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Controlled clinical trial of repeated prefrontal tDCS in patients with chronic minimally conscious state
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...
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Published in: | Brain injury 2017-03, Vol.31 (4), p.466-474 |
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creator | Thibaut, Aurore Wannez, Sarah Donneau, Anne-Francoise Chatelle, Camille Gosseries, Olivia Bruno, Marie-Aurélie Laureys, Steven |
description | 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. |
doi_str_mv | 10.1080/02699052.2016.1274776 |
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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.</description><identifier>ISSN: 0269-9052</identifier><identifier>ISSN: 1362-301X</identifier><identifier>EISSN: 1362-301X</identifier><identifier>DOI: 10.1080/02699052.2016.1274776</identifier><identifier>PMID: 28281845</identifier><language>eng</language><publisher>England: Taylor & Francis</publisher><subject>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</subject><ispartof>Brain injury, 2017-03, Vol.31 (4), p.466-474</ispartof><rights>2017 Taylor & Francis Group, LLC 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-216fb32e92c1e3ef4d234bc4ff6e52393033186e072d10da221e6fe0a33dc2433</citedby><cites>FETCH-LOGICAL-c424t-216fb32e92c1e3ef4d234bc4ff6e52393033186e072d10da221e6fe0a33dc2433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28281845$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thibaut, Aurore</creatorcontrib><creatorcontrib>Wannez, Sarah</creatorcontrib><creatorcontrib>Donneau, Anne-Francoise</creatorcontrib><creatorcontrib>Chatelle, Camille</creatorcontrib><creatorcontrib>Gosseries, Olivia</creatorcontrib><creatorcontrib>Bruno, Marie-Aurélie</creatorcontrib><creatorcontrib>Laureys, Steven</creatorcontrib><title>Controlled clinical trial of repeated prefrontal tDCS in patients with chronic minimally conscious state</title><title>Brain injury</title><addtitle>Brain Inj</addtitle><description>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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>brain injury</subject><subject>brain stimulation</subject><subject>Chronic Disease</subject><subject>Clinical trial: NCT02019615</subject><subject>Cross-Over Studies</subject><subject>disorders of consciousness</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Human health sciences</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Minimally conscious state</subject><subject>Neurologie</subject><subject>Neurology</subject><subject>Persistent Vegetative State - diagnosis</subject><subject>Persistent Vegetative State - physiopathology</subject><subject>Persistent Vegetative State - therapy</subject><subject>Prefrontal Cortex - physiology</subject><subject>Prospective Studies</subject><subject>Sciences de la santé humaine</subject><subject>tDCS</subject><subject>Transcranial Direct Current Stimulation - methods</subject><subject>Treatment Outcome</subject><issn>0269-9052</issn><issn>1362-301X</issn><issn>1362-301X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNp9kN1O3DAQha2qCBbKIxT5BbKMx4mTvQNtf0BC4oJW6p3lODZr5I0j21u0b19HgV5yMx7pnO9Ycwj5ymDNoINrQLHZQINrBCbWDNu6bcUnsmJcYMWB_flMVrOnmk1n5DylFwBgDYNTcoYddqyrmxXZbcOYY_DeDFR7NzqtPM3RlRksjWYyKhdpisbG4pzFb9sn6kY6qezMmBN9dXlH9a7ITtN9idgr749UhzFpFw6JplwyvpATq3wyl2_vBfn94_uv7V318Pjzfnv7UOka61whE7bnaDaomeHG1gPyute1tcI0yDccOGedMNDiwGBQiMwIa0BxPmisOb8gfMn1zjwbGWLv5F-UQbllP_hnqbTsjUQUnUQObTdTzULpGFIqx8opljviUTKQc9_yvW859y3f-i7c1cJNh35vhv_Ue8HFcLMY3GhD3KvXEP0gszr6EG1Uo3ZJ8o__-AcQ6JBm</recordid><startdate>20170321</startdate><enddate>20170321</enddate><creator>Thibaut, Aurore</creator><creator>Wannez, Sarah</creator><creator>Donneau, Anne-Francoise</creator><creator>Chatelle, Camille</creator><creator>Gosseries, Olivia</creator><creator>Bruno, Marie-Aurélie</creator><creator>Laureys, Steven</creator><general>Taylor & Francis</general><general>Taylor and Francis</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>Q33</scope></search><sort><creationdate>20170321</creationdate><title>Controlled clinical trial of repeated prefrontal tDCS in patients with chronic minimally conscious state</title><author>Thibaut, Aurore ; Wannez, Sarah ; Donneau, Anne-Francoise ; Chatelle, Camille ; Gosseries, Olivia ; Bruno, Marie-Aurélie ; Laureys, Steven</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-216fb32e92c1e3ef4d234bc4ff6e52393033186e072d10da221e6fe0a33dc2433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>brain injury</topic><topic>brain stimulation</topic><topic>Chronic Disease</topic><topic>Clinical trial: NCT02019615</topic><topic>Cross-Over Studies</topic><topic>disorders of consciousness</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Human health sciences</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Minimally conscious state</topic><topic>Neurologie</topic><topic>Neurology</topic><topic>Persistent Vegetative State - diagnosis</topic><topic>Persistent Vegetative State - physiopathology</topic><topic>Persistent Vegetative State - therapy</topic><topic>Prefrontal Cortex - physiology</topic><topic>Prospective Studies</topic><topic>Sciences de la santé humaine</topic><topic>tDCS</topic><topic>Transcranial Direct Current Stimulation - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thibaut, Aurore</creatorcontrib><creatorcontrib>Wannez, Sarah</creatorcontrib><creatorcontrib>Donneau, Anne-Francoise</creatorcontrib><creatorcontrib>Chatelle, Camille</creatorcontrib><creatorcontrib>Gosseries, Olivia</creatorcontrib><creatorcontrib>Bruno, Marie-Aurélie</creatorcontrib><creatorcontrib>Laureys, Steven</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Université de Liège - Open Repository and Bibliography (ORBI)</collection><jtitle>Brain injury</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thibaut, Aurore</au><au>Wannez, Sarah</au><au>Donneau, Anne-Francoise</au><au>Chatelle, Camille</au><au>Gosseries, Olivia</au><au>Bruno, Marie-Aurélie</au><au>Laureys, Steven</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Controlled clinical trial of repeated prefrontal tDCS in patients with chronic minimally conscious state</atitle><jtitle>Brain injury</jtitle><addtitle>Brain Inj</addtitle><date>2017-03-21</date><risdate>2017</risdate><volume>31</volume><issue>4</issue><spage>466</spage><epage>474</epage><pages>466-474</pages><issn>0269-9052</issn><issn>1362-301X</issn><eissn>1362-301X</eissn><abstract>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.</abstract><cop>England</cop><pub>Taylor & Francis</pub><pmid>28281845</pmid><doi>10.1080/02699052.2016.1274776</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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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 |
title | Controlled clinical trial of repeated prefrontal tDCS in patients with chronic minimally conscious state |
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