Article (Scientific journals)
Effect of multichannel transcranial direct current stimulation to reduce hypertonia in individuals with prolonged disorders of consciousness: A randomized controlled pilot study.
Thibaut, Aurore; Piarulli, Andrea; Martens, Géraldine et al.
2019In Annals of Physical and Rehabilitation Medicine
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Keywords :
Hypertonia; Minimally conscious state; Spasticity; Transcranial direct current stimulation; Upper motor neuron syndrome; Vegetative state
Abstract :
[en] BACKGROUND: Spasticity management in severely brain-injured patients with disorders of consciousness (DOC) is a major challenge because it leads to complications and severe pain that can seriously affect quality of life. OBJECTIVES: We aimed to determine the feasibility of using transcranial direct current stimulations (tDCS) to reduce spasticity in chronic patients with DOC. METHODS: We enrolled 14 patients in this double-blind, sham-controlled randomized crossover pilot study. Two cathodes were placed over the left and right primary motor cortex and 2 anodes over the left and right prefrontal cortex. Hypertonia of the upper limbs and level of consciousness were assessed by the Modified Ashworth Scale (MAS) and the Coma Recovery Scale-Revised (CRS-R). Resting state electroencephalography was also performed. RESULTS: At the group level, spasticity was reduced in only finger flexors. Four responders (29%) showed reduced hypertonicity in at least 2 joints after active but not sham stimulation. We found no behavioural changes by the CRS-R total score. At the group level, connectivity values in beta2 were higher with active versus sham stimulation. Relative power in the theta band and connectivity in the beta band were higher for responders than non-responders after the active stimulation. CONCLUSION: This pilot study highlights the potential benefit of using tDCS for reducing upper-limb hypertonia in patients with chronic DOC. Large-sample clinical trials are need to optimize and validate the technique.
Disciplines :
Neurology
Author, co-author :
Thibaut, Aurore ;  Université de Liège - ULiège > Consciousness-Coma Science Group
Piarulli, Andrea  ;  Université de Liège - ULiège > GIGA : Coma Group
Martens, Géraldine  ;  Université de Liège - ULiège > Consciousness-Coma Science Group
Chatelle, Camille ;  Université de Liège - ULiège > Consciousness-Coma Science Group
Laureys, Steven  ;  Université de Liège - ULiège > Consciousness-Coma Science Group
Language :
English
Title :
Effect of multichannel transcranial direct current stimulation to reduce hypertonia in individuals with prolonged disorders of consciousness: A randomized controlled pilot study.
Publication date :
2019
Journal title :
Annals of Physical and Rehabilitation Medicine
ISSN :
1877-0657
eISSN :
1877-0665
Publisher :
Elsevier Masson, Paris, France
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 25 October 2019

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