Trigeminal nerve stimulation successfully awakened an unconscious patient

Fan, Shengnuo; Wu, Xiaoge; Xie, Mingwei; Li, Xiao; Liu, Cuicui; Su, Yun-Ai; Yuegui, Chen; Wu, Shaoling; Ma, Chao

doi:10.1016/j.brs.2018.11.001

Cited by 9 publications

(11 citation statements)

References 9 publications

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“…15 A previous study showed that TNS successfully awakened an unconscious patient. 16 Our previous experiments also found that TNS can promote the reversal of TBI-induced comas by activating the trigeminal spinal nucleus and the lateral hypothalamic neurons. 17 In 2017, Chiluwal et al 6 reported the neuroprotective effects of TNS in rat models with severe TBI based on its ability to induce a pressor response and cause cerebrovasodilation, which led to increased cerebral infusion, making TNS a promising therapeutic strategy for treating TBIs.…”

Section: Introductionmentioning

confidence: 85%

The Effectiveness of Trigeminal Nerve Stimulation on Traumatic Brain Injury

Yang

Zhang

et al. 2022

Neuromodulation: Technology at the Neural Interface

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Section: Introductionmentioning

confidence: 85%

The Effectiveness of Trigeminal Nerve Stimulation on Traumatic Brain Injury

Yang

Zhang

et al. 2022

Neuromodulation: Technology at the Neural Interface

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“…These stimulation sites were deemed to reduce phosphenes (compared with stimulation at the first branch) based on prior tests with healthy participants. The intensity of the current was fixed to ±8 mA, which can be considered safe based on the aforementioned prior tests, related TNS research 26 , and our post hoc observation of no skin condition after the stimulation phase in any of our patients. The onset/offset of the current was ramped up/down using 5-s long ramps.…”

Section: Electric Stimulation: Tnsmentioning

confidence: 99%

“…Application of trigeminal nerve stimulation (TNS) has yielded encouraging results in various neurological diseases, such as epilepsy 23 , depressive disorder 24 and migraine 25 . For DOC, so far only a single study in a single patient has been published, with promising results 26 . A systematic investigation of the potential of TNS for DOC treatment is still missing.…”

Section: Introductionmentioning

confidence: 99%

Non-Invasive Rhythmic Musical-Electric Trigeminal Nerve Stimulation Improves Consciousness in Patients with Disorders of Consciousness

Wu¹,

Yu²,

X³

et al. 2021

Preprint

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Disorders of consciousness (DOC) are often accompanied by aberrant oscillatory neural activity in the thalamus and cerebral cortex. Patient-friendly non-invasive treatments targeting this functional anomaly are still missing. We propose and validate a novel approach that aims to restore DOC patients’ thalamocortical oscillations by combining rhythmic trigeminal-nerve stimulation (TNS) with comodulated musical stimulation. In a cluster-randomized, placebo-controlled, double-blinded, pretest-posttest clinical study, we show that application of this multisensory approach for 40 min on five consecutive days reliably leads to long-lasting improvements in DOC patients’ consciousness (assessed with Coma Recovery Scale-Revised) and oscillatory brain activity at the musical-electric TNS frequency (assessed with electroencephalography and a novel rhythmic auditory-speech paradigm). We found diagnostic improvement in 47% of patients in minimally conscious state and a positive relationship between patients’ behavioral and neural improvements. Based on this evidence we argue that non-invasive musical-electric TNS may serve as an effective patient-friendly DOC treatment and suggest frequency-specific oscillatory neural enhancement as its mode of action.

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“…Similar effects of TNS have been shown in human patients diagnosed with disorders of consciousness (DOC). In a single-case study, Fan et al reported an improvement of consciousness after TNS in a DOC patient 7 . Similarly, Dong et al reported consciousness benefits after four weeks of TNS in eight out of 21 DOC patients 18 .…”

Section: Introductionmentioning

confidence: 96%

“…These therapies include pharmacological treatments (e.g., zolpidem, apomorphine) 3,4 and nonpharmacologic interventions, such as sensory or electric stimulation 5,6 . A recent approach, inspired by the increasing knowledge of the neural mechanisms underlying consciousness, involves non-invasive electric stimulation of the trigeminal nerve 7,8 . This cranial nerve projects facial sensation to the brainstem and the cortex, and connects to the reticular activating system, thalamus, insula, and somatosensory brain structures 9 -regions which have been proposed to play a role in consciousness [10][11][12] .…”

Section: Introductionmentioning

confidence: 99%

Multimodal acoustic-electric trigeminal nerve stimulation modulates conscious perception

Auksztulewicz

Riecke

2023

Preprint

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Multimodal stimulation can reverse pathological neural activity and improve symptoms in neuropsychiatric diseases. For example, recent research shows that multimodal acoustic-electric trigeminal-nerve stimulation (TNS) (i.e., musical stimulation synchronized to transcutaneous electrical stimulation of the trigeminal nerve) can improve consciousness in patients with disorders of consciousness. However, the reliability and mechanism of this novel approach remain largely unknown. In the present study, we explored the effects of multimodal acoustic-electric TNS in healthy human participants using a double-blinded, randomized, crossover design. We assessed conscious perception before and after stimulation using behavioral and neural measures in tactile and auditory target-detection tasks. To explore the mechanisms underlying the putative effects of acoustic-electric stimulation, we fitted a biologically plausible neural network model to the neural data using dynamic causal modeling. We observed that (1) acoustic-electric stimulation can improve conscious tactile perception in healthy human participants without a concomitant change in auditory perception, (2) this improvement is caused by the interplay of the acoustic and electric stimulation rather than any of the unimodal stimulation alone, and (3) the effect of acoustic-electric stimulation on conscious perception correlates with inter-regional connection changes in a recurrent neural processing model. These results provide evidence that acoustic-electric trigeminal-nerve stimulation can promote conscious perception, and therewith corroborate the usefulness of multimodal stimulation. Alterations in inter-regional cortical connections might be the mechanism by which acoustic-electric TNS achieves its consciousness benefits.

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Trigeminal nerve stimulation successfully awakened an unconscious patient

Cited by 9 publications

References 9 publications

The Effectiveness of Trigeminal Nerve Stimulation on Traumatic Brain Injury

The Effectiveness of Trigeminal Nerve Stimulation on Traumatic Brain Injury

Non-Invasive Rhythmic Musical-Electric Trigeminal Nerve Stimulation Improves Consciousness in Patients with Disorders of Consciousness

Multimodal acoustic-electric trigeminal nerve stimulation modulates conscious perception

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