Neurophysiological Correlates of a Single Session of Prefrontal tDCS in Patients with Prolonged Disorders of Consciousness: A Pilot Double-Blind Randomized Controlled Study
Neurophysiological Correlates of a Single Session of Prefrontal tDCS in Patients with Prolonged Disorders of Consciousness: A Pilot Double-Blind Randomized Controlled Study
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DOI：
10.3390/brainsci10070469
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发表时间：
2020-07-01
期刊：
影响因子：
3.3
通讯作者：
Thibaut, Aurore
中科院分区：
文献类型：
--
作者：
Carriere, Manon;Mortaheb, Sepehr;Thibaut, Aurore
研究背景：经颅直流电刺激左侧背外侧前额叶皮质（IDLPFC）可促进某些处于最低意识状态（MCS）患者的意识体征恢复，但其对大脑活动的电生理效应仍知之甚少。（使用昏迷恢复量表-修订版; CRS-R）和神经生理学效应（使用高密度脑电图;方法：在一个双盲、假对照、交叉设计中，（2 mA，20分钟）以随机顺序递送。tDCS前后分别记录10 min hdEEG，并给予CRS-R。我们发现，主动tDCS治疗后，在中心区域的α波段以及额叶和后部区域的θ波段中，组水平的相对功率更高（未校正结果）。较高的加权符号互信息（wSMI）的连接被发现之间的左，右顶叶区域，较高的额顶叶加权相位滞后指数（wPLI）的连接被发现，无论是在α波段（未校正的结果）。在组水平，未观察到显著的治疗效应。三名患者表现出行为改善后，积极的会议和一名患者改善sham.Conclusion后，我们提供了初步的迹象表明，神经生理学的变化，可以观察到一个单一的会议后，tDCS患者长期DOC，虽然他们不一定是与显着的行为改善。
Background.Transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (lDLPFC) was reported to promote the recovery of signs of consciousness in some patients in a minimally conscious state (MCS), but its electrophysiological effects on brain activity remain poorly understood.Objective.We aimed to assess behavioral (using the Coma Recovery Scale-Revised; CRS-R) and neurophysiological effects (using high density electroencephalography; hdEEG) of lDLPFC-tDCS in patients with prolonged disorders of consciousness (DOC).Methods.In a double-blind, sham-controlled, crossover design, one active and one sham tDCS (2 mA, 20 min) were delivered in a randomized order. Directly before and after tDCS, 10 min of hdEEG were recorded and the CRS-R was administered.Results.Thirteen patients with severe brain injury were enrolled in the study. We found higher relative power at the group level after the active tDCS session in the alpha band in central regions and in the theta band over the frontal and posterior regions (uncorrected results). Higher weighted symbolic mutual information (wSMI) connectivity was found between left and right parietal regions, and higher fronto-parietal weighted phase lag index (wPLI) connectivity was found, both in the alpha band (uncorrected results). At the group level, no significant treatment effect was observed. Three patients showed behavioral improvement after the active session and one patient improved after the sham.Conclusion.We provide preliminary indications that neurophysiological changes can be observed after a single session of tDCS in patients with prolonged DOC, although they are not necessarily paralleled with significant behavioral improvements.