Spinal cord stimulation modulates frontal delta and gamma in patients of minimally consciousness state

Bai, Yang; Xia, Xiaoyu; Li, Xiaoli; Wang, Yong; Yang, Yi; Liu, Yangfeng; Liang, Zhenhu; He, Jianghong

doi:10.1016/j.neuroscience.2017.01.036

Cited by 45 publications

(52 citation statements)

References 35 publications

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“…When SCS was turned off, connectivity of the frontal-parietal and frontal-occipital returned to pre-SCS levels, but frontal-frontal connectivity in post-SCS remained lower than pre-SCS. These decreases in the frontal regions were consistent with the coherence results from our previous study (Bai et al, 2017). Evidence demonstrating the role of the frontal cortex in SCS has also been provided by other studies using pain-related P250 amplitude.…”

Section: Discussionsupporting

confidence: 93%

“…But there was still few studies investigating the potential mechanism. In a previous study (Bai et al, 2017), we reported that SCS at a frequency of 70 Hz could effectively modulate MCS patients' frontal gamma activities by increasing the relative power and decreasing the coherence and global synchronization. In order to further explore the effects of SCS with 70 Hz on interventing gamma activity, the present study measured functional connectivity and network properties in the gamma band at different SCS stages.…”

Section: Discussionmentioning

confidence: 83%

“…Studies using pain-related P250 amplitude have shown that SCS may indirectly stimulate the frontal cortex, which is part of the awareness and attention network (Yampolsky et al, 2012; Yamamoto et al, 2013). In a previous study, we reported that SCS modulated frontal delta and gamma activity in patients in a minimally conscious state (MCS) (Bai et al, 2017), showing that SCS modulated the brain functions of MCS patients and providing EEG evidence supporting the potential mechanism for doing so: stimulating the reticular formation and further affecting the frontal cortical region through the formation-thalamus-cortex network. However, further research is needed to provide detailed evidence about the pathway by which SCS affects the cerebral cortices of DOC patients.…”

Section: Introductionmentioning

confidence: 85%

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Frontal Connectivity in EEG Gamma (30–45 Hz) Respond to Spinal Cord Stimulation in Minimally Conscious State Patients

Bai

Xia

Liang

et al. 2017

Front. Cell. Neurosci.

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Spinal cord stimulation (SCS) has become a valuable brain-intervention technique used to rehabilitate patients with disorders of consciousness (DOC). To explore how the SCS affects the cerebral cortex and what possible electrophysiological mechanism of SCS effects on the cortex, the present study investigated the functional connectivity and network properties during SCS in minimally conscious state (MCS) patients. MCS patients received both SCS and sham sessions. Functional connectivity of the phase lock value (PLV) in the gamma band (30–45 Hz) was investigated at the pre-, on- and post-SCS stages. In addition, to evaluate global network properties, complex network parameters, including average path length, cluster coefficient and small-world, were measured. When SCS was turned on, significantly decreased connectivity was noted in the local scale of the frontal-frontal region and in the large scales of the frontal-parietal and frontal-occipital regions. The global network showed fewer small-world properties, average path lengths increased and cluster coefficients decreased. When SCS was turned off, the large-scale connectivity and global network returned to its pre-SCS level, but the local scale of frontal-frontal connectivity remained significantly lower than its pre-SCS level. Sham sessions produced no significant changes in either functional connectivity or network. The findings directly showed that SCS could effectively intervene cortical gamma activity, and the intervention included immediate global effects (large scale connectivity and network alteration only occurred in stimulation period) and long-lasting local effects (local scale connectivity alteration persist beyond stimulation period). Moreover, considering the mechanism and propagation of gamma activity, it indicates that the frontal cortex plays a crucial role in the SCS effects on the cerebral cortex.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 85%

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Frontal Connectivity in EEG Gamma (30–45 Hz) Respond to Spinal Cord Stimulation in Minimally Conscious State Patients

Bai

Xia

Liang

et al. 2017

Front. Cell. Neurosci.

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“…Novel non-invasive brain stimulation techniques, including LIFUP, taVNS and spinal cord stimulation, have been tested in a few case-reports. [53][54][55] The only published report of a patient in MCS (19 days post-TBI) who received one session of LIFUP targeting the central thalamus ( figure 2E) showed a recovery of language comprehension and spatio-temporal orientation a few days later. 56 The effects of taVNS were presented in another case-report of UWS patient (50 days post-anoxia) (figure 2F 53 ).…”

Section: Other Novel Approachesmentioning

confidence: 99%

“…Spinal cord stimulation has also been explored in some case-reports or uncontrolled studies. 55,57 However, no RCT evaluating their effects have been performed so far, and the majority of the available studies did not use standardized scales or well-defined outcomes to assess the effects of these interventions. As for all uncontrolled trials, the results of these case-reports could be linked to spontaneous recovery; however, these articles can be seen as feasibility studies.…”

Section: Other Novel Approachesmentioning

confidence: 99%

Therapeutic interventions in patients with prolonged disorders of consciousness

Thibaut

Schiff

Giacino

et al. 2019

The Lancet Neurology

239

188

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The management of patients with severe brain injuries and prolonged disorders of consciousness (DOC) raises important issues particularly with respect to their therapeutic options. The lack of treatment is challenged by new clinical and neuroimaging data indicating that some patients with prolonged DOC may benefit from therapeutic interventions, even years after the injury. The majority of the studies aiming at improving patients' level of consciousness and functional recovery includes behavioural and brain imaging open-label trials and case-reports, but several randomized clinical trials (RCT) have been conducted, especially using non-invasive brain stimulation. Only a couple of RCTs focused on the effects of drugs or sensory stimulation approaches, and only two Class II studies, on amantadine and transcranial direct current stimulation, have been published. While new therapeutic approaches seem to be valuable for patients with prolonged DOC, optimized stimulation parameters, alternative drugs or rehabilitation strategies still need to be tested and validated.

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Emerging Treatment for Patients with Disorders of Consciousness: The Field of Neuromodulation

Hopkins,

Vitello,

Thibaut

et al. 2023

Coma and Disorders of Consciousness

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Spinal cord stimulation modulates frontal delta and gamma in patients of minimally consciousness state

Cited by 45 publications

References 35 publications

Frontal Connectivity in EEG Gamma (30–45 Hz) Respond to Spinal Cord Stimulation in Minimally Conscious State Patients

Frontal Connectivity in EEG Gamma (30–45 Hz) Respond to Spinal Cord Stimulation in Minimally Conscious State Patients

Therapeutic interventions in patients with prolonged disorders of consciousness

Emerging Treatment for Patients with Disorders of Consciousness: The Field of Neuromodulation

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