Transcranial Pulsed-Current Stimulation versus Transcranial Direct Current Stimulation in Patients with Disorders of Consciousness: A Pilot, Sham-Controlled Cross-Over Double-Blind Study.
[en] Transcranial direct-current stimulation (tDCS) over the prefrontal cortex can improve signs of consciousness in patients in a minimally conscious state. Transcranial pulsed-current stimulation (tPCS) over the mastoids can modulate brain activity and connectivity in healthy controls. This study investigated the feasibility of tPCS as a therapeutic tool in patients with disorders of consciousness (DoC) and compared its neurophysiological and behavioral effects with prefrontal tDCS. This pilot study was a randomized, double-blind sham-controlled clinical trial with three sessions: bi-mastoid tPCS, prefrontal tDCS, and sham. Electroencephalography (EEG) and behavioral assessments were collected before and after each stimulation session. Post minus pre differences were compared using Kruskal-Wallis and Wilcoxon signed-rank tests. Twelve patients with DoC were included in the study (eight females, four traumatic brain injury, 50.3 ± 14 y.o., 8.8 ± 10.5 months post-injury). We did not observe any side-effects following tPCS, nor tDCS, and confirmed their feasibility and safety. We did not find a significant effect of the stimulation on EEG nor behavioral outcomes for tPCS. However, consistent with prior findings, our exploratory analyses suggest that tDCS induces behavioral improvements and an increase in theta frontal functional connectivity.
Disciplines :
Neurology
Author, co-author :
Barra, Alice ; Université de Liège - ULiège > GIGA ; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA 02114, USA
Rosenfelder, Martin; Department of Neurology, Therapiezentrum Burgau, Kapuzinerstrasse 34, 89331 Burgau, Germany ; Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, 89081 Ulm, Germany
Mortaheb, Sepehr ; Université de Liège - ULiège > Département des sciences cliniques
Martens, Géraldine ; Centre Hospitalier Universitaire de Liège - CHU > > Service de médecine de l'appareil locomoteur ; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA 02114, USA
Bodien, Yelena G; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA 02114, USA ; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
Morales-Quezada, Leon; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA 02114, USA ; Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA 02114, USA
Bender, Andreas; Department of Neurology, Therapiezentrum Burgau, Kapuzinerstrasse 34, 89331 Burgau, Germany ; Department of Neurology, Ludwig-Maximilians University (LMU), 81377 Munich, Germany
LAUREYS, Steven ; Centre Hospitalier Universitaire de Liège - CHU > > Centre du Cerveau² ; Joint International Research Unit on Consciousness, CERVO Brain Research Centre CIUSS, University Laval, Quebec, QC G1E1T2, Canada
Thibaut, Aurore ; Université de Liège - ULiège > Département des sciences cliniques ; Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA 02114, USA
Fregni, Felipe; Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA 02114, USA
Language :
English
Title :
Transcranial Pulsed-Current Stimulation versus Transcranial Direct Current Stimulation in Patients with Disorders of Consciousness: A Pilot, Sham-Controlled Cross-Over Double-Blind Study.
The study was supported by the University and University Hospital of Liege, the Belgian National Funds for Scientific Research (FRS-FNRS), the FNRS PDR project (T.0134.21), the Televie Foundation, the European Union?s Horizon 2020 Framework Program for Research and Innovation under the Specific Grant Agreement No. 785907 (Human Brain Project SGA2) and No. 945539 (Human Brain Project SGA3), the Luminous project (EU-H2020-fetopenga686764), the European Space Agency (ESA) and the Belgian Federal Science Policy Office (BELSPO) in the framework of the PRODEX Program, the Center-TBI project (FP7-HEALTH-602150), the Public Utility Foundation ?Universit? Europ?enne du Travail?, ?Fondazione Europea di Ricerca Biomedica?, the Bial Foundation, the Mind Science Foundation and the European Commission, the fund Generet, the King Baudouin Foundation, the Fondation Leon Fredericq, the Mind-Care foundation, the DOCMA project [EU-H2020-MSCA?RISE?778234], the Wallonie Bruxelles International WBI, the NIH National Institute of Neurological Disorders and Stroke (R21NS109627, RF1NS115268, UH3NS095554, U01 NS1365885, U01-NS086090), NIH Director?s Office (DP2 HD101400), National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR), Administration for Community Living (90DPCP0008-01-00, 90DP0039), James S. McDonnell Foundation, Tiny Blue Dot Foundation, U.S. Department of Defense (W81XWH-14-2-0176, X81XWH-18-DMRDP-PTCRA), and the National Science Foundation (1014552). We would like to thank Chennu for his valuable input on EEG analyses and Giacino for his role in creating the experimental design. We are especially thankful to the patients and their families for agreeing to take part in the study.Acknowledgments: The study was supported by the University and University Hospital of Liege, the Belgian National Funds for Scientific Research (FRS-FNRS), the FNRS PDR project (T.0134.21), the Televie Foundation, the European Union’s Horizon 2020 Framework Program for Research and Innovation under the Specific Grant Agreement No. 785907 (Human Brain Project SGA2) and No. 945539 (Human Brain Project SGA3), the Luminous project (EU-H2020-fetopenga686764), the European Space Agency (ESA) and the Belgian Federal Science Policy Office (BELSPO) in the framework of the PRODEX Program, the Center-TBI project (FP7-HEALTH-602150), the Public Utility Foundation ‘Université Européenne du Travail’, “Fondazione Europea di Ricerca Biomedica”, the Bial Foundation, the Mind Science Foundation and the European Commission, the fund Generet, the King Baudouin Foundation, the Fondation Leon Fredericq, the Mind-Care foundation, the DOCMA project [EU-H2020-MSCA–RISE–778234], the Wallonie Bruxelles International WBI, the NIH National Institute of Neurological Disorders and Stroke (R21NS109627, RF1NS115268, UH3NS095554, U01 NS1365885, U01-NS086090), NIH Director’s Office (DP2 HD101400), National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR), Administration for Community Living (90DPCP0008-01-00, 90DP0039), James S. McDonnell Foundation, Tiny Blue Dot Foundation, U.S. Department of Defense (W81XWH-14-2-0176, X81XWH-18-DMRDP-PTCRA), and the National Science Foundation (1014552). We would like to thank Chennu for his valuable input on EEG analyses and Giacino for his role in creating the experimental design. We are especially thankful to the patients and their families for agreeing to take part in the study.
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