Behavioural and electrophysiological effects of tDCS to prefrontal cortex in patients with disorders of consciousness

Publication date: Available online 29 November 2018

Source: Clinical Neurophysiology

Author(s): Marianna Cavinato, Clara Genna, Emanuela Formaggio, Caterina Gregorio, Silvia F. Storti, Paolo Manganotti, Emanuela Casanova, Roberto Piperno, Francesco Piccione

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.

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