Effect of conventional treatment plus long-term transcranial direct current stimulation on consciousness recovery of minimally conscious patients after traumatic brain injury
10.3760/cma.j.cn501098-20211104-00571
- VernacularTitle:常规治疗辅以长时程经颅直流电刺激对创伤性脑损伤后微意识状态患者意识恢复的作用
- Author:
Ze YU
1
;
Qiuxia JIANG
;
Yan DONG
;
Manli ZHENG
;
Chen LAI
;
Jianwei SUN
;
Hongyan DU
;
Yuchao DING
;
Xiaohua HU
Author Information
1. 武警浙江省总队医院康复科，杭州 310051
- Keywords:
Brain injuries;
Consciousness disorders;
Transcranial direct current stimulation
- From:
Chinese Journal of Trauma
2022;38(5):401-406
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of conventional treatment plus long-term transcranial direct current stimulation (tDCS) on consciousness recovery in patients with minimally conscious state (MCS) after traumatic brain injury (TBI).Methods:A retrospective cohort study was conducted to analyze the clinical data of 60 patients with MCS after TBI admitted to Zhejiang Armed Police Corps Hospital from January 2019 to December 2020, including 38 males and 22 females, aged 19-60 years [(45.7±11.4)years]. Course of disease was 3-6 months [(4.6±0.9)months]. Of all, 30 patients received internal medicine, hyperbaric oxygen, rehabilitation and other conventional treatment (conventional treatment group), and 30 patients received tDCS stimulation on the basis of conventional treatment (tDCS treatment group). The tDCS stimulation contained 4 cycles for 28 days with each cycle lasting for 7 days (stimulation for 5 days, rest for 2 days). Coma recovery scale-revised (CRS-R) total score, brainstem auditory evoked potential (BAEP) score and clinical effictive rate (significantly effective+effective) were compared between the two groups before treatment, during 4 cycles of treatment and at 6 months and 12 months after treatment. Complications induced by tDCS were also evaluated.Results:There was no significant difference in CRS-R total score and BAEP score between the two groups before treatment (all P>0.05). CRS-R total score and BAEP score in tDCS treatment group were significantly higher than those in conventional treatment group during 4 cycles of treatment and at 6 months and 12 months after treatment (all P<0.05). CRS-R total score and BAEP score in both groups gradually increased during 4 cycles of treatment and at 6 months and 12 months after treatment (all P<0.05). The clinical effective rate in tDCS treatment group was 73% (22/30) when compared to 57% (17/30) in conventional treatment group ( P<0.05). In tDCS treatment group, 10 patients had local reversible slight redness at the cathodal position, while no other serious adverse effects, such as local burns, ulceration, exudation or epilepsy. Conclusion:Compared with conventional treatment, conventional treatment plus long-term tDCS can be more effective in improving the state of consciousness without serious adverse effects for MCS patients after TBI.
