The clinical curative effect of transcranial direct current stimulation on patients with disorders of consciousness

Abstract

Objective To assess the clinical efficacy of transcranial direct current stimulation (tDCS) in improving consciousness in patients with severe disorders of consciousness. Methods Thirty-eight patients with disorders of consciousness were divided into an observation group and a control group according to a random number table, each of 19. Both groups received conventional rehabilitation therapy, while the observation group was additionally provided with tDCS at the intensity of 2 mA for 20 minutes per day, 6 days per week, for 20 times, with the anodal electrode ( isotonic saline gelatin sponge, 7 cm×5 cm) placed over the left dorsolateral prefrontal cortex and the cathodal stimulation over the right eye socket or right shoulder. The patients were evaluated with brainstem auditory evoked potential (BAEP), upper limb somatosensory evoked potential (USEP), electroencephalogram (EEG) and Glasgow coma scale (GCS) and persistent vegetative state (PVS) scores before and after the treatment. Results There were no significant differences between the two groups with regard to BAEP, USEP, EEG, GCS and PVS scores (P>0.05). After the treatment, significant improvement was observed in all the measurements, with those of the observation group superior to the control group (P<0.05). In the evaluation of clinical efficacy, the total effective rate and the significant effective rate of the observation group was 89.47% and 78.95%, respectively, significantly higher than those of the control group (84.21% and 42.11% ) (P<0.05). Conclusions Conventional rehabilitation treatment can improve the BAEP, USEP, EEG, GCS and PVS scores of patients with severe disorders of consciousness, and the addition of tDCS on the basis of conventional rehabilitation treatment is more effective. Key words: Transcranial direct current stimulation; Disorders of consciousness; Rehabilitation; Vegetative state; Minimally conscious state