seed-based approach for regions of left extrinsic control network (ECN) and default-mode network (DMN) was performed. tDCS responders showed an increased left intra-network connectivity for regions co-activated with left DLPFC, and significantly with left inferior frontal gyrus. Non-responders (NR) MCS patients showed an increased connectivity between left DLPFC and midline cortical structures, including anterior cingulate cortex and precuneus. Our findings suggest that a prior high connectivity with regions belonging to ECN can facilitate transitory recovery of consciousness in a subgroup of MCS patients that underwent tDCS treatment. Therefore, resting state-fMRI could be very valuable in detecting the neuronal conditions necessary for tDCS to improve behavior in MCS.

摘要

经颅直流电刺激(tDCS)是一种最近用于意识障碍治疗的非侵入性技术,在几乎一半的最低意识状态(MCS)患者中可促使意识体征出现短暂恢复。尽管有越来越多的证据表明其在治疗多种神经和精神疾病方面可能发挥作用,但关于tDCS反应背后的脑功能连接基质尚无证据。我们回顾性评估了16例亚急性和慢性MCS患者(6例tDCS反应者)的静息态功能磁共振成像(fMRI),这些患者在一项双盲随机交叉试验中先后接受了单次左侧背外侧前额叶皮质(DLPFC)tDCS治疗。采用基于种子点的方法对左侧外在控制网络(ECN)和默认模式网络(DMN)区域进行分析。tDCS反应者与左侧DLPFC共同激活区域的左侧网络内连接增加,与左侧额下回显著相关。无反应(NR)的MCS患者左侧DLPFC与中线皮质结构(包括前扣带回皮质和楔前叶)之间的连接增加。我们的研究结果表明,与属于ECN的区域先前具有高连接性可以促进接受tDCS治疗的MCS患者亚组中意识的短暂恢复。因此,静息态fMRI在检测tDCS改善MCS患者行为所需的神经元条件方面可能非常有价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90f2/5093112/452baebced2a/fncel-10-00257-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90f2/5093112/b3fd1250b3a3/fncel-10-00257-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90f2/5093112/452baebced2a/fncel-10-00257-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90f2/5093112/b3fd1250b3a3/fncel-10-00257-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90f2/5093112/452baebced2a/fncel-10-00257-g0002.jpg

相似文献

[1]
Functional Connectivity Substrates for tDCS Response in Minimally Conscious State Patients.

Front Cell Neurosci. 2016-11-3

[2]
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[3]
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[4]
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[5]
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[6]
Altered functional connectivity and regional brain activity in a triple-network model in minimally conscious state and vegetative-state/unresponsive wakefulness syndrome patients: A resting-state functional magnetic resonance imaging study.

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[7]
DLPFC stimulation alters large-scale brain networks connectivity during a drug cue reactivity task: A tDCS-fMRI study.

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[8]
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[9]
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[10]
tDCS in patients with disorders of consciousness: sham-controlled randomized double-blind study.

Neurology. 2014-2-26

引用本文的文献

[1]
Resting-State Activity Changes Induced by tDCS in MS Patients and Healthy Controls: A Simultaneous tDCS rs-fMRI Study.

Bioengineering (Basel). 2025-6-19

[2]
Impact of transcranial direct current stimulation combined with median nerve stimulation on CRS-R in patients with prolonged disorders of consciousness after cerebral hemorrhage: protocol for a randomized controlled trial.

Front Neurol. 2025-6-10

[3]
Assessing Consciousness through Neurofeedback and Neuromodulation: Possibilities and Challenges.

Life (Basel). 2023-8-2

[4]
Measure functional network and cortical excitability in post-anoxic patients with unresponsive wakefulness syndrome diagnosed by behavioral scales.

Front Neurosci. 2023-1-11

[5]
Behavioral effects in disorders of consciousness following transcranial direct current stimulation: A systematic review and individual patient data meta-analysis of randomized clinical trials.

Front Neurol. 2022-9-29

[6]
Effectiveness of transcranial direct current stimulation over dorsolateral prefrontal cortex in patients with prolonged disorders of consciousness: A systematic review and meta-analysis.

Front Neurol. 2022-9-26

[7]
Functional Connectivity Increases in Response to High-Definition Transcranial Direct Current Stimulation in Patients with Chronic Disorder of Consciousness.

Brain Sci. 2022-8-18

[8]
tDCS-EEG for Predicting Outcome in Patients With Unresponsive Wakefulness Syndrome.

Front Neurosci. 2022-6-24

[9]
High-Definition Transcranial Direct Current Stimulation of the Dorsolateral Prefrontal Cortex Modulates the Electroencephalography Rhythmic Activity of Parietal Occipital Lobe in Patients With Chronic Disorders of Consciousness.

Front Hum Neurosci. 2022-5-27

[10]
A Meta-Analysis of Transcranial Direct Current Stimulation on Substance and Food Craving: What Effect Do Modulators Have?

Front Psychiatry. 2020-6-26

本文引用的文献

[1]
Resting-state Network-specific Breakdown of Functional Connectivity during Ketamine Alteration of Consciousness in Volunteers.

Anesthesiology. 2016-11

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Neuropsychiatr Dis Treat. 2015-10-7

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Clinical Response to tDCS Depends on Residual Brain Metabolism and Grey Matter Integrity in Patients With Minimally Conscious State.

Brain Stimul. 2015-9-14

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tDCS in patients with disorders of consciousness: sham-controlled randomized double-blind study.

Neurology. 2014-2-26

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Disorders of consciousness after acquired brain injury: the state of the science.

Nat Rev Neurol. 2014-1-28

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