Effects of simultaneous transcutaneous auricular vagus nerve stimulation and high-definition transcranial direct current stimulation on disorders of consciousness: a study protocol
BackgroundNon-invasive brain stimulation (NIBS) techniques are now widely used in patients with disorders of consciousness (DOC) for accelerating their recovery of consciousness, especially minimally conscious state (MCS). However, the effectiveness of single NIBS techniques for consciousness rehabi...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1165145/full |
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| author | Yutong Zhuang Yutong Zhuang Weihang Zhai Qinghua Li Haoyang Jiao Qianqian Ge Peijing Rong Jianghong He |
| author_facet | Yutong Zhuang Yutong Zhuang Weihang Zhai Qinghua Li Haoyang Jiao Qianqian Ge Peijing Rong Jianghong He |
| author_sort | Yutong Zhuang |
| collection | DOAJ |
| description | BackgroundNon-invasive brain stimulation (NIBS) techniques are now widely used in patients with disorders of consciousness (DOC) for accelerating their recovery of consciousness, especially minimally conscious state (MCS). However, the effectiveness of single NIBS techniques for consciousness rehabilitation needs further improvement. In this regard, we propose to enhance from bottom to top the thalamic–cortical connection by using transcutaneous auricular vagus nerve stimulation (taVNS) and increase from top to bottom cortical-cortical connections using simultaneous high-definition transcranial direct current stimulation (HD-tDCS) to reproduce the network of consciousness.Methods/designThe study will investigate the effect and safety of simultaneous joint stimulation (SJS) of taVNS and HD-tDCS for the recovery of consciousness. We will enroll 84 MCS patients and randomize them into two groups: a single stimulation group (taVNS and HD-tDCS) and a combined stimulation group (SJS and sham stimulation). All patients will undergo a 4-week treatment. The primary outcome will be assessed using the coma recovery scale-revised (CRS-R) at four time points to quantify the effect of treatment: before treatment (T0), after 1 week of treatment (T1), after 2 weeks of treatment (T2), and after 4 weeks of treatment (T3). At the same time, nociception coma scale-revised (NCS-R) and adverse effects (AEs) will be collected to verify the safety of the treatment. The secondary outcome will involve an analysis of electroencephalogram (EEG) microstates to assess the response mechanisms of dynamic brain networks to SJS. Additionally, CRS-R and AEs will continue to be obtained for a 3-month follow-up (T4) after the end of the treatment.DiscussionThis study protocol aims to innovatively develop a full-time and multi-brain region combined neuromodulation paradigm based on the mesocircuit model to steadily promote consciousness recovery by restoring thalamocortical and cortical-cortical interconnections. |
| first_indexed | 2024-03-12T13:30:36Z |
| format | Article |
| id | doaj.art-8d8ca051198347ea91c82e2dfcfb6c95 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-12T13:30:36Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-8d8ca051198347ea91c82e2dfcfb6c952023-08-24T14:07:10ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-08-011410.3389/fneur.2023.11651451165145Effects of simultaneous transcutaneous auricular vagus nerve stimulation and high-definition transcranial direct current stimulation on disorders of consciousness: a study protocolYutong Zhuang0Yutong Zhuang1Weihang Zhai2Qinghua Li3Haoyang Jiao4Qianqian Ge5Peijing Rong6Jianghong He7Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, The Second Clinical College of Southern Medical University, Guangzhou, ChinaInstitute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, ChinaCollege of Anesthesiology, Shanxi Medical University, Taiyuan, ChinaInstitute of Documentation, Chinese Academy of Traditional Chinese Medicine, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaInstitute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaBackgroundNon-invasive brain stimulation (NIBS) techniques are now widely used in patients with disorders of consciousness (DOC) for accelerating their recovery of consciousness, especially minimally conscious state (MCS). However, the effectiveness of single NIBS techniques for consciousness rehabilitation needs further improvement. In this regard, we propose to enhance from bottom to top the thalamic–cortical connection by using transcutaneous auricular vagus nerve stimulation (taVNS) and increase from top to bottom cortical-cortical connections using simultaneous high-definition transcranial direct current stimulation (HD-tDCS) to reproduce the network of consciousness.Methods/designThe study will investigate the effect and safety of simultaneous joint stimulation (SJS) of taVNS and HD-tDCS for the recovery of consciousness. We will enroll 84 MCS patients and randomize them into two groups: a single stimulation group (taVNS and HD-tDCS) and a combined stimulation group (SJS and sham stimulation). All patients will undergo a 4-week treatment. The primary outcome will be assessed using the coma recovery scale-revised (CRS-R) at four time points to quantify the effect of treatment: before treatment (T0), after 1 week of treatment (T1), after 2 weeks of treatment (T2), and after 4 weeks of treatment (T3). At the same time, nociception coma scale-revised (NCS-R) and adverse effects (AEs) will be collected to verify the safety of the treatment. The secondary outcome will involve an analysis of electroencephalogram (EEG) microstates to assess the response mechanisms of dynamic brain networks to SJS. Additionally, CRS-R and AEs will continue to be obtained for a 3-month follow-up (T4) after the end of the treatment.DiscussionThis study protocol aims to innovatively develop a full-time and multi-brain region combined neuromodulation paradigm based on the mesocircuit model to steadily promote consciousness recovery by restoring thalamocortical and cortical-cortical interconnections.https://www.frontiersin.org/articles/10.3389/fneur.2023.1165145/fulldisorders of consciousnesshigh-definition transcranial direct current stimulationtranscutaneous auricular vagus nerve stimulationsimultaneous stimulationEEG microstate |
| spellingShingle | Yutong Zhuang Yutong Zhuang Weihang Zhai Qinghua Li Haoyang Jiao Qianqian Ge Peijing Rong Jianghong He Effects of simultaneous transcutaneous auricular vagus nerve stimulation and high-definition transcranial direct current stimulation on disorders of consciousness: a study protocol Frontiers in Neurology disorders of consciousness high-definition transcranial direct current stimulation transcutaneous auricular vagus nerve stimulation simultaneous stimulation EEG microstate |
| title | Effects of simultaneous transcutaneous auricular vagus nerve stimulation and high-definition transcranial direct current stimulation on disorders of consciousness: a study protocol |
| title_full | Effects of simultaneous transcutaneous auricular vagus nerve stimulation and high-definition transcranial direct current stimulation on disorders of consciousness: a study protocol |
| title_fullStr | Effects of simultaneous transcutaneous auricular vagus nerve stimulation and high-definition transcranial direct current stimulation on disorders of consciousness: a study protocol |
| title_full_unstemmed | Effects of simultaneous transcutaneous auricular vagus nerve stimulation and high-definition transcranial direct current stimulation on disorders of consciousness: a study protocol |
| title_short | Effects of simultaneous transcutaneous auricular vagus nerve stimulation and high-definition transcranial direct current stimulation on disorders of consciousness: a study protocol |
| title_sort | effects of simultaneous transcutaneous auricular vagus nerve stimulation and high definition transcranial direct current stimulation on disorders of consciousness a study protocol |
| topic | disorders of consciousness high-definition transcranial direct current stimulation transcutaneous auricular vagus nerve stimulation simultaneous stimulation EEG microstate |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1165145/full |
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