Journal
BRAIN SCIENCES
Volume 12, Issue 4, Pages -Publisher
MDPI
DOI: 10.3390/brainsci12040429
Keywords
minimally conscious state; coma; non-invasive brain stimulation; electrophysiology; neuromodulation; randomized controlled trial
Categories
Funding
- University Hospital of Liege
- Belgian National Funds for Scientific Research (FRS-FNRS)
- FNRS PDR project [T.0134.21]
- Televie Foundation
- European Union [785907, 945539]
- Luminous project (EU-H2020-fetopenga) [686764]
- European Space Agency (ESA)
- Belgian Federal Science Policy Office (BELSPO)
- Center-TBI project [FP7-HEALTH- 602150]
- Public Utility Foundation 'Universite Europeenne du Travail'
- Fondazione Europea di Ricerca Biomedica
- Bial Foundation
- Mind Science Foundation
- European Commission
- fund Generet
- King Baudouin Foundation
- Fondation Leon Fredericq
- Mind-Care foundation
- DOCMA project [EU-H2020-MSCA-RISE-778234]
- Wallonie Bruxelles International WBI
- NIH National Institute of Neurological Disorders and Stroke [R21NS109627, RF1NS115268, UH3NS095554, U01 NS1365885, U01- NS086090]
- NIH Director's Office [DP2 HD101400]
- National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR), Administration for Community Living [90DPCP0008-01-00, 90DP0039]
- James S. McDonnell Foundation
- Tiny Blue Dot Foundation
- U.S. Department of Defense [W81XWH- 14-2-0176, X81XWH-18-DMRDP-PTCRA]
- National Science Foundation [1014552]
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This study investigated the feasibility and effectiveness of tPCS as a therapeutic tool in patients with disorders of consciousness (DoC) and compared it with prefrontal tDCS. The results showed that tPCS did not have a significant effect on EEG or behavioral outcomes, while tDCS improved behavior and increased frontal functional connectivity.
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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