Transcranial Direct Current Stimulation in Patients With Disorders of Consciousness: a Sham-controlled Randomised Double Blind Study
Trial Snapshot
- Phase
- Phase 2
- Status
- Completed
- Sponsor
- University of Liege
- Enrollment
- 55
- Locations
- 2
- Primary Endpoint
- Change in CRS-R Total Scores
Study Overview
Brief Summary
Previous studies showed that anodal transcranial direct current stimulation (tDCS) applied to the left dorsolateral prefrontal (DLPF) cortex transiently improves performance of memory and attention. Investigator assessed the effects of left DLPF-tDCS on Coma Recovery Scale-Revised (CRS-R) scores in severely brain damaged patients with disorders of consciousness in a double-blind sham-controlled experimental design.
Detailed Description
Following severe brain damage and coma, some patients may remain in a vegetative state (VS) or minimally conscious state (MCS). At present, there are no evidence-based guidelines regarding the treatment of patients with disorders of consciousness (DOC).
Investigator aim to assess the effect of single session anodal (i.e., excitatory) transcranial direct current stimulation (tDCS) of the left dorsolateral prefrontal cortex (DLPF) on the level of consciousness in DOC patients in a double blind randomized sham controlled study.
tDCS is a form of safe non-invasive cortical stimulation, modulating cortical excitability at stimulation sites via weak polarizing currents, previously reported to transiently improve working memory and attention by stimulating the left DLPF in healthy subjects and patients with stroke, Parkinson's or Alzheimer's disease.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Crossover
- Primary Purpose
- Treatment
- Masking
- Triple (Participant, Care Provider, Investigator)
Eligibility Criteria
- Ages
- 15 Years to 75 Years (Child, Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •post-comatose patients
- •patients in vegetative/unresponsive or minimally conscious state
- •patients with stable cardiorespiratory parameters
- •patients free of sedative drugs and Na+ or Ca++ channel blockers (e.g., carbamazepine) or NMDA receptor antagonists (e.g., dextromethorphan)
Exclusion Criteria
- •premorbit neurology antecedent
- •patients in coma or <1week after the acute brain insult
- •patients with a metallic cerebral implant or a pacemaker (in line with the safety criteria for tDCS in humans)
Outcomes
Primary Outcomes
Change in CRS-R Total Scores
Time Frame: Baseline and directly after the tDCS (20 minutes)
At the group level, assess the modification of CRS-R total scores in anodal tDCS as compared to sham stimulation in VS/UWS and MCS populations The Coma Recovery Scale Revised (CRS-R) is a behavioral scale performed at the patient's bedside. It consists of 23 hierarchically arranged items that comprise 6 subscales addressing auditory, visual, motor, verbal, communication, and arousal functions. Scoring is based on the presence or absence of specific behavioral responses to sensory stimuli administered in a standardized manner. Maximum scores of each subscale are summed to obtain the total score (from 0 to 23). The lowest item on each subscale represents reflexive activity, whereas the highest items represent cognitively mediated behaviors.
Secondary Outcomes
- Influence of Diagnosis on the Results(participants will be followed for the duration of 1 year)
- Influence of Etiology on the Results(participants will be followed for the duration of 1 year)
- Influence of Time Since Insult on the Results(participants will be followed for the duration of 1 year)
Investigators
Aurore Thibaut
Principal Investigator
University of Liege