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经颅直流电刺激联合音乐刺激治疗意识障碍延长患者的随机对照试验研究方案。

Combining HD-tDCS with music stimulation for patients with prolonged disorders of consciousness: Study protocol for an RCT trial.

机构信息

Department of Rehabilitation, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.

Department of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China.

出版信息

NeuroRehabilitation. 2024;54(3):495-504. doi: 10.3233/NRE-230282.

Abstract

BACKGROUND

Patients with prolonged disorders of consciousness (pDOC) pose significant challenges to healthcare workers due to their severe motor impairments and limited interaction with the environment. Non-invasive brain stimulation such as high-definition transcranial direct current stimulation (HD-tDCS) and music stimulation show promise in awakening this population.

OBJECTIVE

In this study, we present a protocol aiming at investigating the efficacy of combined HD-tDCS and music stimulation in awakening patients with pDOC through a single-blind, randomized controlled trial.

METHODS

Ninety patients with pDOC will be randomly divided into three groups: active HD-tDCS with music stimulation, active HD-tDCS, and sham HD-tDCS. All participants will receive 20 treatment sessions over a period of 10 days and the Coma Recovery Scale-Revised, Glasgow Outcome Scale and electroencephalogram will be used as assessment measures to evaluate their level of consciousness throughout the study. Adverse events and complications will be recorded during treatment. Within-group pre-post comparisons and between-group efficacy comparisons will be conducted to identify the most effective intervention approach. Statistical analysis will be performed using SPSS software with a significance level set at P < 0.05.

CONCLUSION

The pursuit of awakening therapy for patients with pDOC remains a clinical research challenge. This study protocol is designed with the aim of introducing an innovative non-pharmacological approach which combined HD-tDCS and music stimulation to facilitate the reinstatement of consciousness in patients with pDOC.

摘要

背景

持续性意识障碍(pDOC)患者由于严重的运动障碍和与环境的有限互动,对医护人员构成重大挑战。非侵入性脑刺激,如高清晰度经颅直流电刺激(HD-tDCS)和音乐刺激,在唤醒这一人群方面显示出前景。

目的

本研究旨在通过单盲、随机对照试验,提出一项方案,研究联合使用 HD-tDCS 和音乐刺激唤醒 pDOC 患者的疗效。

方法

将 90 名 pDOC 患者随机分为三组:主动 HD-tDCS 加音乐刺激组、主动 HD-tDCS 组和假刺激 HD-tDCS 组。所有参与者将在 10 天内接受 20 次治疗,使用昏迷恢复量表修订版、格拉斯哥结局量表和脑电图作为评估措施,在整个研究过程中评估他们的意识水平。治疗期间将记录不良事件和并发症。将进行组内前后比较和组间疗效比较,以确定最有效的干预方法。统计分析将使用 SPSS 软件进行,显著性水平设为 P<0.05。

结论

对 pDOC 患者进行觉醒治疗仍然是临床研究的挑战。本研究方案旨在引入一种创新的非药物方法,即联合使用 HD-tDCS 和音乐刺激,以促进 pDOC 患者意识的恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0d6/11091638/6c0dbe7d920f/nre-54-nre230282-g001.jpg

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