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双侧经颅直流电刺激神经调节对微意识状态患者的认知和神经生理影响。

Cognitive and neurophysiological effects of bilateral tDCS neuromodulation in patients with minimally conscious state.

作者信息

Gangemi Antonio, Impellizzeri Federica, Fabio Rosa Angela, Suriano Rossella, D'Arrigo Angela, Rifici Carmela, Porcari Bruno, Quartarone Angelo, De Luca Rosaria, Calabrò Rocco Salvatore

机构信息

IRCCS Centro Neurolesi Bonino Pulejo, 98124, Messina, Italy.

Department of Biomedical, Dental and Morphological and Functional Imaging Sciences, University of Messina, 98100, Messina, Italy.

出版信息

Sci Rep. 2025 Apr 24;15(1):14389. doi: 10.1038/s41598-025-99591-8.

Abstract

The minimally conscious state (MCS) is a clinical condition characterized by severely reduced but present awareness of self and the environment. Transcranial direct current stimulation (tDCS) has shown promising potential. The aim of this quasi-randomised control study was to investigate the effects of bilateral of tDCS applied to the right and left dorsolateral prefrontal cortex (DLPFC) on neurophysiological and cognitive outcomes in 28 patients with MCS. Participants were quasi-randomly assigned to one of two groups: experimental group with tDCS over both DLPFC, and a control group, which received sham tDCS. Neurophysiological assessments included event-related potentials (ERPs) analysis (N200 and P300) and EEG beta band study. Clinical outcomes were measured using ad hoc psychometric battery, including Coma Recovery Scale-Revised (CRS-R), Levels of Cognitive Functioning Scale (LCFS), and Functional Independence Measure (FIM). The findings revealed a significant improvement in ERP latencies and increased beta band rhythms in the experimental group, indicating enhanced neural responsiveness to cognitive stimuli. Additionally, significant improvements were observed in clinical measures of awareness and functional capacity. These findings suggest that tDCS may represent a promising therapeutic option for enhancing both neurophysiological responses and cognitive functioning in patients with MCS.

摘要

微意识状态(MCS)是一种临床状态,其特征是自我及环境意识严重减退但仍存在。经颅直流电刺激(tDCS)已显示出有前景的潜力。这项半随机对照研究的目的是调查对28例MCS患者双侧应用tDCS于右侧和左侧背外侧前额叶皮质(DLPFC)对神经生理和认知结果的影响。参与者被半随机分配到两组之一:对双侧DLPFC进行tDCS的实验组,以及接受伪tDCS的对照组。神经生理评估包括事件相关电位(ERP)分析(N200和P300)以及脑电图β波段研究。临床结果使用专门的心理测量量表进行测量,包括昏迷恢复量表修订版(CRS-R)、认知功能水平量表(LCFS)和功能独立性测量(FIM)。研究结果显示,实验组的ERP潜伏期有显著改善,β波段节律增加,表明对认知刺激的神经反应性增强。此外,在意识和功能能力的临床测量中也观察到显著改善。这些发现表明,tDCS可能是增强MCS患者神经生理反应和认知功能的一种有前景的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb8a/12022346/2f45861df810/41598_2025_99591_Fig1_HTML.jpg

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