Clinical Study of Repetitive Transcranial Direct Current Stimulation Combined with Rehabilitation Therapy for Patients with Consciousness Disorder

Abstract

<bold>Objective</bold> To explore the effect of repetitive transcranial direct current combined with rehabilitation therapy on promoting consciousness and improving spasticity in patients with consciousness disorder. <bold>Methods</bold> A retrospective analysis was performed on 42 patients with disturbance of consciousness，whom hospitalized in rehabilitation medicine department of Lanzhou University Second Hospital from April 2017 to April 2021. They were divided into observation group and control group according to whether they received transcranial direct current stimulation （tDCS），21 cases in each group. The control group were treated with conventional rehabilitation treatment and the observation group were treated with conventional rehabilitation therapy and tDCS，the anode was placed in the left primary motor cortex （M1） and the cathode was placed in the right shoulder region，current intensity of 2 mA，once daily，20 min once a day，5 times per week，for 6 weeks. Before and after treatment，the level of consciousness was assessed by the Coma Recovery Scale-Revised （CRS-R） and Glasgow Coma Scale （GCS），the Modified Ashworth Scale （MAS） was used to assess changes muscle tone of the right flexor elbow muscle. <bold>Results</bold> Before treatment，there were no significant difference in CRS-R and GCS scores between the two groups （<italic>P</italic>＞0.05）；After treatment，the scores of the two groups were improved，and the CRS-R and GCS scores of the observation group were better than the control group，the differences were statistically significant （<italic>P</italic>&lt;0.05）. In terms of clinical efficacy，there were 13 （38.10%） responders and 8 （61.90%） non responders in the observation group. In the control group，there were 2 （9.50%） patients with responded and 19 （90.50%） patients who did not respond，the difference between the two groups was significant difference （<italic>P</italic>&lt;0.05）. As for MAS score，there was no significant difference in MAS score of right flexor elbow muscle between the two groups before treatment （<italic>P</italic>＞0.05）; There was no significant difference in MAS score of bilateral flexor elbow muscle in the control group before and after treatment （<italic>P</italic>＞0.05），but there was significant difference in the observation group before and after treatment （<italic>P</italic>&lt;0.05）. Comparison among groups，MAS score of flexor elbow muscle in the observation group was better than the control group，the difference was significant difference （<italic>P</italic>&lt;0.05）. <bold>Conclusion</bold> Repetitive transcranial direct current stimulation combined with rehabilitation therapy can effectively improve the level of consciousness and spasticity of patients with consciousness disorder.