title: Effects of High-Frequency Repetitive Transcranial Magnetic Stimulation on Cerebral Hemodynamics in Patients with Disorders of Consciousness: A Sham-Controlled Study.
abstract: This study aimed to determine the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) on cerebral hemodynamics in patients with disorders of consciousness (DOC).
  
  
  
  In this sham-controlled study, 20-Hz and sham rTMS were applied over the left primary motor cortex (M1) of 5 patients in a vegetative state (VS) and 5 patients in a minimally conscious state (MCS). The clinical behavior and cerebral blood flow (CBF) velocity in the bilateral middle cerebral artery (MCA) of the patients were evaluated before and after rTMS.
  
  
  
  Compared with the VS group, the MCS group exhibited significant increases in peak systolic velocity (PSV; p = 0.024) and mean flow velocity (MFV) of the left MCA that were temporally related to the rTMS (p = 0.042). There were no significant effects on CBF velocity in the sham-stimulation group or the right MCA.
  
  
  
  High-frequency rTMS exerts different effects on CBF depending on the level of consciousness in patients with DOC such that it increased PSV and MFV in patients in a MCS. These effects may be related to the varying degrees of disrupted neurovascular coupling and the autonomic control of the cerebral hemodynamics in patients in a VS or MCS.
authors.affiliation: Department of Neurology and Brain Medical Centre, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Liu
authors.forename: Jian
authors.initials: J
authors.lastname: Gao
authors.forename: Siwei
authors.initials: S
authors.lastname: Pan
authors.forename: Fanxia
authors.initials: F
authors.lastname: Meng
authors.forename: Gang
authors.initials: G
authors.lastname: Pan
authors.forename: Jingqi
authors.initials: J
authors.lastname: Li
authors.forename: Benyan
authors.initials: B
authors.lastname: Luo
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018458:Persistent Vegetative State / Q000503:physiopathology / Q000628:therapy*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome