Controlled clinical trial of repeated prefrontal tDCS in patients with chronic minimally conscious state

• Published in: Brain injury 2017-03, Vol.31 (4), p.466-474
• Main Authors: Thibaut, Aurore, Wannez, Sarah, Donneau, Anne-Francoise, Chatelle, Camille, Gosseries, Olivia, Bruno, Marie-Aurélie, Laureys, Steven
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; brain injury; brain stimulation; Chronic Disease; Clinical trial: NCT02019615; Cross-Over Studies; disorders of consciousness; Double-Blind Method; Female; Human health sciences; Humans; Male; Middle Aged; Minimally conscious state; Neurologie; Neurology; Persistent Vegetative State - diagnosis; Persistent Vegetative State - physiopathology; Persistent Vegetative State - therapy; Prefrontal Cortex - physiology; Prospective Studies; Sciences de la santé humaine; tDCS; Transcranial Direct Current Stimulation - methods; Treatment Outcome
• ISSN: 0269-9052; 1362-301X; 1362-301X
• DOI: 10.1080/02699052.2016.1274776

Objectives: To assess the effects of repeated transcranial direct current stimulation (tDCS) sessions on the level of consciousness in chronic patients in minimally conscious state (MCS). Methods: In this randomized double-blind sham-controlled crossover study, we enrolled 16 patients in chronic MCS. For 5 consecutive days, each patient received active or sham tDCS over the left prefrontal cortex (2 mA during 20 min). Consciousness was assessed with the Coma Recovery Scale-Revised (CRS-R) before the first stimulation (baseline), after each stimulation (day 1-day 5) and 1 week after the end of each session (day 12). Results: A treatment effect (p = 0.013; effect size = 0.43) was observed at the end of the active tDCS session (day 5) as well as 1 week after the end of the active tDCS session (day 12; p = 0.002; effect size = 0.57). A longitudinal increase of the CRS-R total scores was identified for the active tDCS session (p < 0.001), while no change was found for the sham session (p = 0.64). Nine patients were identified as responders (56%). Conclusion: Our results suggest that repeated (5 days) left prefrontal tDCS improves the recovery of consciousness in some chronic patients in MCS, up to 1 week after the end of the stimulations.