Efficiency of Repetitive Transcranial Direct Current Stimulation of the Dorsolateral Prefrontal Cortex in Disorders of Consciousness: A Randomized Sham-Controlled Study
Efficiency of Repetitive Transcranial Direct Current Stimulation of the Dorsolateral Prefrontal Cortex in Disorders of Consciousness: A Randomized Sham-Controlled Study
复制标题
重复经颅直流电刺激背外侧前额叶皮层在意识障碍中的效率：一项随机假对照研究
DOI：
10.1155/2019/7089543
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发表时间：
2019-01-01
影响因子：
3.1
通讯作者：
Luo, Benyan
中科院分区：
文献类型：
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作者：
Wu, Min;Yu, Yamei;Luo, Benyan
传统的经颅直流电刺激（tDCS）对左背外侧前额叶皮层（DLPFC）的觉醒有改善作用。然而，左侧DLPFC的阳极刺激和tDCS的电生理效应的比较效果尚未确定。在这个随机的假对照设计中，患者分为三组（左/右淋巴结tDCS，假手术）。临床评估和脑电图数据在基线和tDCS 2周后收集。3个月随访的结果使用格拉斯哥结局量表进行评估。结果显示，左侧tDCS的会话促进了前额叶皮层的兴奋性，而只有一名患者有积极的结果。瞄准右侧DLPFC效果较差，只会导致刺激部位的激活，对唤醒状态没有影响。此外，假刺激对任何结果的影响都很小或没有影响。这些结果为DOC患者的tDCS效应的半球不对称性提供了证据。与右侧DLPFC的tDCS相比，左侧淋巴结tDCS对皮质兴奋性的调节可能更有效。然而，未来需要更大样本量的研究来证实这些发现。本试验注册号为NCT03809936。
Conventional transcranial direct current stimulation (tDCS) targeting the left dorsolateral prefrontal cortex (DLPFC) could improve arousal in disorders of consciousness (DOC). However, the comparative effectiveness of anodal stimulation of the left DLPFC and the electrophysiological effect of tDCS are yet to be determined. In this randomized sham-controlled design, patients were separated into three groups (left/right anodal tDCS, sham). Data on the clinical assessments and EEG were collected at baseline and after 2 weeks of tDCS. The outcome at 3-month follow-up was evaluated using the Glasgow Outcome Scale-Extended. Results showed that sessions of the left tDCS facilitated the excitability of the prefrontal cortex, whereas only one patient had a positive outcome. Targeting the right DLPFC was less effective, merely leading to activation of the stimulation site, with no effect on the state of arousal. Moreover, sham stimulation had minimal or no effect on any of the outcomes. These results provide evidence for a hemispheric asymmetry of tDCS effects in patients with DOC. Left anodal tDCS might be more effective for modulating cortical excitability compared to tDCS on the right DLPFC. However, future studies with large sample sizes are needed to confirm these findings. This trial is registered with NCT03809936.