Abstract

Recently a positive treatment effect on disorders of consciousness (DOCs) with high-definition transcranial direct-current stimulation (HD-tDCS) has been reported; however, the neural modulation mechanisms of this treatment’s efficacy need further investigation. To better understand the processing of HD-tDCS interventions, a long-lasting HD-tDCS protocol was applied to 15 unresponsive wakefulness syndrome (UWS) patients and 20 minimally conscious states (MCS) patients in this study. Ten minutes of resting-state electroencephalograms (EEGs) were recorded from the patients, and the coma recovery scale-revised scores (CRS-Rs) were assessed for each patient from four time-points (T0, T1, T2, and T3). Brain networks were constructed by calculating the EEG spectral connectivity using the debiased weighted phase lag index (dwPLI) and then quantified the network information transmission efficiency by graph theory. We found that there was an increasing trend in local and global information processing of beta and gamma bands in resting-state functional brain networks during the 14 days of HD-tDCS modulation for MCS patients. Furthermore, the increased functional connectivity not only occurred in the local brain area surrounding the stimulation position but was also present across more global brain areas. Our results suggest that long-lasting HD-tDCS on the precuneus may facilitate information processing among neural populations in MCS patients.

Highlights

  • Understanding the neural mechanisms of recovery processes in patients with chronic disorders of consciousness (DOCs) is a daunting challenge for modern neuroscience (Chennu et al, 2016)

  • There are no significant differences between the unresponsive wakefulness syndrome (UWS) and minimally conscious states (MCS) groups, except for coma recovery scale-revised scores (CRS-Rs) at the T0 phase

  • Our results proved that the stimulation on precuneus with high-definition transcranial direct-current stimulation (HD-transcranial directcurrent stimulation (tDCS)) could benefit the recovery of MCS patients

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Summary

Introduction

Understanding the neural mechanisms of recovery processes in patients with chronic disorders of consciousness (DOCs) is a daunting challenge for modern neuroscience (Chennu et al, 2016). Due to the use of invasive stimulation techniques have the ethical and technical limitations, the transcranial directcurrent stimulation (tDCS) has been widely investigated to improve the consciousness level of DOC patients (Zhang and Song, 2018). This technique could avoid surgical risks and is lower costs for patients compared to surgical interventions (Huang et al, 2019). The posterior parietal cortex, cerebellar cortex, and precuneus have been selected in some studies (Huang et al, 2017; Cai et al, 2019) It is still a long way before tDCS becoming a formal clinical application for treating DOCs

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