Repetitive transcranial magnetic stimulation over the posterior parietal cortex improves functional recovery in nonresponsive patients: A crossover, randomized, double-blind, sham-controlled study
BackgroundRecent studies have shown that patients with disorders of consciousness (DoC) can benefit from repetitive transcranial magnetic stimulation (rTMS) therapy. The posterior parietal cortex (PPC) is becoming increasingly important in neuroscience research and clinical treatment for DoC as it p...
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1059789/full |
| _version_ | 1797905133426704384 |
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| author | Chengwei Xu Wanchun Wu Xiaochun Zheng Qimei Liang Xiyan Huang Haili Zhong Qiuyi Xiao Yue Lan Yang Bai Yang Bai Qiuyou Xie |
| author_facet | Chengwei Xu Wanchun Wu Xiaochun Zheng Qimei Liang Xiyan Huang Haili Zhong Qiuyi Xiao Yue Lan Yang Bai Yang Bai Qiuyou Xie |
| author_sort | Chengwei Xu |
| collection | DOAJ |
| description | BackgroundRecent studies have shown that patients with disorders of consciousness (DoC) can benefit from repetitive transcranial magnetic stimulation (rTMS) therapy. The posterior parietal cortex (PPC) is becoming increasingly important in neuroscience research and clinical treatment for DoC as it plays a crucial role in the formation of human consciousness. However, the effect of rTMS on the PPC in improving consciousness recovery remains to be studied.MethodWe conducted a crossover, randomized, double-blind, sham-controlled clinical study to assess the efficacy and safety of 10 Hz rTMS over the left PPC in unresponsive patients. Twenty patients with unresponsive wakefulness syndrome were recruited. The participants were randomly divided into two groups: one group received active rTMS treatment for 10 consecutive days (n = 10) and the other group received sham treatment for the same period (n = 10). After a 10-day washout period, the groups crossed over and received the opposite treatment. The rTMS protocol involved the delivery of 2000 pulses/day at a frequency of 10 Hz, targeting the left PPC (P3 electrode sites) at 90% of the resting motor threshold. The primary outcome measure was the JFK Coma Recovery Scele-Revised (CRS-R), and evaluations were conducted blindly. EEG power spectrum assessments were also conducted simultaneously before and after each stage of the intervention.ResultrTMS-active treatment resulted in a significant improvement in the CRS-R total score (F = 8.443, p = 0.009) and the relative alpha power (F = 11.166, p = 0.004) compared to sham treatment. Furthermore, 8 out of 20 patients classified as rTMS responders showed improvement and evolved to a minimally conscious state (MCS) as a result of active rTMS. The relative alpha power also significantly improved in responders (F = 26.372, p = 0.002) but not in non-responders (F = 0.704, p = 0.421). No adverse effects related to rTMS were reported in the study.ConclusionsThis study suggests that 10 Hz rTMS over the left PPC can significantly improve functional recovery in unresponsive patients with DoC, with no reported side effects.Clinical trial registrationwww.ClinicalTrials.gov, identifier: NCT05187000. |
| first_indexed | 2024-04-10T10:00:11Z |
| format | Article |
| id | doaj.art-8a0f9d8fdbb242fa9f1422f7accec055 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-10T10:00:11Z |
| publishDate | 2023-02-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-8a0f9d8fdbb242fa9f1422f7accec0552023-02-16T09:56:17ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-02-011410.3389/fneur.2023.10597891059789Repetitive transcranial magnetic stimulation over the posterior parietal cortex improves functional recovery in nonresponsive patients: A crossover, randomized, double-blind, sham-controlled studyChengwei Xu0Wanchun Wu1Xiaochun Zheng2Qimei Liang3Xiyan Huang4Haili Zhong5Qiuyi Xiao6Yue Lan7Yang Bai8Yang Bai9Qiuyou Xie10Department of Rehabilitation Medicine, Joint Research Centre for Disorders of Consciousness, Zhujiang Hospital of Southern Medical University, Guangzhou, ChinaDepartment of Rehabilitation Medicine, Joint Research Centre for Disorders of Consciousness, Zhujiang Hospital of Southern Medical University, Guangzhou, ChinaDepartment of Rehabilitation Medicine, Joint Research Centre for Disorders of Consciousness, Zhujiang Hospital of Southern Medical University, Guangzhou, ChinaDepartment of Rehabilitation Medicine, Joint Research Centre for Disorders of Consciousness, Zhujiang Hospital of Southern Medical University, Guangzhou, ChinaDepartment of Rehabilitation Medicine, Joint Research Centre for Disorders of Consciousness, Zhujiang Hospital of Southern Medical University, Guangzhou, ChinaDepartment of Rehabilitation Medicine, Joint Research Centre for Disorders of Consciousness, Zhujiang Hospital of Southern Medical University, Guangzhou, ChinaDepartment of Rehabilitation Medicine, Joint Research Centre for Disorders of Consciousness, Zhujiang Hospital of Southern Medical University, Guangzhou, ChinaDepartment of Rehabilitation Medicine, Joint Research Centre for Disorders of Consciousness, Zhujiang Hospital of Southern Medical University, Guangzhou, ChinaDepartment of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaSchool of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, ChinaDepartment of Rehabilitation Medicine, Joint Research Centre for Disorders of Consciousness, Zhujiang Hospital of Southern Medical University, Guangzhou, ChinaBackgroundRecent studies have shown that patients with disorders of consciousness (DoC) can benefit from repetitive transcranial magnetic stimulation (rTMS) therapy. The posterior parietal cortex (PPC) is becoming increasingly important in neuroscience research and clinical treatment for DoC as it plays a crucial role in the formation of human consciousness. However, the effect of rTMS on the PPC in improving consciousness recovery remains to be studied.MethodWe conducted a crossover, randomized, double-blind, sham-controlled clinical study to assess the efficacy and safety of 10 Hz rTMS over the left PPC in unresponsive patients. Twenty patients with unresponsive wakefulness syndrome were recruited. The participants were randomly divided into two groups: one group received active rTMS treatment for 10 consecutive days (n = 10) and the other group received sham treatment for the same period (n = 10). After a 10-day washout period, the groups crossed over and received the opposite treatment. The rTMS protocol involved the delivery of 2000 pulses/day at a frequency of 10 Hz, targeting the left PPC (P3 electrode sites) at 90% of the resting motor threshold. The primary outcome measure was the JFK Coma Recovery Scele-Revised (CRS-R), and evaluations were conducted blindly. EEG power spectrum assessments were also conducted simultaneously before and after each stage of the intervention.ResultrTMS-active treatment resulted in a significant improvement in the CRS-R total score (F = 8.443, p = 0.009) and the relative alpha power (F = 11.166, p = 0.004) compared to sham treatment. Furthermore, 8 out of 20 patients classified as rTMS responders showed improvement and evolved to a minimally conscious state (MCS) as a result of active rTMS. The relative alpha power also significantly improved in responders (F = 26.372, p = 0.002) but not in non-responders (F = 0.704, p = 0.421). No adverse effects related to rTMS were reported in the study.ConclusionsThis study suggests that 10 Hz rTMS over the left PPC can significantly improve functional recovery in unresponsive patients with DoC, with no reported side effects.Clinical trial registrationwww.ClinicalTrials.gov, identifier: NCT05187000.https://www.frontiersin.org/articles/10.3389/fneur.2023.1059789/fullrepetitive transcranial magnetic stimulationdisorders of consciousnessunresponsive wakefulness syndrome/vegetative staterandomized control trialEEG |
| spellingShingle | Chengwei Xu Wanchun Wu Xiaochun Zheng Qimei Liang Xiyan Huang Haili Zhong Qiuyi Xiao Yue Lan Yang Bai Yang Bai Qiuyou Xie Repetitive transcranial magnetic stimulation over the posterior parietal cortex improves functional recovery in nonresponsive patients: A crossover, randomized, double-blind, sham-controlled study Frontiers in Neurology repetitive transcranial magnetic stimulation disorders of consciousness unresponsive wakefulness syndrome/vegetative state randomized control trial EEG |
| title | Repetitive transcranial magnetic stimulation over the posterior parietal cortex improves functional recovery in nonresponsive patients: A crossover, randomized, double-blind, sham-controlled study |
| title_full | Repetitive transcranial magnetic stimulation over the posterior parietal cortex improves functional recovery in nonresponsive patients: A crossover, randomized, double-blind, sham-controlled study |
| title_fullStr | Repetitive transcranial magnetic stimulation over the posterior parietal cortex improves functional recovery in nonresponsive patients: A crossover, randomized, double-blind, sham-controlled study |
| title_full_unstemmed | Repetitive transcranial magnetic stimulation over the posterior parietal cortex improves functional recovery in nonresponsive patients: A crossover, randomized, double-blind, sham-controlled study |
| title_short | Repetitive transcranial magnetic stimulation over the posterior parietal cortex improves functional recovery in nonresponsive patients: A crossover, randomized, double-blind, sham-controlled study |
| title_sort | repetitive transcranial magnetic stimulation over the posterior parietal cortex improves functional recovery in nonresponsive patients a crossover randomized double blind sham controlled study |
| topic | repetitive transcranial magnetic stimulation disorders of consciousness unresponsive wakefulness syndrome/vegetative state randomized control trial EEG |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1059789/full |
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