Randomized controlled trial of home-based 4-week tDCS in chronic minimally conscious state

[en] Background Patients with chronic disorders of consciousness face a significant lack of treatment options. Objective We aimed at investigating the feasibility and the behavioral effects of home-based transcranial direct current stimulation (tDCS), applied by relatives or caregivers, in chronic patients in minimally conscious state (MCS). Methods Each participant received, in a randomized order, 20 sessions of active and 20 sessions of sham tDCS applied over the prefrontal cortex for 4 weeks; separated by 8 weeks of washout. Level of consciousness was assessed using the Coma Recovery Scale-Revised before the first stimulation (baseline), after the end of the 20 tDCS sessions (direct effects) and 8 weeks after the end of each stimulation period (long-term effects). Reported adverse events and data relative to the adherence (i.e., amount of sessions effectively received) were collected as well. Results Twenty-seven patients completed the study and 22 patients received at least 80% of the stimulation sessions. All patients tolerated tDCS well, no severe adverse events were noticed after real stimulation and the overall adherence (i.e., total duration of stimulation) was good. A moderate effect size (0.47 and 0.53, for modified intention to treat and per protocol analysis, respectively) was observed at the end of the 4 weeks of tDCS in favor of the active treatment. Conclusions We demonstrated that home-based tDCS can be used adequately outside a research facility or hospital by patients’ relatives or caregivers. In addition, 4 weeks of tDCS moderately improved the recovery of signs of consciousness in chronic MCS patients.

Disciplines :

Neurology

Author, co-author :

Martens, Géraldine ; Université de Liège - ULiège > GIGA : Coma Group

Lejeune, Nicolas ; Université de Liège - ULiège > Form. doct. sc. méd. (paysage)

O'Brien, Anthony

Fregni, Felipe

Martial, Charlotte ; Université de Liège - ULiège > GIGA : Coma Group

Wannez, Sarah ; Université de Liège - ULiège > Doct. sc. bioméd. & pharma. (Bologne)

Laureys, Steven ; Université de Liège - ULiège > GIGA : Coma Group

Thibaut, Aurore ; Université de Liège - ULiège > GIGA : Coma Group

Language :

English

Title :

Randomized controlled trial of home-based 4-week tDCS in chronic minimally conscious state

Publication date :

May 2018

Journal title :

Brain Stimulation

ISSN :

1935-861X

eISSN :

1876-4754

Publisher :

Elsevier, Netherlands

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://www.sciencedirect.com/science/article/pii/S1935861X18301463

European Projects :

H2020 - 686764 - LUMINOUS - Studying, Measuring and Altering Consciousness through information theory in the electrical brain

Funders :

F.R.S.-FNRS - Fonds de la Recherche Scientifique [BE]
ASE - Agence Spatiale Européenne [FR]
CE - Commission Européenne [BE]

Available on ORBi :

since 03 May 2018

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