Barra Alice, Rosenfelder Martin, Mortaheb Sepehr, Carrière Manon, Martens Geraldine, Bodien Yelena G, Morales-Quezada Leon, Bender Andreas, Laureys Steven, Thibaut Aurore, Fregni Felipe
Coma Science Group, GIGA Consciousness-GIGA Research, University of Liège, 4000 Liège, Belgium.
Centre du Cerveau, University Hospital of Liège, 4000 Liège, Belgium.
Brain Sci. 2022 Mar 24;12(4):429. doi: 10.3390/brainsci12040429.
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.
经颅直流电刺激（tDCS）作用于前额叶皮层可改善最低意识状态患者的意识体征。经颅脉冲电流刺激（tPCS）作用于乳突可调节健康对照者的脑活动和脑连接。本研究调查了tPCS作为意识障碍（DoC）患者治疗工具的可行性，并将其神经生理学和行为学效应与前额叶tDCS进行比较。这项前瞻性研究是一项随机、双盲、假刺激对照的临床试验，共三个疗程：双侧乳突tPCS、前额叶tDCS和假刺激。在每个刺激疗程前后收集脑电图（EEG）和行为评估数据。使用Kruskal-Wallis检验和Wilcoxon符号秩检验比较刺激后与刺激前的差异。12名DoC患者纳入研究（8名女性，4名创伤性脑损伤患者，年龄50.3±14岁，受伤后8.8±10.5个月）。我们未观察到tPCS和tDCS后的任何副作用，并证实了它们的可行性和安全性。我们未发现tPCS刺激对EEG和行为结果有显著影响。然而，与先前的研究结果一致，我们的探索性分析表明，tDCS可诱导行为改善并增加额叶θ波功能连接。
