Noninvasive brain stimulation for patients with a disorder of consciousness: a systematic review and meta-analysis

Author:

Feng Yali1,Zhang Jiaqi2,Zhou Yi1,Bai Zhongfei23,Yin Ying1

Affiliation:

1. Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Linjiang Road 74, Chongqing400010, China

2. Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China

3. Department of Occupational Therapy, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Shanghai, China

Abstract

AbstractNoninvasive brain stimulation (NIBS) techniques have been used to facilitate the recovery from prolonged unconsciousness as a result of brain injury. The aim of this study is to systematically assess the effects of NIBS in patients with a disorder of consciousness (DOC). We searched four databases for any randomized controlled trials on the effect of NIBS in patients with a DOC, which used the JFK Coma Recovery Scale-Revised (CRS-R) as the primary outcome measure. A random-effects meta-analysis was conducted to pool effect sizes. Fourteen studies with 273 participants were included in this review, of which 12 studies with sufficient data were included in the meta-analysis. Our meta-analysis showed a significant effect on increasing CRS-R scores in favor of real stimulation as compared to sham (Hedges’ g = 0.522; 95% confidence interval [CI], 0.318–0.726; P < 0.0001, I2 = 0.00%). Subgroup analysis demonstrated that only anodal transcranial direct current stimulation (tDCS) of the left dorsolateral prefrontal cortex (DLPFC) significantly enhances the CRS-R scores in patients with a DOC, as compared to sham (Hedges’ g = 0.703; 95% CI, 0.419–0.986; P < 0.001), and this effect was predominant in patients in a minimally conscious state (MCS) (Hedges’ g = 0.815; 95% CI, 0.429–1.200; P < 0.001). Anodal tDCS of the left DLPFC appears to be an effective approach for patients with MCS.

Funder

Kuanren Talents Program of the second affiliated hospital of Chongqing Medical University

Publisher

Walter de Gruyter GmbH

Subject

General Neuroscience

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