Abstract

ObjectiveTo explore the effect of combining repetitive transcranial magnetic stimulation (rTMS) and conventional rehabilitation on the recovery of consciousness in patients in a persistent vegetative state (PVS).MethodsA total of 48 patients in a PVS were randomly divided into a treatment and control group. Patients in the treatment group were treated with rTMS to stimulate the dorsolateral prefrontal cortex, and patients in the control group were treated with false stimulation. All patients were evaluated using scales and neuroelectrophysiological assessment before treatment, after 30 days of treatment, and following 60 days of treatment.ResultsBased on the Coma Recovery Scale-Revised (CRS-R) and electroencephalogram (EEG) grading indexes, the treatment group was significantly higher than those of the control group after 30 and 60 days of treatment. The average difference in the three measurements between the two groups before treatment, at 30 days, and 60 days was 0.04, 1.54, and 2.09 for CRS-R and 0.08, −0.83, and −0.62 for EEG indexes, respectively. The latency periods of each wave of the brainstem auditory evoked potentials (BAEPs) in the treatment group were shorter than those in the control group after 30 and 60 days of treatment. In both groups, the BAEP scores after 30 days of treatment were significantly higher than the scores before treatment, and the scores after 60 days of treatment were higher than the scores after 30 days.ConclusionIn patients in a PVS, rTMS assists in the recovery of consciousness function.

Highlights

  • In recent years, owing to rapid developments in emergency medicine and intensive care technology, the mortality rate of critically ill patients has decreased significantly

  • The current study investigates the effect of Repetitive transcranial magnetic stimulation (rTMS), combined with conventional rehabilitative therapy, on the recovery of consciousness in patients in a vegetative state (VS), as measured by electroencephalogram (EEG) and brainstem auditory evoked potentials (BAEPs)

  • The 48 people who had been selected as the subjects of the study were randomly divided into a treatment and a control group (n = 24 in both groups)

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Summary

Introduction

In recent years, owing to rapid developments in emergency medicine and intensive care technology, the mortality rate of critically ill patients has decreased significantly. The number of patients with severe consciousness disorders, such as a vegetative state (VS) and minimally conscious state (MCS), has increased dramatically. Treatments for improving consciousness in patients in a VS include drugs, hyperbaric oxygen treatment, acupuncture, central thalamic deep brain stimulation, and peripheral sensory stimulation programs. These methods have all been reported to affect patients in a VS but each has advantages and disadvantages. Finding a safe and effective method for improving the consciousness of patients in a VS remains an urgent problem to be solved

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