Combined behavioral and electrophysiological evidence for a direct cortical effect of prefrontal tDCS on disorders of consciousness.

Scientific Reports
Bertrand HermannLionel Naccache

Abstract

Severe brain injuries can lead to long-lasting disorders of consciousness (DoC) such as vegetative state/unresponsive wakefulness syndrome (VS/UWS) or minimally conscious state (MCS). While behavioral assessment remains the gold standard to determine conscious state, EEG has proven to be a promising complementary tool to monitor the effect of new therapeutics. Encouraging results have been obtained with invasive electrical stimulation of the brain, and recent studies identified transcranial direct current stimulation (tDCS) as an effective approach in randomized controlled trials. This non-invasive and inexpensive tool may turn out to be the preferred treatment option. However, its mechanisms of action and physiological effects on brain activity remain unclear and debated. Here, we stimulated 60 DoC patients with the anode placed over left-dorsolateral prefrontal cortex in a prospective open-label study. Clinical behavioral assessment improved in twelve patients (20%) and none deteriorated. This behavioral response after tDCS coincided with an enhancement of putative EEG markers of consciousness: in comparison with non-responders, responders showed increases of power and long-range cortico-cortical functional connectivity in th...Continue Reading

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Citations

Jun 26, 2020·Brain : a Journal of Neurology·Bertrand HermannLionel Naccache
Sep 12, 2020·Journal of Neurology·Yang BaiUlf Ziemann
Sep 16, 2020·Brain Sciences·Rodrigo CofréEnzo Tagliazucchi
Nov 10, 2020·The Journal of Head Trauma Rehabilitation·Angela PhillipsMaheen Adamson
Apr 3, 2021·Chinese Medical Journal·Yue-Hao WuBen-Yan Luo
Jun 22, 2021·Frontiers in Human Neuroscience·Yusuke Yokota, Yasushi Naruse
Jul 3, 2021·Brain Sciences·Giulio E LancioniLorenzo Desideri
Oct 7, 2021·Disability and Rehabilitation·Giulio E LancioniLorenzo Desideri

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