Electroencephalography and Functional Magnetic Resonance Imaging-Guided Simultaneous Transcranial Direct Current Stimulation and Repetitive Transcranial Magnetic Stimulation in a Patient With Minimally Conscious State
机构：[1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China,内科系统神经内科神经科系统神经内科江苏省人民医院[2]School of Biomedical Engineering, Tianjin Medical University, Tianjin, China,[3]State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China,[4]The Beijing Key Laboratory of Neuromodulation, Beijing, China,[5]Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
Objective: A minimally conscious state (MCS) is characterized by discernible behavioral evidence of consciousness that cannot be reproduced consistently. This condition is highly challenging to treat. Recent studies have demonstrated the potential therapeutic effect of non-invasive brain stimulation in patients with MCS. In one patient in an MCS, we delivered simultaneous transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) based on an individual brain network analysis and evaluated the therapeutic effect. Methods: The directional transfer function (DTF) was calculated based on electroencephalograph (EEG) analysis. Global brain connectivity was calculated based on functional magnetic resonance imaging (fMRI) analysis. By referring to the EEG and fMRI results, we identified inferior parietal lobes (IPLs) as targets. In the 2-week treatment period, 14 sessions were applied to the identified bilateral parietal regions. Simultaneous 1.5-mA anodal tDCS and 5-Hz rTMS were delivered for 20 min per hemisphere in each session. Clinical evaluation scores were recorded weekly throughout the treatment. A second patient given the routine treatment was evaluated as a control. Results: The clinical scores of patient 1 with MCS improved after 2 weeks of stimulation treatment, and the effect lasted for up to 1 month. EEG analysis showed a significant increase (p < 0.001) in the DTF value in the gamma band in a bilateral set of posterior regions, and fMRI showed a trend toward normalized activity in the IPLs. The clinical scores of patient 2 with coma did not improve much after 2 weeks of routine treatment. The EEG analysis showed a significant increase (p = 0.021) in the DTF value in the gamma band in a bilateral set of posterior regions. Conclusion: The application of EEG and fMRI to characterize the functional connectivity features of the network in an MCS patient provided a reasonable and accurate stimulation target and verified the changes in functional connectivity resulting from stimulation.
第一作者机构：[1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China,
共同第一作者：
通讯作者：
通讯机构：[1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China,[4]The Beijing Key Laboratory of Neuromodulation, Beijing, China,[5]Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
推荐引用方式(GB/T 7714)：
Lin Yicong,Liu Tiaotiao,Huang Qian,et al.Electroencephalography and Functional Magnetic Resonance Imaging-Guided Simultaneous Transcranial Direct Current Stimulation and Repetitive Transcranial Magnetic Stimulation in a Patient With Minimally Conscious State[J].FRONTIERS IN NEUROSCIENCE.2019,13(JUL):doi:10.3389/fnins.2019.00746.
APA：
Lin, Yicong,Liu, Tiaotiao,Huang, Qian,Su, Yingying,Chen, Weibi...&Wang, Yuping.(2019).Electroencephalography and Functional Magnetic Resonance Imaging-Guided Simultaneous Transcranial Direct Current Stimulation and Repetitive Transcranial Magnetic Stimulation in a Patient With Minimally Conscious State.FRONTIERS IN NEUROSCIENCE,13,(JUL)
MLA：
Lin, Yicong,et al."Electroencephalography and Functional Magnetic Resonance Imaging-Guided Simultaneous Transcranial Direct Current Stimulation and Repetitive Transcranial Magnetic Stimulation in a Patient With Minimally Conscious State".FRONTIERS IN NEUROSCIENCE 13..JUL(2019)
