Repeated transcranial direct current stimulation in prolonged disorders of consciousness: A double-blind cross-over study
Repeated transcranial direct current stimulation in prolonged disorders of consciousness: A double-blind cross-over study
复制标题
DOI：
10.1016/j.jns.2017.02.036
复制
发表时间：
2017-04-15
影响因子：
4.4
通讯作者：
Trojano, Luigi
中科院分区：
文献类型：
--
作者：
Estraneo, Anna;Pascarella, Angelo;Trojano, Luigi
目的：评价经颅直流电刺激左侧前额叶背外侧皮质治疗持续性意识障碍(DOC)的疗效。方法：将7例植物状态(VS)和6例微意识状态(MCS)患者随机分为两组：第1组给予1周的TDC刺激，1周给予假刺激，间隔1周；第2组接受逆序刺激。分别在第一次刺激前、刺激结束后、每周刺激后2小时、休息一周内两次、3个月随访期间进行临床和脑电检查。结果：观察到第一次刺激后和5次刺激后即刻患者病情的微小变化。13例患者中有5例(MCS组3例，VS组2例)在整个刺激方案(主动刺激和假刺激)后观察到明显的临床和脑电改变，并在接下来的几个月中进一步发展。没有基线特征来区分改善的患者和没有改善的患者。结论：重复TDC对DOC延长的患者没有显著的短期临床和脑电影响。进一步的研究应该确定tdcs是否可以在长期内促进临床恢复。(C)2017爱思唯尔B.V.保留所有权利。
Objective: To evaluate effects of 5 sessions of transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex in patients with prolonged disorders of consciousness (DOC).Methods: Seven patients in vegetative state (VS) and 6 in minimally conscious state (MCS), at >= 3 months after brain injury, were randomized into two groups: group 1 received one week of active tDCS and 1 week of sham stimulation, separated by 1 resting week; group 2 received active and sham stimulation in reverse order. We performed clinical and EEG evaluations before and after the first stimulation session, two hours after the last weekly stimulation, twice during the resting week, and during a 3-month follow-up.Results: We observed small changes of patients' conditions after the first tDCS session and immediately after the 5 active stimulations. Substantial clinical and EEG changes were observed in 5/13 patients (3 in MCS and 2 in VS) starting after entire (active and sham) stimulation protocol and further progressing during the next months. No baseline features distinguished patients who improved from patients who did not improve.Conclusions: Repeated tDCS did not exert remarkable short-term clinical and EEG effects in patients with prolonged DOC. Further studies should ascertain whether tDCS might promote clinical recovery in the longterm period. (C) 2017 Elsevier B.V. All rights reserved.