Transcranial Direct Current Stimulation Improves Some Neurophysiological Parameters but not Clinical Outcomes after Severe Traumatic Brain Injury

Abstract

Background: Disorders of consciousness (DOC) are one of the clinical hallmarks of severe traumatic brain injury (TBI). DOC impair patient life quality and increase the burden on their families and society. Methods: A double-blind, randomized, controlled clinical trial was conducted to determine the efficacy of routine rehabilitation combined with transcranial direct current stimulation (tDCS) in DOC patients after TBI. A total of 78 DOC patients were randomly divided after TBI into two groups: participants in the treatment group received routine rehabilitation combined with an active tDCS protocol. In contrast, participants in the control group received routine rehabilitation combined with a sham tDCS protocol. An anode was placed over the left dorsolateral prefrontal cortex and a cathode was placed over the right supraorbital area. The stimulation intensity was 2 mA. Both tDCS protocols lasted for eight consecutive weeks (20 minutes per day, six days per week). Patients were followed up for a further eight weeks. Glasgow Outcome Scale (GOS), Glasgow Coma Scale (GCS), brainstem auditory evoked potentials, somatosensory evoked potentials and electroencephalogram were measured at weeks zero, two, four, six, eight and sixteen from the start of tDCS. Results: Neither the GOS nor GCS scores differed significantly between the two groups, while brainstem auditory evoked potentials, somatosensory evoked potentials and electroencephalogram scores did. Conclusions: This study found that tDCS improves some neurophysiological parameters but not clinical outcomes of DOC patients after TBI. Clinical Trial Registration: Chinese Clinical Trial Registry, ChiCTR1800014808 (The version is V.1.0). Registered on February 7, 2018. http://www.chictr.org.cn/showproj.aspx?proj=25003.

Large conductance voltage-and calcium-activated K+ (BK) channel in health and disease

“…BK channels are found in microglial cells in various regions of the brain, including the hippocampus, striatum, neocortex, and entorhinal cortex, as well as in the spinal cord following nerve injury (Buttigieg et al, 2011;Regehr and Kaeser, 2014;Schilling and Eder, 2015;Sun et al, 2023). Microglia are immune cells that reside in the brain, and the activity of BK channels regulates their phagocytosis activation and migration (Larson et al, 2016).…”

Combining HD-tDCS with music stimulation for patients with prolonged disorders of consciousness: Study protocol for an RCT trial

“…This study protocol aims to explore the effects and mechanisms of a combined intervention involving HD-tDCS and music for patients with pDOC. Coma Recovery Scale-Revised (CRS-R) ( Fan et al, 2022 ), Glasgow Outcome Scale (GOS) ( Sun et al, 2023 ), and EEG ( He et al, 2018 ) are selected as outcome measures to comprehensively evaluate changes in the consciousness state of patients with pDOC before and after treatment. The findings of this study can provide valuable insights into the development of innovative rehabilitation strategies for this challenging population.…”

Transcranial direct current stimulation promotes angiogenesis and improves neurological function via the OXA-TF-AKT/ERK signaling pathway in traumatic brain injury

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