Marianna Cavinato1, Clara Genna2, Emanuela Formaggio3, Caterina Gregorio4, Silvia F Storti5, Paolo Manganotti6, Emanuela Casanova7, Roberto Piperno7, Francesco Piccione3. 1. Neurophysiology and Magnetoencephalography Department, Fondazione Ospedale San Camillo IRCCS, Venezia, Italy. Electronic address: marianna.cavinato@ospedalesancamillo.net. 2. BioRobotics Institute of Scuola Superiore Sant'Anna, Pisa, Italy. 3. Neurophysiology and Magnetoencephalography Department, Fondazione Ospedale San Camillo IRCCS, Venezia, Italy. 4. Department of Economic, Mathematical and Statistical Sciences, University of Trieste, Italy. 5. Department of Computer Science, University of Verona, Verona, Italy. 6. Department of Medicine, Surgery and Health Sciences, Clinical Neurology Unit, Cattinara University Hospital, Trieste, Italy. 7. Department of Physical Medicine and Rehabilitation, Ospedale Maggiore, Bologna, Italy.
Abstract
OBJECTIVES:Left dorsolateral prefrontal cortex anodal transcranial direct current stimulation (tDCS) was applied in a group of patients with disorders of consciousness to determine the effects of modulation of spontaneous oscillatory brain activity. METHODS:12 patients in an unresponsive wakefulness syndrome (UWS) and 12 in a minimally conscious state (MCS) underwent 2-weeks active and 2-weeks sham tDCS. Neurophysiological assessment was performed with EEG power spectra and coherence analysis directly before and after each session. RESULTS: An increase of power and coherence of the frontal and parietal alpha and beta frequency bands and significant clinical improvements were seen after the active tDCS in MCS patients. In contrast, UWS patients showed some local frontal changes in the slow frequencies. No treatment effect was observed after sham. CONCLUSIONS:tDCS could induce changes in cortical EEG oscillations, modulating the travel of alpha and beta waves between anterior and posterior brain areas when some cognitive functions were preserved. This plays an important role in consciousness by integrating cognitive-emotional processing with the state of arousal. In unresponsive people, brain integration seems to be lost. SIGNIFICANCE: Our results further support the critical role of long-range fronto-parietal connections in consciousness and show the potential therapeutic utility of tDCS.
RCT Entities:
OBJECTIVES: Left dorsolateral prefrontal cortex anodal transcranial direct current stimulation (tDCS) was applied in a group of patients with disorders of consciousness to determine the effects of modulation of spontaneous oscillatory brain activity. METHODS: 12 patients in an unresponsive wakefulness syndrome (UWS) and 12 in a minimally conscious state (MCS) underwent 2-weeks active and 2-weeks sham tDCS. Neurophysiological assessment was performed with EEG power spectra and coherence analysis directly before and after each session. RESULTS: An increase of power and coherence of the frontal and parietal alpha and beta frequency bands and significant clinical improvements were seen after the active tDCS in MCS patients. In contrast, UWS patients showed some local frontal changes in the slow frequencies. No treatment effect was observed after sham. CONCLUSIONS: tDCS could induce changes in cortical EEG oscillations, modulating the travel of alpha and beta waves between anterior and posterior brain areas when some cognitive functions were preserved. This plays an important role in consciousness by integrating cognitive-emotional processing with the state of arousal. In unresponsive people, brain integration seems to be lost. SIGNIFICANCE: Our results further support the critical role of long-range fronto-parietal connections in consciousness and show the potential therapeutic utility of tDCS.
Authors: Alice Barra; Martin Rosenfelder; Sepehr Mortaheb; Manon Carrière; Geraldine Martens; Yelena G Bodien; Leon Morales-Quezada; Andreas Bender; Steven Laureys; Aurore Thibaut; Felipe Fregni Journal: Brain Sci Date: 2022-03-24
Authors: Brian L Edlow; Leandro R D Sanz; Robert D Stevens; Olivia Gosseries; Len Polizzotto; Nader Pouratian; John D Rolston; Samuel B Snider; Aurore Thibaut Journal: Neurocrit Care Date: 2021-07-08 Impact factor: 3.210